整体甲状腺切除术:减少术后的小甲状腺功能障碍症
Rasmus Reinke1, Stefano Christian Londero1, Martin Almquist2
1Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Endocrine connections
|July 24, 2023
概括
将格雷夫斯病的全甲状腺切除术限制在经验丰富的副甲状腺外科手术的外科医生身上,显著降低了永久性副甲状腺症的发生率. 这种集中化改善了患者的治疗结果和生活质量.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 甲状腺手术 甲状腺手术
背景情况:
- 整体甲状腺切除术具有显著的手术后甲状腺功能低下症的风险,原因是甲状腺侧腺体或其血管供应的潜在损伤.
- 具有甲状腺和副甲状腺手术专业知识的外科医生可能在甲状腺切除术中获得更好的结果.
- 永久性缺甲状腺症的高发病率会对患者的生活质量产生负面影响,并增加长期的发病率.
研究的目的:
- 研究将格雷夫斯病全甲状腺切除术集中给经验丰富的外科医生,对手术后甲状腺功能低下率的影响.
- 评估将甲状腺切除术程序限制在甲状腺和副甲状腺手术中熟练的外科医生的有效性.
主要方法:
- 在一个单一的机构进行了一项回顾性队列研究.
- 甲状腺切除术最初由七名外科医生 (2012-2016) 进行.
- 从2017年开始,这些手术仅限于两名具有并发副甲状腺手术经验的外科医生.
主要成果:
- 在全甲状腺切除术后,永久性甲状腺缺血的总比率从28% (2012-2014) 降至6% (2020-2021).
- 对于格雷夫斯病患者来说,永久性甲状腺功能障碍症的发病率从36% (2015-2016) 降至2% (2020-2021).
- 在甲状腺癌患者中,发病率从30% (2012-2014) 降至10% (2020-2021).
结论:
- 将全甲状腺切除术集中给具有广泛副甲状腺手术经验的外科医生,显著减少了术后的副甲状腺功能障碍症.
- 这一策略通过将严重的手术并发症降至最低,改善了患者的治疗结果和生活质量.
- 建议包括将复杂的甲状腺手术集中到具有专门外科专业知识的高体积中心.
相关概念视频
Synthesis and Regulation of Thyroid Hormones
4.7K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.7K
Skeleton and Calcium Homeostasis
4.6K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.6K
The Parathyroid Glands
2.2K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
2.2K
Hormones and Bone Tissue
2.7K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.7K
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Functions of Thyroid Hormones
2.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.8K


