Effects of different calcium and vitamin D3 supplementation schemes on the complications and prognosis of patients with thyroid cancer after bilateral thyroidectomy during perioperative period

doi:10.3877/cma.j.issn.1674-3946.2020.05.025

Abstract

Abstract:

Objective

To explore the effects of different calcium and vitamin D3 supplementation on complication and prognosis after bilateral thyroidectomy of thyroid cancer during the perioperative period.

Methods

The data of 186 patients with thyroid cancer who underwent bilateral thyroidectomy from January 2014 to January 2015 were retrospectively analyzed. They were divided into preoperative groups (68 Cases), postoperative group (60 cases) and control group (58 cases) according to different calcium and vitamin D3 supplementation, the preoperative group was given calcium and vitamin D3 1 week before the operation, the postoperative group was given calcium and vitamin D3 after the operation, and the control group was not given calcium and vitamin D3 .The SPSS22.0 and GraphPad Prism software were selected for statistical analysis and mapping. Measurement data such as serum Ca²+ and PTH levels were expressed as (±s), and compared by one-way analysis of variance; postoperative complications and other count data were compared by χ²; Kaplan-Meier survival curve was drewfor the prognostic survival. The difference was statistically significant when (P<0.05).

Results

The incidence of hypocalcemia in the preoperative group, postoperative group, and control group were 1 case (1.5%), 5 cases (8.53), and 10 cases (17.2%); intravenous calcium supplementation were 1 case (1.5%) and 2 cases(3.3%), 7 cases (12.1%); hypercalcemia were 0 cases, 1 case (1.7%), 4 cases (6.9%), The differences were statistically significant in hypocalcemia, intravenous calcium supplementation and hypercalcemia among the three groups (P<0.05). The 5-year recurrence rate of the three groups was 39.8% and the 5-year survival rate was 86.6%. There was no significant difference in survival prognosis among the three groups (P>0.05).

Conclusion

Preoperative and postoperative calcium and vitamin D3 supplementations can reduce the incidence of hypocalcemia after bilateral thyroidectomy of thyroid cancer, the former is more effective. But these supplementations have no effect on the prognosis of patients with thyroid cancer.

Key words: Thyroid neoplasms, Thyroidectomy, Vitamin D, Prognosis, Comparative effectiveness research, Perioperative period

Jianming Yuan, Tao Liu, Xiaoli Jin, Maofei Wang, Mingliang Wang. Effects of different calcium and vitamin D3 supplementation schemes on the complications and prognosis of patients with thyroid cancer after bilateral thyroidectomy during perioperative period[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 522-525.

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References 21

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组别	例	性别	年龄(岁)	病程(月)	肿瘤类型
组别	例	男/女	年龄(岁)	病程(月)	A/B/C/D
术前组	68	24/44	54.36±8.6	13.1±2.7	59/4/3/2
术后组	60	21/39	54.8±8.8	12.7±3.1	53/3/3/1
对照组	58	22/36	55.0±9.3	12.8±3.0	52/3/2/1
统计值	?	0.234	0.098	0.634	0.252
P值	?	0.935	0.906	0.578	0.881

组别	例	性别	年龄(岁)	病程(月)	肿瘤类型
组别	例	男/女	年龄(岁)	病程(月)	A/B/C/D
术前组	68	24/44	54.36±8.6	13.1±2.7	59/4/3/2
术后组	60	21/39	54.8±8.8	12.7±3.1	53/3/3/1
对照组	58	22/36	55.0±9.3	12.8±3.0	52/3/2/1
统计值	?	0.234	0.098	0.634	0.252
P值	?	0.935	0.906	0.578	0.881

组别	例	喉返神经损伤	甲状旁腺功能减退	低血钙	静脉补钙	高钙血症
术前组	68	3(4.4)	8(11.7)	1(1.5)^ab	1(1.5)^b	0(0)^b
术后组	60	4(6.7)	12(20.0)	5(8.3)^b	2(3.3)^b	1(1.7)^b
对照组	58	4(6.9)	13(22.4)	10(17.2)	7(12.1)	4(6.9)
χ²值	?	0.437	1.738	9.910	7.637	6.004
P值	?	0.804	0.419	0.007	0.022	0.048

组别	例	喉返神经损伤	甲状旁腺功能减退	低血钙	静脉补钙	高钙血症
术前组	68	3(4.4)	8(11.7)	1(1.5)^ab	1(1.5)^b	0(0)^b
术后组	60	4(6.7)	12(20.0)	5(8.3)^b	2(3.3)^b	1(1.7)^b
对照组	58	4(6.9)	13(22.4)	10(17.2)	7(12.1)	4(6.9)
χ²值	?	0.437	1.738	9.910	7.637	6.004
P值	?	0.804	0.419	0.007	0.022	0.048

组别	例	?	Ca^2＋(mmol/l)	PTH(pg/ml)
术前组	68	术前1 d	2.2±0.4	45.1±8.6
?	?	术后1 d	1.9±0.4^ab	24.7±4.3
?	?	术后5 d	2.2±0.4	37.6±5.7
?	?	术后3月	2.2±0.4	41.3±8.4
术后组	60	术前1 d	2.2±0.3	45.4±7.9
?	?	术后1 d	1.8±0.3^b	26.4±5.2
?	?	术后5 d	2.1±0.3	38.4±6.3
?	?	术后3月	2.2±0.4	42.7±8.8
对照组	58	术前1 d	2.3±0.4	45.8±9.1
?	?	术后1 d	1.7±0.4	25.7±6.1
?	?	术后5 d	2.0±0.3	36.8±7.2
?	?	术后3月	2.1±0.4	44.3±8.7

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