关键词: 甲状旁腺移植,  , 腔镜手术,  , 甲状旁腺激素,  , 甲状腺结节,  , 血清钙离子,  , 甲状旁腺解剖

Abstract:

Objective To evaluate the effect of endoscopic thyroidectomy combined with parathyroid trans⁃ plantation on recovery of parathyroid function. Methods 72 patients with thyroid nodule who had received surgi⁃ cal treatment from January 2018 to December 2020 in our hospital were selected. The baseline and postoperative serum parathyroid hormone（PTH）in the transplanted and non⁃transplanted sides and serum Ca2+ level in systemic circulation were detected. The postoperative serum PTH concentration in the transplanted and non ⁃ transplanted sides at different time points and the preoperative and postoperative serum Ca2 + concentrations were compared by paired sample t⁃test to judge the survival status and functional recovery of the transplanted parathyroid glands. Results At each postoperative monitoring time point，serum PTH level showed an upward trend，whereasit was higher at different degrees in the transplanted side than in the non⁃transplanted side. There was no significant differ⁃ ence in serum PTH level between the transplanted and non⁃transplanted side on postoperative day 1（P > 0.05）. With the prolonged recovery duration，there was a statistically significant difference in serum PTH between the transplanted and the non⁃transplanted side in postoperative week 1，months 1 to 3，and month 6（P < 0.05）. Serum Ca2 + in the systemic circulation decreased on postoperative day 1 and in week 1 and months 1 to 2. As time went by，Ca2+ gradually increased and basically recovered to the preoperative level by month 3. As compared with preop⁃ erative serum Ca2+ on postoperative day 1 and in week 1 and months 1 to 2，the difference was statistically signifi⁃ cant（P > 0.05）. However，there were no statistically significant differences in serum Ca2 + in systemic circulation between the baseline and postoperative level in months 3 and 6（P > 0.05）. Conclusions Endoscopic thyroidectomy combined with parathyroid transplantation evidently lowered the rate of hypoparathyroidism，effectively improved PTH，and increased Ca2+ level following surgical treatment.

Key words:

transplantation of parathyroid gland, endoscopic surgery, parathyroid hormone, thyroid nodule, serum calcium, anatomy of parathyroid gland