探索甲状腺切除术前血酶在治疗甲状腺毒性病中的作用:综合范围审查
Weronika Koziak1, Stanisław Dudek1, Zbigniew Putowski2
12nd Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland.
概括
治疗性血交换 (TPE) 在甲状腺切除术前有效降低甲状腺激素水平. 新鲜冷血 (FFP) 可能是首选的,以尽量减少在这种桥梁治疗期间出血的风险.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
背景情况:
- 甲状腺风暴是一种严重的甲状腺毒理症并发症,需要进行甲状腺切除术以获得最终治疗.
- 治疗性血交换 (TPE) 是对标准治疗无反应的患者的最后手段.
- 关于TPE作为甲状腺切除术的桥梁的疗效的数据有限.
研究的目的:
- 对TPE作为甲状腺切除术的桥梁治疗在甲状腺毒性病的使用进行范围审查.
- 评估TPE在降低甲状腺激素水平及其相关副作用方面的有效性.
主要方法:
- 在Medline,EMBASE,Web of Science和Google Scholar进行了全面的文献搜索,截至2023年11月30日.
- 确定了1047个记录,其中包括42篇文章和234名患者.
- 提取了关于TPE指示,激素水平变化和副作用的数据.
主要成果:
- 对TPE的首要症状是传统治疗的副作用.
- TPE显著降低了甲状腺激素水平,平均fT4降低了51.9%,平均fT3降低了66.6%.
- 副作用包括新鲜冷血 (FFP) 的过敏反应和与专蛋白的术后出血.
结论:
- 在甲状腺毒性病的甲状腺切除术前,血激活是降低甲状腺激素水平的有效选择.
- 限制TPE疗程可能允许更早的外科干预.
- 建议使用FFP作为替代液体,以减轻出血风险,特别是在手术前.
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