谁在诊断儿童甲状腺结节? 一个三级儿童医院审查
Joy M Justice1, Janavi Sethurathnam1, Nanda Nayak1
1Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
概括
初级保健提供者是诊断儿科甲状腺结节的关键,经常通过体检检测到. 与其他专家相比,他们的诊断与较大的结节大小和更频繁的恶性瘤发现有关.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 在瘤学瘤学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 儿童甲状腺癌的发病率正在上升.
- 了解不同医疗保健提供者在诊断儿科甲状腺结节方面的作用,对于优化患者护理至关重要.
- 关于提供者类型如何影响结节的检测和后续管理的数据有限.
研究的目的:
- 分析医疗保健提供者诊断小儿甲状腺结节的类型.
- 调查诊断提供者类型对结节大小和临床管理的影响.
- 检查不同类型的提供者使用的诊断方法.
主要方法:
- 2006年至2023年间诊断出甲状腺结节的儿科患者 (0-17岁) 的回顾性图表审查.
- 诊断提供者类型,诊断方法,结节大小,临床管理和最终诊断的分析.
- 根据提供者专业 (例如,初级保健,内分泌学,放射学) 的发现进行比较.
主要成果:
- 主要护理人员诊断出大多数结节 (43.0%),通常是通过体检.
- 初级保健提供者诊断的结节比内分泌学家或放射学家诊断的结节更大 (中位数为1.50厘米),并且比内分泌学家或放射学家诊断的结节更频繁地导致活检,手术或恶性诊断.
- 放射科医生偶然诊断的结节的比例在2017年后显著增加.
结论:
- 初级保健提供者在儿童甲状腺结节的初始检测中发挥着至关重要的作用.
- 身体检查仍然是识别儿童显著甲状腺病理的一个重要工具.
- 需要进一步的研究来探索影响结节管理的社会经济地位和地理位置等因素.
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