关键词: 甲状腺乳头状癌, 甲状旁腺功能减退, 手术, 预测因素

Abstract: Objective To explore the predictive factors and protective strategies of hypoparathyroidism after operation for papillary thyroid carcinoma(PTC）.
Methods The clinical data of 588 cases of patients with PTC who underwent the first surgery in the same diagnosis and treatment group of general surgery of the Affiliated Hospital of Nanjing University of Chinese Medicine from July 2016 to October 2019 were analyzed retrospectively.The clinicopathological features of hypoparathyroidism were analyzed.The predictive factors of hypoparathyroidism after operation for PTC by logistic regression.
Results The total incidence of hypoparathyroidism was 40.8%,and the incidence of permanent parathyroid injury was 0.9%.The proportion of nodular goiter,multifocal cancer,thyroid capsule invasion,total thyroidectomy and bilateral CLN dissection in low parathyroid hormone(PTH）group was higher than that in normal PTH group(P＜0.05).Multivariate logistic regression analysis showed that the risk of hypoparathyroidism after operation in PTC patients with nodular goiter,multifocal cancer and thyroid capsule invasion was significantly increased (OR: 2.196,3.071,1.554;P<0.001,<0.001,0.030).In terms of operation method,the risk of hypoparathyroidism in PTC patients after total thyroidectomy was significantly increased (OR: 3.630,P:<0.001).
Conclusion Combined with nodular goiter,multifocal carcinoma and thyroid capsule invasion are independent predictors of postoperative hypoparathyroidism in PTC patients.For the patients who had the above factors in preoperative examination,the current methods should be used to protect parathyroid gland,so as to reduce the incidence of hypoparathyroidism.

Key words: papillary thyroid carcinoma, hypoparathyroidism, operation, predictive factors