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甲状腺切除术在有症状,无甲状腺哈希莫托病患者的结果:一个病例对照研究
Hazel Serrao-Brown1, Amna Saadi1, Jessica Wong1
1Department of Endocrine Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
ANZ journal of surgery
|July 16, 2024
概括
整体甲状腺切除术 (TT) 可以改善症状哈西莫托甲状腺炎 (HT) 患者的生活质量,即使甲状腺功能良好. 这种手术是安全有效的,可以缓解耐火性症状,而不会增加并发症风险.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 生活质量研究 研究 生命质量研究
背景情况:
- 哈西莫托的甲状腺炎 (HT) 管理通常涉及甲状腺激素的替代.
- 一部分HT患者经历了持续的症状,对药物无反应.
- 甲状腺切除术 (TT) 可能缓解耐火症症状,但由于感知到的风险和有限的生活质量 (QoL) 数据,手术不情愿存在.
研究的目的:
- 分析经过TT的症状性,无甲状腺性HT患者的结局和QoL得分.
- 为了比较HT患者的TT结局与多节 (MNG) 患者的TT结局.
主要方法:
- 对30名接受了TT (2017-2022) 的优甲状腺HT患者进行了回顾性病例对照研究.
- 接受TT的MNG患者的年龄匹配的对照组.
- 人口统计,生物化学,组织学,结果和手术前/后SF-36和ThyPRO-39QOL分数的比较.
主要成果:
- 在HT组没有手术并发症;在MNG组有两个并发症.
- 类似的副甲状腺自移植率,在HT组中移植的腺体更多.
- 在HT组中,TT后的QoL得分 (甲状腺过高症状,社会和日常生活) 显著改善.
- 在HT组中,TT后抗TPO,抗TG和TSH水平的显著变化.
结论:
- 尽管目前使用率不足,但有症状的无甲状腺型HT患者可能会从TT中受益.
- TT与更好的验证的QoL得分有关.
- 在适当选择的HT患者中,TT与增加的并发症率无关.
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