Page 213 - EJMO-9-1

Eurasian Journal of Medicine and
Oncology Anticoagulant therapy on parathyroid

that the global age-standardized incidence rate has Helsinki Declaration and its subsequent amendments.
nearly tripled over the past 3 decades, increasing from Informed consent was obtained from all patients, permitting
approximately 4.2/100,000 to over 14/100,000 in certain the anonymous use of their data for research purposes.
regions. Despite this surge, the overall 5-year survival rate
3
for differentiated thyroid carcinoma, particularly papillary 2. Participants and methods
thyroid carcinoma, exceeds 95%, highlighting the typically 2.1. Participants
indolent nature of most thyroid tumors. Nonetheless,
4
more aggressive subtypes, such as anaplastic thyroid From May 2021 to October 2022, thyroid cancer patients
carcinoma, have a markedly worse prognosis, with a 5-year from the Department of Breast and Thyroid Surgery, Zibo
survival rate below 10%. Central Hospital, who underwent total thyroidectomy
and central regional lymph node dissection by the same
Surgical resection remains the cornerstone of surgical team, were followed up. Post-operative drainage
curative therapy for differentiated thyroid cancer, often volumes and PTH levels were collected from the inpatient
coupled with radioactive iodine ablation and thyroid Health Information System. A total of 928 patients met
hormone suppression therapy in selected patients the inclusion criteria, of whom 261 exhibited decreased
with intermediate- or high-risk features. Additional parathyroid function and hypocalcemia. Among these
interventions, including targeted therapies (e.g., tyrosine 261 patients, 151 (anticoagulant group) received calcium
kinase inhibitors) and external beam radiotherapy, are supplementation, and MaiLuoShuTong pills combined
generally reserved for advanced or refractory diseases. with dalteparin anticoagulant therapy, while the remaining
Although total thyroidectomy is highly effective 110 patients (control group) were treated with calcium
for managing resectable thyroid cancer, post-operative supplementation only. Written informed consent was
complications continue to pose significant clinical obtained from all patients and their families.
challenges. Among these, hypoparathyroidism is the 2.2. Inclusion and exclusion criteria
most common complication, substantially impairing
patients’ quality of life and increasing treatment costs. Its The inclusion criteria for patients were as follows:
incidence ranges from 30% to 60%, depending on surgical (1) provided informed consent; (2) have no major systemic
complexity and patient-specific factors. In cases of transient organ diseases or mental health conditions; (3) underwent
hypoparathyroidism, serum parathyroid hormone (PTH) total thyroidectomy with central lymph node dissection,
levels often recover within weeks or months. However, and have post-operative pathology revealing no lymph
permanent hypoparathyroidism necessitates lifelong node metastasis; (4) have not received iodine 131 treatment
medication and leads to disturbances in calcium and within the past 6 months; and (5) have not taken
phosphorus metabolism, profoundly affecting patients’ anticoagulant drugs (aspirin or rivaroxaban) before surgery.
quality of life. Together with recurrent laryngeal nerve The exclusion criteria for patients were as follows:
paralysis, post-operative hypoparathyroidism also (1) had other serious chronic or disabling diseases, such
contributes to a higher risk of medicolegal disputes due to as hypertension or diabetes; (2) unable to understand or
its long-term implications for patient outcomes. make decisions due to intellectual or mental factors; (3) did
Hypoparathyroidism after total thyroidectomy not undergo central lymph node dissection; (4) had tumor
primarily arises from injury to the parathyroid vasculature, tissue invasion of the parathyroid or membrane tissues;
vasospasm, or thrombosis during surgical dissection, (5) had a bleeding tendency or used anticoagulation or
which disrupts blood supply and leads to transient or antiplatelet therapy or had the hematopoietic disease;
permanent parathyroid dysfunction. Both dalteparin and (6) had intraoperative parathyroid glands that could not
MaiLuoShuTong pills have anticoagulant properties that be retained in situ; and (7) who had thyroid ultrasound
help treat vascular spasms and prevent ischemic events, findings suggesting enlarged lymph nodes in the lateral
such as myocardial infarction (MI). This study analyzes neck area requiring biopsy or dissection.
clinical data from thyroid cancer patients who underwent
total thyroidectomy and central lymph node dissection 2.3. Treatment regimens
at Zibo Central Hospital between May 2021 and October Among the 151 patients in the anticoagulant group, the
2022, focusing on measures to facilitate post-operative following treatments were administered:
parathyroid gland recovery. This study was approved by • MaiLuoShuTong pills (Registration no. Z19991025;
the Ethics Committee of Zibo Central Hospital (approval Manufacturer: Lunan Houpu Pharmaceutical Co.,
number: 201801020). All procedures involving human Ltd.; Specification: 12 g/bottle; 1 bottle/dose, taken
participants were conducted in accordance with the 1964 3 times daily).

Volume 9 Issue 1 (2025) 205 doi: 10.36922/ejmo.8105