甲状腺切除术后过渡性和永久性甲状腺功能低下症的危险因素:系统性审查和元分析
Kang Ning1,2, Yongchao Yu1,2, Xinyi Zheng3
1Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center.
International journal of surgery (London, England)
|April 23, 2024
概括
在甲状腺手术后确定了手术后偏甲状腺功能障碍症 (hypoPT) 的危险因素. 女性性别,癌症病理和部剖析显著增加了低PT风险,强调了手术方法和手术期间的预防护理.
科学领域:
- 内分泌学和外科瘤学.
背景情况:
- 手术后的小甲状腺功能低下症 (hypoPT) 是甲状腺手术后的常见并发症.
- 现有的对低PT风险因素的研究不一致,需要对暂时性和永久性低PT进行全面分析.
- 了解这些因素对于改善患者治疗结果至关重要.
研究的目的:
- 系统地审查和分析与甲状腺手术后过渡性和永久性低PT相关的风险因素.
- 确定影响低PT发育的关键人口,手术和病理因素.
主要方法:
- 在PubMed和Embase数据库中进行了系统的文献搜索,直到2024年.
- 包括93项研究,研究质量使用纽卡斯尔-太华尺度进行评估.
- 为了确定风险因素和hypoPT之间的关联,计算了聚合概率比率,并进行了子组分析和出版偏差评估.
主要成果:
- 分析了19个风险因素,其中性别和副甲状腺自移植是最常见的.
- 女性性别,晚期癌症阶段 (cN阶段),中部和侧部部切割,全甲状腺切除术和癌症病理学与短暂和永久的低PT显著相关.
- 手术前的和副甲状腺自移植与短暂的低PT有关,而手术前的PTH则起到了保护因素的作用. 样本中的节点转移和副甲状腺存在与永久的hypoPT相关.
结论:
- 女性甲状腺癌患者接受全甲状腺切除术,并进行部剖析和淋巴结转移,面临着低PT的最高风险.
- 优化手术策略和手术内保护对于预防术后低PT至关重要.
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