在性副甲状腺功能障碍症的手术治疗中,实践模式的变化
Sophie Dream1, Ryan Conrardy2, Jennifer Kuo3
1Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Surgery
|October 20, 2024
概括
大多数外科医生每年对二次和三次性甲状腺功能障碍症进行的甲状腺膜切除术少于10次. 副全额甲状腺切除术是常见的,但实践模式各不相同,突出显示需要传播指南以改善患者护理.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 手术瘤学手术瘤学
背景情况:
- 过甲状腺功能障碍在患有慢性病,末期病和移植后的患者中普遍存在.
- 美国内分泌外科协会发布了二次和三次性甲状腺功能障碍症外科治疗的临床实践指南.
研究的目的:
- 评估目前对二次和三次性甲状腺功能障碍症的外科治疗的实践模式.
- 在发布新的临床指南之前评估外科决策.
主要方法:
- 一个Qualtrics电子邮件调查在2022年分发给美国内分泌外科协会的成员.
- 受访者按外科子专业,每年副甲状腺切除体积和二级/三级副甲状腺功能障碍手术的特定体积进行分类.
- 进行了描述性统计和对手术体积作用的分析.
主要成果:
- 收到了142个回答 (18%的响应率),其中84%的人认为自己是内分泌外科医生.
- 大多数外科医生每年为二级和三级甲状腺功能障碍症 (53.7%) 进行不到10次甲状腺切除术.
- 副全甲状腺切除术是最常见的手术,但在手术前管理 (calcitriol,cinacalcet) 和手术后护理方面缺乏共识,包括低血症方案和手术内甲状腺激素监测.
结论:
- 很大一部分外科医生每年对二次和三次性副甲状腺功能障碍进行有限的手术.
- 副全额甲状腺切除术经常使用,但在外科手术期间的管理策略中存在相当大的差异.
- 已确立的指导方针的传播为标准化和改善为甲状腺功能障碍症进行手术治疗的患者的护理提供了机会.
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