甲状腺全切除术后的低血症:与甲状腺激素导向的和酸补充方案的十年,单一机构的经验
Ana-Maria Chindris1, Rockey Dahiya2, Michael G Heckman3
1Department of Endocrinology, Mayo Clinic, Jacksonville, Florida.
概括
一个副甲状腺激素 (PTH) 引导的协议显著降低了全甲状腺切除术 (TT) 后的低血症. 这种方法有效地管理 (Ca) 和醇补充剂,降低了医院再入院.
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:
- 甲状腺切除术后的低血是常见的并发症.
- 目前对 (Ca) 和醇补充剂的管理策略各不相同.
- 副甲状腺激素 (PTH) 水平可以预测低血症风险.
研究的目的:
- 为了评估10年的经验,以PTH引导的Ca和酸补充方案.
- 评估该方案在完全甲状腺切除术 (TT) 后减少低血症发病率方面的有效性.
主要方法:
- 对883名接受TT的患者进行了回顾性图表审查.
- 实施一个为期4小时的PTH指导协议,用于Ca和酸的管理.
- 根据PTH水平将患者分为低血症风险组的分层.
主要成果:
- 治疗后的低血症发生率从20.9%降至9.9% (P < .001).
- 相关的再接收人数从4.7%下降到0.9% (P = .004).
- 确定了危险因素:淋巴结解剖和嵌入在甲状腺组织中的副甲状腺.
结论:
- 一个以PTH为指导的补充方案显著降低了TT后的低血症.
- 该协议还降低了相关的医院再入院.
- 这种方法可能有利于TT患者的门诊治疗.
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