摘要 目的 探讨3种不同甲状腺术式对甲状腺癌患者甲状旁腺素及血钙水平的影响。 方法 回顾性分析2017年7月—2018年6月在我院手术治疗的甲状腺癌患者175例，按不同术式分为3组，单侧腺叶切除+同侧中央区淋巴结清扫术42例（A组），甲状腺全切+单侧中央区淋巴结清扫术71例（B组），甲状腺全切+双侧中央区淋巴结清扫术62例（C组），分析术前2 d、术后3 d患者血钙及甲状旁腺素水平的变化。 结果 C组低钙血症及低甲状旁腺素血症发生率明显高于A、B两组，差异具有显著性（χ2=40.042、53.159，q=－10.990～10.299，P<0.05）；各组间术前血钙及甲状旁腺素水平比较差异无显著性（P>0.05）;各组间术后血钙及甲状旁腺素水平比较差异有显著性（F=23.134、35.859，q=2.780～11.762，P<0.05）；A组手术前后血钙及甲状旁腺素水平比较差异无显著性（P>0.05）；B组、C组手术前后血钙及甲状旁腺素水平比较，差异均有显著性（t=3.537～8.241，P<0.05）。 结论 单侧腺叶切除+同侧中央区淋巴结清扫术对术后血钙及甲状旁腺素水平无明显影响；甲状腺全切除术随淋巴结清扫范围扩大，术后低钙血症及低甲状旁腺素血症发生率增高，双侧中央区淋巴结清扫尤为显著。 Abstract：Objective To investigate the effect of three surgical procedures for thyroid carcinoma on serum calcium and parathyroid hormone in patients with thyroid carcinoma. Methods A retrospective analysis was performed for the clinical data of 175 patients with thyroid carcinoma who underwent surgical treatment in our hospital from July 2017 to June 2018. According to the surgical procedure, they were divided into group A (42 patients underwent unilateral thyroid lobectomy+ipsilateral central lymph node dissection), group B (71 patients underwent total thyroidectomy+unilateral central lymph node dissection), and group C (62 patients underwent total thyroidectomy+bilateral central lymph node dissection). The levels of serum calcium and parathyroid hormone were analyzed on day 2 before surgery and on day 3 after surgery. Results Group C had significantly higher incidence rates of hypocalcemia and hypoparathyroidism than groups A and B (χ2=40.042,53.159, q=-10.990-10.299,P<0.05). There were no significant differences in the levels of serum calcium and parathyroid hormone between the three groups before surgery (P>0.05), while there were significant differences in these levels after surgery (F=23.134,35.859,q=2.780-11.762,P<0.05). Group A had no significant changes in the levels of serum calcium and parathyroid hormone after surgery (P>0.05), while groups B and C had significant changes after surgery (t=3.537-8.241,P<0.05). Conclusion Unilateral thyroid lobectomy combined with ipsilateral central lymph node dissection has no significant effect on the levels of serum calcium and parathyroid hormone. With the enlargement of the scope of lymph node dissection, increased incidence rates of hypocalcemia and hypoparathyroidism are observed in patients undergoing total thyroidectomy, especially in those undergoing bilateral central node dissection
