护甲状腺切除术后长期监测,用于原发性副甲状腺功能障碍症
William Jenkins1, Edward Chisholm2, Faith Protts3
1Otolaryngology, University of Bristol, Bristol, GBR.
Cureus
|March 7, 2024
概括
在为原发性副甲状腺功能障碍症进行副甲状腺切除术后的长期随访显示,复发率低,为5.26%. 手术后每年进行监测可能过度,建议建议进行五年后续监测.
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:
- 原发性甲状腺功能增强症 (PHPT) 甲状腺切除术提供了优异的治愈率,短期的高血症复发率较低.
- 最近的研究表明,长期复发率高于预期,这促使重新评估术后监测协议.
研究的目的:
- 为了评估长期复发的高血症的比率超过四年后的副甲状腺切除术为PHPT.
- 根据长期复发数据,确定目前的年度监测建议是否合适.
主要方法:
- 对于PHPT (2014-2016) 进行52次顺序性甲状腺切除术的回顾性分析.
- 血清水平在手术前,手术后立即跟踪,并在最近的随访时跟踪.
- 随访时间少于48个月的患者被排除在外;复发被定义为高血症>6个月后的高血症.
主要成果:
- 分析了一组38名患者 (平均年龄66.4岁,78.9%为女性),随访时间中位数为73.17个月.
- 观察到高血症复发率为5.26% (2/38名患者),主要是在错误诊断的副甲状腺增生病例中.
- 长期治愈率确定为94.74% (36/38名患者).
结论:
- 结果支持高治愈率和偏甲状腺切除术后的低复发率,即使随着延长的随访.
- 该研究表明,每年的监测可能过度,主张在最初的几年少频监测.
- 建议在初始评估后进行五年后续评估,随后进行年度检查,因为已证实延迟高血病复发.
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