Post-thyroidectomy hypocalcemia is more frequent complication than others after thyroid operation so there has been studied about prevalence, causes, factors, treatments and preventions of postoperative hypocalcemia, and will be discussed.
The incidence and risk factors for postoperative hypocalcemia were analysed according to diseases, preoperative thyroid funtions and types of operations in 274 patients at the Chonnam University Hospital from january 1986 to December 1986.
@ES The results were as fallows ;
@EN 1) In patients undergoing thyroidectomy, postoperative hypocalcemia was developed in 48.2% (132/274), transient asymptomatic hypocalcemia in 35.8%(98/274), transient symptomatic hypocalaemia in 9.1%(25/274), and permanent hypocalcemia in
3.3%(19/274).
2) The incidence of postoperative hypocalcemia in patients with Graves' disease is greater than other thyroid diseases.
3) In the influence of the operations on the incidence of post-thyroidectomy hypocalcemia, in general, the more extensive procedure, the higher incidence. That is, in symptomatic hypocalcemia, 1.3% in lobectomy, 23.7% in subtotal thyroidectomy,
26.9%
in total thyroidectomy and 75.0% in thyroidectomy with RND.
4) Patients with preoperative hyperthyodism developed postoperative hypocalcemia in 90.9%, in contrast Euthyroid patients in 42.9%.
5) In all cases of post-thyroidectomy symptomatic hypocalcemia, serum calcium levels were developed less than 4.1 mEq/L, and symptoms related to the difference between preoperative and postoperative serum clacium levels, but not always related
to
serum
calcium levels.
Conclusively, post-thyroidecomy hypocalcemia seems to be as a result of the direct damage, inadvertant removal of the parathyroid glands, or inadequated blood supply to the parathyroid glans. The patients with high risk factors(Graves' disease,
hyperthroidism, extensive operation, etc) will be operated more carefully to lower the complications of hypocalcemia, and the auto-transplantations of parathyroid glands to prevent premanennt hopocalcemia and treatments will be needed for further
studies.
|