在患有原发性副甲状腺症的患者中对外科骨密度的评估
Michael J Kirsch1, Elizabeth M Stoeckl2, Antony Aziz2
1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
The Journal of surgical research
|December 6, 2024
概括
对于原发性副甲状腺症 (PHPT) 患者的骨密度查指南的遵守率很低,不到一半接受了推的手术前双能X射线吸收计 (DEXA) 扫描. 这凸显了需要在PHPT中改善骨质疏松症的检测和管理.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 外科手术的结果
背景情况:
- 原发性偏甲状腺症 (PHPT) 与骨质疏松症和骨折风险的增加有关.
- 国家指南建议在PHPT患者中使用双能X射线吸收计 (DEXA) 进行骨矿物质密度 (BMD) 评估.
- 目前对这些DEXA查指南的遵守程度不足于最佳水平.
研究的目的:
- 评估PHPT患者遵守DEXA扫描指南的情况.
- 确定影响使用术前和术后DEXA扫描的因素.
- 评估遵守指南对骨质疏松症检测的影响.
主要方法:
- 在2000年至2018年间接受手术的3384名PHPT患者的回顾性审查.
- 对手术前和手术后的DEXA扫描实践进行分析.
- 统计分析以确定DEXA扫描粘附的预测因素.
主要成果:
- 只有45.4%的PHPT患者接受了手术前的DEXA扫描.
- 女性,老年患者 (≥65岁),以及有骨痛或骨折史的人更有可能接受手术前的DEXA.
- 在没有进行手术前扫描的患者中,术后的DEXA扫描不常见 (13.8%).
结论:
- 在遵守国家对PHPT患者的DEXA查指南方面存在重大差距.
- 骨质疏松症的低查可能会导致患者的发病率增加.
- 临床实践需要改进,以与PHPT管理的推最佳实践保持一致.
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