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甲状腺切除术后术后并发症的预测因素:系统性审查

Philip Kw Hong¹, Aman Pathak², Aditya S Shirali³

¹Department of Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.

Surgery in practice and science

|January 23, 2025

概括

甲状腺切除术并发症的预测因子被不均地研究,大多数研究集中在低血症和低甲状腺瘤症上. 未来的模型应该包含更广泛的预测因素,以改善风险评估.

科学领域:

内分泌学在内分泌学.
手术瘤学手术瘤学
临床生物信息学临床生物信息学

背景情况:

甲状腺切除术是一种常见的手术,并发症率通常较低.
确定术后并发症的预测因素对于改善共享决策和患者结果至关重要.
生物信息学的进步为改善外科手术决策支持提供了潜力.

研究的目的:

系统地审查和评估目前对预测甲状腺切除术后术后并发症的因素的理解.
在各种甲状腺切除术并发症中识别共同和独立的预测因子.
突出研究差距,并指导未来的研究在甲状腺切除术的预测建模.

主要方法:

在PubMed/MEDLINE,科学网和EMBASE (2010年至2023年10月) 的系统文献搜索.
包括调查低血症,低甲状腺症,声带 (VCP),血液瘤或其他并发症的预测因素的研究.
排除仅依赖于单变量和ROC分析的研究;评估独立预测因子,分为生化,手术和患者/疾病特异性.

主要成果:

包含了45项研究,重点关注低血症 (15.7-76.7%) 和低甲状腺症 (12.9-53.8%).
生物化学标志物 (血清,甲状腺激素) 是这两种并发症的常见预测因素.
手术因素 (例如,无意的副甲状腺切除术),年龄,性别和甲状腺病理也被确定为常见的预测因素.

结论:

在甲状腺切除术并发症预测因子的研究中存在显著差异,仅限于VCP,血瘤和死亡率.
缺乏高质量的证据,特别是来自前性和随机对照试验的证据,需要进一步调查.
未来的研究应该将更广泛的独立预测因素,特别是手术因素,整合到全面的模型中,以改善风险预测.

关键词:

术后并发症术后并发症预测者预测者甲状腺手术甲状腺手术

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