目的：探讨双极电凝在甲状腺全切除术中对甲状旁腺功能保护的应用效果。方法甲状腺全切除术患者94例，分为双极电凝组（51例）和超声刀组（43例），观察术后1 d、3 d、7 d、6月血钙及PTH变化，统计暂时性甲状旁腺功能减退和永久性甲状旁腺功能减退发生例数。结果两组术后6月内低钙血症（33.33%vs 53.49%）及低PTH发生率（37.25%vs 58.14%）比较，差异有统计学意义（χ2分别=3.88、4.08，P均＜0.05）。两组患者术后第1天、第3天、第7天血钙及PTH比较，差异均有统计学意义（t分别=2.01、2.16、3.26；1.85、2.16、2.56，P均＜0.05）。两组术后6月暂时性甲状旁腺功能减退发生率（21.57%vs 44.19%）比较，差异有统计学意义（χ2=5.49，P＜0.05），且均未发生永久性甲状旁腺功能减退。结论甲状腺全切除术中采用双极电凝处理甲状腺真假被膜间三级血管分支对甲状旁腺功能保护效果理想。%Objective To explore the effect of bipolar coagulation on parathyroid glands protection in thyroidectomy.Methods Ninety-four patients underwent total thyroidectomy were divided into bipolar coagulation group (51 cases) and harmonic scalpel group(43 cases). The blood calcium and PTH were observed on 1st day, 3rd day, 7th day and 6th month after operation. And the number of transient or permanent hypoparathyroidism patients was recorded. Results There were statistical difference of hypocalcemia(33.33% vs 53.49%) and low PTH incidences(37.25% vs 58.14%) between two groups on 6th month after operation (χ2=3.88,4.08, P<0.05),The blood calcium and PTH on 1st day, 3rd day, 7th day after operation between two groups were significantly different (t=2.01,2.16, 3.26,1.85,2.16,2.56,P<0.05). The incidence of transient hypoparathyroidism(21.57% vs 44.19%) in the bipolar coagulation group was significantly lower than in harmonic scalpel group (χ2=5.49,P<0.05). No case with permanent hypoparathyroidism was occurred in two groups. ConclusionDissecting the third -blood vessel between the real and false throid capsules by bipolar coagulation forceps is good for parathyroid glands protection in thyroidectomy.
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