甲状腺功能障碍症甲状腺功能障碍症的副总切除术的结果
Katherine A Baugh1, Linwah Yip1, Kimberly M Ramonell1
1Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Surgery
|November 9, 2023
概括
用75-100毫克的残留体大小进行甲状腺功能障碍症的副总切除术具有较低的并发症率. 脏移植可能为复发性副甲状腺症提供更持久的治疗方法.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 性甲状腺功能增强症 (RH) 是末期病 (ESKD) 的常见并发症.
- 耐火性RH通常需要副甲状腺切除术,但复发是一个重要的手术挑战.
- 对于初始手术的最佳副甲状腺残留体大小尚未确定.
研究的目的:
- 为了评估RH的副全额甲状腺切除术的结果.
- 为了确定副甲状腺残留物大小对复发率的影响.
- 评估移植在预防RH复发中的作用.
主要方法:
- 从1990年到2022年,对204名从1990年到2022年为RH进行了副全额甲状腺切除术的患者进行了回顾性队列研究.
- 部分甲状腺切除术涉及切除3个腺体±部分切除第四个腺体,留下75-100毫克的残留物.
- 在手术期间对甲状腺上腺激素 (PTH) 水平进行监测,目标是150-250 pg/mL.
主要成果:
- 低的手术并发症率 (血瘤1.4%,喉神经复发性损伤<1%).
- 在10%的患者 (14/139) 中发生了复发性RH,中位数为58.6个月.
- 在随后接受移植的19名患者中没有观察到复发.
结论:
- 在RH的副甲状腺切除术中准75-100毫克的甲状腺残留物与低并发症率有关.
- 移植似乎与RH的持久治愈有关.
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