在南非学术医院的一个急性病患者甲状腺功能测试的审计
E C Kruger1,2, M Conradie2, A Coetzee2
1National Health Laboratory Service (NHLS), Cape Town, South Africa.
甲状腺刺激激素 (TSH) 测试经常被要求用于危急病患者,通常表明非甲状腺疾病综合征 (NTIS),而不是原发性甲状腺疾病. 对异常结果的后续测试是不常见的,强调了对适当的甲状腺功能测试的临床医生教育的需要.
科学领域:
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
- 临床病理学 临床病理学
背景情况:
- 非甲状腺疾病综合征 (NTIS) 在没有原发性甲状腺疾病的急性病患者中表现为甲状腺功能异常.
- 甲状腺功能测试,包括TSH,可以在危急病患者中产生误导性的结果.
研究的目的:
- 分析甲状腺刺激激素 (TSH) 测试要求在急诊和重症监护病房中的模式.
- 评估泰格伯格医院 (南非) 临界病患者中TSH结果的流行率和解释.
主要方法:
- 一项回顾性,描述性研究分析了6个月的TSH测试请求.
- 从接受急诊和重症监护病房治疗的患者收集数据.
主要成果:
- 在973个评估的TSH测试中,有14%是异常的.
- 大多数异常的TSH结果 (79.4%) 归因于NTIS.
- 对异常TSH水平的后续检测仅在18%的病例中进行.
结论:
- 在重症患者中,通常会要求进行TSH测试,异常结果经常与NTIS有关.
- 观察到对异常TSH结果的后续检测不足.
- 建议对临床医生加强在危急疾病中进行甲状腺功能测试的教育.
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