Total Tiroidektomi Sonrası Hipokalsemi

Amaç: Hipokalsemi total tiroidektomi sonrası gelişen en önemli komplikasyonlardan biridir. Çalışmada total tiroidektomi sonrası hipokalsemi gelişimine yol açan nedenler incelendi. Materyal ve Metot: Hastalarda yaş, cinsiyet, preoperatif tanı, hormonal durum, operasyon süresi, ameliyat sırasında paratiroid bezi hasarı varlığı, paratiroid bezi oto transplantasyonu, preoperatif olarak antitiroid ilaç kullanımını ve ameliyat sırasında kanama miktarı gözden geçirildi. Kategorik değişkenleri analiz etmek icin Kikare testi kullanıldı. Tek değişkenli analizde hipokalsemi riskini saptamak icin lojistik regresyon modeli kullanıldı. Bulgular: Total tiroidektomi yapılan 200 hastanın 56’sında hipokalsemi gelişti. Kadın cinsiyeti, preoperatif olarak tiroid kanseri ve toksik nodüler guatr teşhisi konulması, nodül büyüklüğünün < 3 cm olması, düşük D vitamin düzeyi, paratiroid hasarı gibi faktörler hipokalsemi ile ilişkili bulundu. Sonuç: Cinsiyet, preoperatif tanı, paratiroid gland hasarı, nodül büyüklüğü ve D vitamini eksikliği hipokalsemi ile ilişkilidir. Bu komplikasyonun gelişiminde geniş spektrumda multifaktöryel etiolojilerin spektrumda multifaktöryel etiolojilerin sözkonusu olduğu düşünüldü.

Anahtar Kelimeler:

Hipokalsemi, guatr, paratiroid, tiroidektomi

Hypocalcemia Following Total Thyroidectomy

Aim: Hypocalcemia following total thyroidectomy is one of the clinically relevant complication for clinicians. In this study, we examined the factors associated with development of hypocalcemia after total thyroidectomy. Material and Method: We studied gender, age, preoperative diagnosis, operative time, hormonal status, existence of parathyroid gland injury at the operation, parathyroid gland auto-transplantation, amount of bleeding at the operation and preoperative use of antithyroid drugs with the patients. In the first day after operation serum phosphor, calcium, parathyroid hormone levels were obtained. In the second day, phosphor and calcium were measured. The chi-square test was used for categorical variables. Logistic regression model was used to define the risk of hypocalcemia in the univariate analysis. Results: Hypocalcemia were observed in 56 of 200 patients. Female gender, preoperative diagnosis of toxic nodular goitre, and of thyroid cancer, parathyroid injury, nodule size <3cm, and auto-transplantation were found to be associated with hypocalcemia in logistic regression analysis.Conclusion: The risk factors related with hypocalcemia were found to be gender, parathyroid gland injury, preoperative diagnosis, nodule size, D vitamin deficiency. Hypocalcemia after total thyroidectomy seems to be a multifactorial problem with a rich spectrum of aetiology.

Keywords:

Hypocalcaemia, goitre, parathyroid, thyroidectomy,

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