术内干预对全甲状腺切除术后低血症的影响:元分析
Hao-Wei Hsu1, Sheng-Hsin Huang2, Shao Huai Lee3
1Department of Education, Taipei Veterans General Hospital, Taipei, Taiwan.
概括
近红外自光学 (NIRAF) 和绿色血管学 (ICGA) 降低了全甲状腺切除术 (TT) 后的低血症. 副甲状腺自移植 (PTA) 没有显示类似的益处,需要进一步研究组合技术.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 医疗成像医学成像
背景情况:
- 手术后的低血是完全甲状腺切除术 (TT) 后的常见并发症,影响患者的生活质量.
- 为了最大限度地降低这种风险,最优的手术内策略仍在调查中.
研究的目的:
- 评估甲状腺附带腺体自移植 (PTA),近红外自光 (NIRAF) 和氨酸绿色血管学 (ICGA) 在预防 TT 后低血症的有效性.
- 为了比较不同手术内干预的过渡性和永久性低血症的发生率.
主要方法:
- 根据PRISMA指南进行了一项元分析,搜索PubMed,Embase和Cochrane图书馆,直到2024年2月.
- 包括的研究涉及患者接受TT与或没有PTA,NIRAF,ICGA或组合方法.
- 测量的主要结局是术后过渡性和永久性低血症的发生率.
主要成果:
- 对包括13,299名患者在内的32项研究的分析表明,PTA与过渡性低血症的风险增加有关 (OR = 1.98).
- 相反,NIRAF (OR = 0.45) 和ICGA (OR = 0.22) 显著降低了短暂低血的发生率.
- 综合NIRAF和ICGA方法显示不确定的结果 (OR = 0.62),干预措施对永久性低血症的影响最小.
结论:
- 术内NIRAF和ICGA在降低TT后过渡性低血症方面是有效的.
- PTA没有在减少术后低血症方面表现出有效性.
- 进一步的研究是有必要的,以澄清NIRAF和ICGA技术结合的好处.
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