一项关于在甲状腺叶切除术后手术后甲状腺激素补充率的国家研究
Q Lina Hu1, Ling Chen2, Eric J Kuo1
1Division of GI/Endocrine Surgery, Columbia University, New York, NY.
Surgery
|December 14, 2023
概括
根据针对低风险甲状腺癌的更新指南,甲状腺叶切除率增加. 癌症患者的手术后激素补充剂水平较高,但指导方针的改变没有增加完成甲状腺切除术的数量.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 卫生政策 卫生政策
背景情况:
- 美国甲状腺协会 (ATA) 在2015年修订了指导方针,允许甲状腺叶切除术用于选择低风险甲状腺癌.
- 甲状腺癌管理和手术方法已经发展,影响了患者的治疗结果和治疗策略.
研究的目的:
- 为了评估甲状腺叶切除术后的术后甲状腺激素补充率.
- 评估2015年ATA指导方针修订对甲状腺癌患者的脑膜切除和激素补充趋势的影响.
主要方法:
- 对Merative MarketScan数据库 (2008-2019) 的回顾性分析,涉及接受甲状腺切除术的成年患者.
- 使用统计分析,比较激素补充剂,叶切除术和完成甲状腺切除术在 (2008-2015) 之前和 (2016-2019) 之后的指导方针变化率.
主要成果:
- 患有甲状腺癌且经过分泌管切除术的患者比患有良性疾病的患者 (39.4%) 需要更高的激素补充剂 (59.3%).
- 在2015年指南更新后,甲状腺癌的叶切除率增加 (34.3%与30.3%相比),而完成甲状腺切除率下降 (25.6%与29.8%相比).
- 在改变指南后,甲状腺激素补充剂的轻微但显著下降被观察到 (56.9%与60.1%相比).
结论:
- 术后的甲状腺激素补充剂在甲状腺癌患者中比在良性甲状腺疾病患者中更为常见.
- 更新的ATA指南成功地提高了甲状腺癌的带切除率,而没有相应的完成甲状腺切除率的增加,这表明该指南的适当应用.
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