患有无症状原发性甲状腺功能障碍症的老年患者:应该扩大手术标准吗?
Marisa A Bartz-Kurycki1, Sophie Dream2, Tina W Yen2
1James A. Haley Veterans Hospital, Tampa, FL 33216, USA.
Journal of the Endocrine Society
|October 24, 2023
概括
扩大原发性偏甲状腺症指导方针,包括老年人和骨质疏松症等症状,可能会提高手术转诊率. 这可能会导致更多患有这种疾病的患者更早地接受治疗.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 原发性偏甲状腺症 (PHPT) 呈现出多种不同的临床表现.
- 目前的临床实践指导方针规定了副甲状腺切除术的手术转诊.
- 患者的年龄和特定症状影响了外科手术的候选人.
研究的目的:
- 为了评估50岁以上患者的手术指示,这些患者接受了为PHPT而进行的副甲状腺切除术.
- 评估修改当前指南对外科推的影响.
主要方法:
- 对1182名50岁以上的患者进行了回顾性审查,他们接受了PHPT (2012-2020) 的副甲状腺切除术.
- 根据指导标准 (经典,无症状,没有标准) 和年龄组进行分类.
- 分析与年龄有关的常见的外科指标和症状.
主要成果:
- 31%的患者有经典的症状,56%的患者有无症状的迹象表明需要手术.
- 超血症,骨质疏松症和结石病是主要的手术驱动因素.
- 在不符合标准的患者中,神经认知症状和骨质疏松症普遍存在,无论年龄如何.
结论:
- 扩大PHPT指导方针,包括更广泛的年龄范围和骨质疏松症和神经认知问题等症状,可能有助于更早的手术转诊.
- 这种更广泛的方法可以提高PHPT患者的及时评估和最终治疗.
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