通过预测甲状腺切除术后的偏偏甲状腺功能障碍症,提前出院
Antonio Galindo Fernández1, Ana Giribet Fernández-Pacheco2, Nathalie Fages Cárceles2
1Servicio de Otorrinolaringología y Cirugía de Cabeza de Cuello, Hospital General Universitario Los Arcos del Mar de Menor, Pozo Aledo, Murcia, Spain; Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos n°135, Guadalupe, 30107, Murcia, Spain.
Acta otorrinolaringologica espanola
|March 3, 2024
概括
甲状腺切除术后的低血症可以使用完整的副甲状腺激素 (iPTH) 和 (Ca) 水平在手术后24小时可靠地预测. 这种评估有助于识别需要治疗的患者,并允许低风险个体提前出院.
科学领域:
- 内分泌学 在内分泌学.
- 手术并发症 手术并发症
- 神经外科 神经外科
背景情况:
- 甲状腺功能低下症是全甲状腺切除术后的常见并发症,通常导致长时间住院.
- 准确预测低血症对于有效治疗甲状腺切除术后的患者至关重要.
研究的目的:
- 用完整的副甲状腺激素 (iPTH) 水平来预测甲状腺切除术后低血症的概率.
- 根据血清 (Ca) 水平来确定补充的必要性.
- 建立早期出院和患者风险分层的协议.
主要方法:
- 一项回顾性研究包括了94名在2017年1月至2020年1月期间接受全甲状腺切除术的患者.
- 完整的副甲状腺激素 (iPTH) 和血清 (Ca) 水平在手术后4小时,24小时和48小时被测量.
- 进行了6个月的随访,以评估结果.
主要成果:
- 临时性和永久性甲状腺功能低下的发病率分别为51.06%和6.38%.
- 手术后24小时完整的副甲状腺激素 (iPTH) 水平高度预测临时性副甲状腺功能障碍 (AUC = 0.933,p < .001).
- 在手术后,IPTH水平≥29 pg/mL表明副甲状腺功能正常.
结论:
- 甲状腺切除术后24小时的IPTH和Ca测量组合提供了一种可靠的方法来管理低副甲状腺症.
- 这种方法可以促进低风险患者的早期出院以及早期识别高风险个体.
- 该协议旨在改善患者流动并减少医疗保健资源利用率.
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