Objective

The aim was to explore the effects of preoperative calcium and activated vitamin D3 supplementation on post-thyroidectomy hypocalcemia and hypo-parathyroid hormone-emia (hypo-PTHemia).

Methods

A total of 209 patients were randomly divided into control group (CG) and experimental group (EG). Oral calcium and activated vitamin D3 supplementation were preoperatively administered to EG, whereas a placebo was administered to CG. Data on serum calcium, phosphorus, and PTH concentrations before operation, on postoperative day 1 (POPD1), at postoperative week 3 (POPW3), and on the length of postoperative hospitalization were collected.

Results

The serum calcium, phosphorus, and PTH concentrations, as well as the incidence of postoperative hypocalcemia and hypo-PTHemia, did not significantly differ between EG and CG. Subgroup analysis revealed that the serum calcium concentrations of the experimental bilateral thyroidectomy subgroup (eBTS) on POPD1 and POPW3 were higher than that of the control bilateral thyroidectomy subgroup (cBTS) (P < 0.05); the reduction of serum calcium in eBTS on POPD1 and POPW3 was less than those in cBTS (P < 0.05). However, significant differences were not observed between the unilateral thyroidectomy subgroups (UTS) (P > 0.05). Moreover, the incidence of postoperative hypocalcemia in cBTS on POPD1 was significantly higher than that in eBTS (65.9% vs 41.7%) (P < 0.05). The length of hospitalization in cBTS (3.55 ± 1.89 days) was significantly longer than that (2.79 ± 1.15 days) in eBTS (P < 0.05).

Conclusion

Short-term preoperative prophylactic oral calcium and activated vitamin D3 supplementation could effectively reduce the incidence of postoperative hypocalcemia and decrease the length of postoperative hospitalization in patients who have undergone bilateral thyroidectomy.

中文翻译：

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甲状腺切除术中术前短期补充钙和活性维生素 D3 的意义：一项随机试验和前瞻性研究

客观的

目的是探讨术前补充钙和活性维生素 D3 对甲状腺切除术后低钙血症和低甲状旁腺激素血症（低 PTH 血症）的影响。

方法

共有209例患者随机分为对照组（CG）和实验组（EG）。术前对 EG 给予口服钙和活性维生素 D3 补充剂，而对 CG 给予安慰剂。收集术前、术后第 1 天 (POPD1)、术后第 3 周 (POPW3) 以及术后住院时间的血清钙、磷和 PTH 浓度数据。

结果

EG 和 CG 之间的血清钙、磷和 PTH 浓度以及术后低钙血症和低 PTH 血症的发生率没有显着差异。亚组分析显示，实验双侧甲状腺切除亚组（eBTS）POPD1、POPW3 血清钙浓度高于对照双侧甲状腺切除亚组（cBTS）（P < 0.05）；eBTS 对 POPD1 和 POPW3 的血清钙降低幅度小于 cBTS（P < 0.05）。然而，单侧甲状腺切除亚组（UTS）之间未观察到显着差异（P > 0.05）。此外，POPD1 上的 cBTS 术后低钙血症发生率显着高于 eBTS（65.9% vs 41.7%）（P < 0.05）。cBTS 的住院时间（3.55 ± 1.89 天）显着长于 eBTS 的住院时间（2.79 ± 1.15 天）（P < 0.05）。

结论

双侧甲状腺切除术患者术前短期预防性口服钙剂和补充活性维生素D3可有效降低术后低钙血症的发生率，缩短术后住院时间。