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在全喉切除术患者的甲状腺刺激激素检测和结果
James D Warren1, Kacie R Oglesby2, Carlton R Homan3
1School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
The Annals of otology, rhinology, and laryngology
|February 17, 2025
概括
在全喉切除术 (TL) 期间切除甲状腺与较高的甲状腺刺激激素 (TSH) 水平和甲状腺功能低下有关. 由于推迟的TSH测试和高的甲状腺功能低下率,在TL后监测甲状腺功能至关重要.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 全喉切除术 (TL) 是针对晚期喉癌的手术程序.
- 在TL期间操纵或切除甲状腺会影响甲状腺功能.
- 手术后的甲状腺功能障碍需要仔细监测和管理.
研究的目的:
- 评估TL后甲状腺刺激激素 (TSH) 测试的时间和患病率.
- 为了确定术后甲状腺功能低下症的发生率.
- 调查甲状腺切除术,甲状腺功能低下症和喉皮质 (PCF) 等伤口并发症之间的关联.
主要方法:
- 在两个三级保健中心 (2013-2021) 接受TL的成年患者的回顾性图表审查.
- 收集人口统计数据,术后实验室结果和术后结果.
- 统计分析以确定关联和重要因素.
主要成果:
- 237名患者中有65.8%的甲状腺被切除;56.1%的患者接受了甲状腺切除术.
- 在58.6%的受试患者中出现了手术后的甲状腺功能低下症.
- 术后提升的TSH与部分或全部的甲状腺切除显著相关 (OR=2.631).
- 平均TSH测试间隔为222天,根据年龄,性别,PCF,辐射史和levothyroxine使用情况有显著差异.
结论:
- 在TL期间的甲状腺切除与术后的TSH水平增加有关.
- 该研究强调了对TL患者甲状腺功能监测的重要性,原因是测试延迟和甲状腺功能低下率高.
- 在临床上适当时,可以考虑避免在TL期间切除甲状腺.
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