在整体甲状腺切除术后,对甲状腺腺的外科治疗和对甲状腺功能的长期结果
Feng-Yu Chiang1,2, Kang Dae Lee3, Kyung Tae4
1Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung 824, Taiwan.
Diagnostics (Basel, Switzerland)
|March 13, 2025
概括
在甲状腺手术期间,在位保存副甲状腺 (PGs) 是至关重要的. 一个简单的刺伤测试有助于外科医生评估PG活力,显著降低了全甲状腺切除术后永久性甲状腺缺陷的发生率.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 神经外科 神经外科
背景情况:
- 在位置保存是甲状腺外科手术期间甲状腺前腺 (PG) 功能的主要策略.
- 自体移植仅适用于意外移除或脱细胞化的病例.
- 对于暴露的PG来说,内部决策仍然是一个挑战.
研究的目的:
- 为了评估外科手术时副甲状腺的治疗策略.
- 评估甲状腺全切除术后副甲状腺功能的长期结果.
- 为了确定刺伤试验在指导手术内PG管理中的有效性.
主要方法:
- 对543名接受全甲状腺切除术的患者进行了回顾性研究.
- 一个刺伤测试评估了暴露PG的血管供应.
- 在术后和随访期间监测完整的副甲状腺激素 (iPTH) 和电离 (iCa) 水平.
- 永久性偏偏甲状腺症 (PHPS) 通过特定的IPTH,iCa水平或手术后12个月的补充需求来定义.
主要成果:
- 五名患者 (0.95%) 在手术后12个月经历了永久性偏偏甲状腺症 (PHPS).
- 至少有一种可生存的PG在现场保存的患者的PHPS率为0.2%.
- 没有在现场保存的可活性PG的患者的PHPS率为6.1% (p < 0.001).
结论:
- 永久性副甲状腺功能低下症很少见,当至少有一个可行的副甲状腺在现场被保存时.
- 刺伤测试是一种简单,有用和具有成本效益的方法,用于评估PG血管供应.
- 刺伤试验为在全甲状腺切除术期间的手术内PG管理提供了必要的信息.
相关概念视频
The Parathyroid Glands
1.8K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
1.8K
Hormones and Bone Tissue
2.5K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.5K
Skeleton and Calcium Homeostasis
4.3K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.3K
Appendicitis-II: Diagnostic Studies and Management
54
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
54
Chronic Pancreatitis II: Collaborative Care
54
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
54


