Analysis of the causes of hypoparathyroidism after total thyroidectomy and treatment of calcium supplement

ObjectiveTo analyze the causes of hypoparathyroidism after total thyroidectomy and effects of calcium supplement.

MethodsThe clinical data of 80 cases treated with total thyroidectomy were retrospectively analyzed.According to the treatment with or without calcium supplement, the patients were divided into the treatment group and observation group (40 cases in each group).The levels of parathyriod hormone(PTH) and Ca²⁺ between two groups were compared before and after 1 month and 1 week of operation.The PTH recovery time, Ca²⁺ recovery time, disappearance time of hypocalcemia, incidence rate of hypocalcemia and incidence rate of permanent hypocalcemia were compared between two groups.The patients with and without hypoparathyroidism in observation group were evaluated using single factor analysis.The factors with significant difference were included in the logistic regression analysis model to identify the risk factors of hypoparathyroidism.

ResultsThe levels of PTH and Ca²⁺ in two groups after 1 month and 1 week of operation, and before operation gradually decreased, and the difference of which was statistically significant(P < 0.01).The levels of PTH and Ca²⁺ in treatment group after 1 month and 1 week of operation and before operation were significantly higher than those in observation group(P < 0.05 to P < 0.01).The PTH recovery time, Ca²⁺ recovery time, hypocalcemia disappearance time and hypocalcemia incidence in treatment group were significantly lower than those in observation group(P < 0.05 to P < 0.01).The proportions of hypoparathyroidism patients with malignant pathological type, from outside to inside surgical approach, tumor ≥4 cm, tumor locating the back membrane, lymph node cleaning, parathyroid gland miss cutting and using nano carbon tracer were significantly higher than those of the patients without hypoparathyroidism(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the malignant pathological type, from outside to inside surgical approach, tumor ≥4 cm, tumor locating the back membrane, lymph node cleaning, parathyroid gland miss cutting and using nano carbon tracer were the risk factors of hypoparathyroidism after total thyroidectomy(P < 0.05 to P < 0.01).

ConclusionsThe hypoparathyroidism is affected by many factors, so the preventive calcium supplement should be performed.