在进行甲状腺切除术和不进行甲状腺切除术后对低血症的评估
Hänel W Eberly1, Bao Y Sciscent1, F Jeffrey Lorenz1
1Department of Otolaryngology-Head and Neck Surgery, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA.
概括
经过全喉切除术 (TL) 和全甲状腺切除术的患者与单独TL患者相比,面临较高的低血症风险. 建议在手术后密切监测副甲状腺激素 (PTH) 水平,并采取多学科的方法.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 手术瘤学手术瘤学
背景情况:
- 低甲状腺症和低血是喉腔切除术后已知的并发症.
- 同时甲状腺切除术对这些结果的具体影响需要进一步描述.
研究的目的:
- 为了比较经过全喉切除术 (TL) 且没有并发甲状腺切除术 (甲状腺切除术或全甲状腺切除术) 的患者的低血率.
- 评估这些手术组之间的副甲状腺激素 (PTH) 水平和补充需求的差异.
主要方法:
- 使用TrinetX非识别患者数据库进行的回顾性队列研究.
- 分析包括接受TL的患者,包括带有或没有甲状腺切除术或全甲状腺切除术的患者.
- 多变量后勤回归被用来比较低血症,低PTH和补充剂的比率.
主要成果:
- 经过全甲状腺切除术进行TL治疗的患者在术后0-1,1-6和6-12个月出现显著更高的低血病率,与单独进行TL治疗相比 (ORs从2.63到5.08).
- 在同一术后期间,在全甲状腺切除组中也观察到低PTH水平的增加率 (ORs从3.47到5.13不等).
- 在手术后补充的情况更为频繁的是,在1-6个月和6-12个月的患者中,全甲状腺切除术与单独的TL相比.
结论:
- 整体甲状腺切除术与TL相结合会增加术后低血症的风险.
- 增加对PTH监测的重视和多学科的管理策略对于接受TL的患者来说至关重要 完全甲状腺切除术以减轻与副甲状腺损伤相关的风险.
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