在非胸膜性骨髓灰质炎中进行甲状腺切除术后的结果
Nathaniel Deboever1, Ying Xu2, Hope A Feldman1
1Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Journal of thoracic disease
|July 10, 2023
概括
在18至50岁的成年人中,用于治疗非胸膜性骨髓灰质炎 (NTMG) 的胸膜切除术很少使用,但减少了救援治疗的需要. 手术后的结果是可以接受的,尽管类固醇使用增加.
科学领域:
- 神经学 神经学
- 手术瘤学手术瘤学
背景情况:
- 骨髓灰质炎 (MG) 是一种影响神经肌肉结合的自身免疫性疾病.
- 在18-50岁的患者中,指导方针建议为非胸膜性肌痛性肌痛症 (NTMG) 进行甲状腺切除术.
- 在临床试验以外的NTMG患者中,对甲状腺切除术的现实应用尚未得到充分证实.
研究的目的:
- 研究18-50岁的NTMG患者中甲状腺切除术的利用和结果.
- 评估药物使用的变化,医疗保健的利用率,以及甲状腺切除术前后的成本.
主要方法:
- 对Optum被取消身份的Clinformatics数据马特索赔数据库 (2007-2021) 的回顾性分析.
- 鉴定了18-50岁的NTMG患者,他们在诊断后12个月内接受了乳腺切除术.
- 结果的比较包括类固醇使用,非类固醇免疫抑制剂 (NSIS),救援疗法,急诊室 (ED) 访问,以及在术前和术后的6个月内入院.
主要成果:
- 在符合条件的NTMG患者中,只有3.47% (45/1298) 接受了甲状腺切除术;53.3%是微创手术.
- 胸膜切除术后,类固醇使用增加 (53.3%至66.7%),NSIS使用保持稳定,救援治疗使用显著下降 (44.4%至24.4%).
- 救援治疗的平均成本下降了4700多美元,而与NTMG相关的急救诊所和住院费用保持稳定. 两次90天的再接收 (4.44%) 被记录在案.
结论:
- 18-50岁的NTMG患者的胸膜切除导致对救援疗法的依赖减少,尽管类固醇处方增加.
- 这种手术在这个人群中未得到充分利用,但却显示出可接受的术后结果.
- 进一步的研究可能会阐明甲状腺切除术采用的障碍,并优化NTMG的治疗策略.
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