The impact of different surgical procedures on hypoparathyroidism after thyroidectomy: A population-based study.
The impact of different surgical procedures on hypoparathyroidism after thyroidectomy: A population-based study.
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DOI：
10.1097/md.0000000000008245
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发表时间：
2017-10
期刊：
影响因子：
1.6
通讯作者：
Jian WS
中科院分区：
文献类型：
--
作者：
Chen KC;Iqbal U;Nguyen PA;Hsu CH;Huang CL;Hsu YE;Atique S;Islam MM;Li YJ;Jian WS
这项研究的主要目的是调查甲状腺疾病患者手术治疗与甲状旁腺功能减退的风险之间的结果。我们分析了1998年至2011年台湾国民健康保险局(BNHI)研究资料库的资料，发现有9,316名接受甲状腺手术的病人。采用Cox回归模型计算危险比(HR)。甲状旁腺功能减退症314例(3.4%)。甲状旁腺功能减退症9年累计发生率以双侧甲状腺全切除组最高(13.5%)，单侧甲状腺次全切除组最低(1.2%)。单侧大部切除的风险最高(HR：11.86)，其次是甲状腺根治术加单侧颈淋巴清扫(HR：8.56)，单侧大部切除(HR，4.39)，一侧和一侧大部切除(HR：2.80)。甲状腺切除的程度决定了发生甲状旁腺功能减退症的风险。建议在今后的研究中探讨这些因素之间的联系。
Supplemental Digital Content is available in the text The main objective of this study is to investigate the outcome between surgical procedures and the risk of development of hypoparathyroidism followed by surgical procedure in patients with thyroid disorders. We analyzed the data acquired from Taiwan's Bureau of National Health Insurance (BNHI) research database from 1998 to 2011 and found 9316 patients with thyroid surgery. Cox regression model was used to calculate the hazard ratio (HR). A count of 314 cases (3.4%) of hypoparathyroidism was identified. The 9 years cumulated incidence of hypoparathyroidism was the highest in patient undergone bilateral total thyroidectomy (13.5%) and the lowest in the patient with unilateral subtotal thyroidectomy (1.2%). However, in the patients who had undergone unilateral subtotal, the risk was the highest in bilateral total (HR: 11.86), followed by radical thyroidectomy with unilateral neck lymph node dissection (HR: 8.56), unilateral total (HR, 4.39), and one side total and another side subtotal (HR: 2.80). The extent of thyroid resection determined the risk of development of hypoparathyroidism. It is suggested that the association of these factors is investigated in future studies.