甲状腺癌全切除术致甲状旁腺损伤对患者骨密度及骨代谢的影响OACSTPCD

Objective:Currently,clinical surgical approaches for thyroid cancer include total thyroidectomy resection,subtotal thyroidectomy resection,and total thyroidectomy with neck lymph node dissection.These different surgical methods cause varying degrees of damage to the parathyroid glands.Increasingly,clinicians are focusing on the importance of protecting the parathyroid glands.This study investigates the impact of parathyroid gland injury caused by thyroid cancer resection on bone density and metabolism in patients. Methods:A retrospective analysis was conducted on 167 patients who underwent radical total thyroidectomy for thyroid cancer at the First Affiliated Hospital of Nanjing Medical University from March 2017 to June 2019.Parathyroid hormone(PTH)levels and other indicators were measured to assess the extent of parathyroid gland injury.The patients with parathyroid injury(87 cases)were classified as a study group,and those without parathyroid injury(80 cases)were classified as a control group.Both groups had preoperative and postoperative measurements of PTH,free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid-stimulating hormone(TSH),serum calcium,phosphorus,magnesium,bone density,and bone metabolism markers N-terminal propeptide of type 1 precollagen(P1NP)and β-C-terminal telopeptide of type Ⅰ collagen(CTX). Results:Postoperatively,the study group showed significantly lower PTH and bone density compared to the control group.Additionally,bone metabolism markers P1NP and CTX were significantly lower in the study group,the level of blood calcium was also lower than that of the control group,and the level of blood phosphorus was higher than that of the control group,with all differences being statistically significant(P<0.05). Conclusion:Patients with parathyroid injury following total thyroidectomy for thyroid cancer exhibit significantly reduced serum PTH levels,decreased bone density,and lower levels of bone metabolism markers.The imbalance of calcium and phosphorus accelerates bone calcium loss,suggesting that parathyroid gland injury may be a contributing factor for osteoporosis.