하시모토갑상선염 동반여부에 따른 갑상선전절제술 후 부갑상선기능저하증의 특징 분석

이동명; 김은영; 정일용; 김성엽; 안은정; 박종민; 박세혁; 윤여규

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자료유형: 학술저널

저자정보: 이동명 김은영 정일용 김성엽 안은정 박종민 박세혁 윤여규

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제14권 제4호

발행연도: 2014.1

수록면: 195 - 199 (5page)

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Purpose: The characteristics of hypoparathyroidism in patients with Hashimoto thyroiditis (HT) after total thyroidectomy are not well established. The aim of this study was to investigate the relationship between hypoparathyroidism and loss of parathyroid glands in patients with or without HT who underwent total thyroidectomy. Methods: Patients who underwent total thyroidectomy were divided into two groups; with HT (n=166) and without HT (n=526). Clinicopathologic characteristics were compared between the two groups. Results: The mean numbers of parathyroid glands in specimens were significantly smaller in the with HT group than in the without HT group (0.34±0.51 vs. 0.42±0.58, P=0.003). The rate of transient hypoparathyroidism was significantly higher in the with HT group than in the without HT group (51.8% vs. 34.6%, P=0.000). Serum total calcium levels in patients who experienced transient hypoparathyroidism did not differ significantly between groups (P=0.335). The incidence of transient hypoparathyroidism of patients who preserved all four parathyroid glands or sacrificed one parathyroid gland was higher in the with HT group than in the without HT group, although that of patients who sacrificed two or more parathyroid glands was similar between groups. The incidence of permanent hypoparathyroidism in the two groups did not differ (P=0.546). Conclusion: Patients with HT had a higher rate of transient hypoparathyroidism after total thyroidectomy, particularly patients who preserved all four or three parathyroid glands. It is likely that the blood supply to the parathyroid gland might be vulnerable in patients with HT. Therefore, even though all parathyroid glands were preserved, careful monitoring of hypoparathyroidism is necessary after total thyroidectomy in patients with HT.

#하시모토갑상선염 #갑상선전절제술 #부갑상선기능저하증 #Hashimoto thyroiditis #Total thyroidectomy #Hypoparathyroidism

참고문헌 (19)

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/ / Health Insurance Review & Assessment Service

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Demeester-Mirkine N / 1992 / Hypocalcemia after thyroidectomy / Arch Surg 127 : 854 ~ 858

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Henry JF / 1998 / Morbidity of prophylactic lymph node dissection in the central neck area in patients with papillary thyroid carcinoma / Langenbecks Arch Surg 383 : 167 ~ 16