| Popis: |
Early hypocalcemia is one of the most frequent complications in the early postoperative period during operations on the thyroid gland. Several studies tried to determine the main factors affecting the development of postoperative hypocalcemia, but no clear answer was received. Therefore, this study is dedicated to the search for predictors of the development of hypocalcemia. Materials and methods: A retrospective study of the medical histories of 415 patients who were operated on by one surgeon for various thyroid pathologies was conducted. The presence of postoperative hypocalcemia was determined not only by the presence of clinical manifestations, but also by the results of determining the level of ionized calcium in the blood the day after the operation. During the study, the following factors were also taken into account: sex, age, distribution by age groups, gland function before surgery and preoperative diagnosis, preoperative and postoperative level of ionized calcium in the blood, volume of surgical intervention. Results: according to the results of the study, gender, volume of surgical intervention and function of the thyroid gland before surgery showed a significant correlation with the development of postoperative hypocalcemia. In female patients, the complication occurred in 16% (52 of 325) compared with 1.7% (1 in 60) in men. A significant difference also arose depending on the volume of surgical intervention: after total thyroidectomy with/without lymphadenectomy - 17.4%, and with hemithyroidectomy - 1.1%. Thyroid status before surgery also influenced the development of complications: in the presence of thyrotoxicosis, hypocalcemia occurred in 34.7% of cases, and in 4.5% of surgical interventions due to other thyroid pathology. Conclusion: The obtained results make it possible to conclude that only the gender of the patient, the amount of surgical intervention and the presence of thyrotoxicosis before the operation are the main risk factors for the development of postoperative hypocalcemia. And the age of the patient and the nature of the pathological process in the thyroid gland are not predictors of the development of postoperative hypocalcemia. |
