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在总甲状腺切除术中用Lugol的溶液进行预治疗,用于Graves病和有毒的多元囊:它仍然适用吗?
D Ciriotto1,2, S Bernardi2,3, R Eramo1
1Division of General Surgery, ASUGI, Cattinara Teaching Hospital, Trieste, Italy.
Updates in surgery
|December 19, 2025
概括
在甲状腺切除手术前用Lugol的溶液 (LS) 进行预治疗,以治疗格雷夫斯病或有毒多元囊,对手术结果没有显著的益处. 对于所有接受全甲状腺切除术的患者来说,常规的LS使用可能不是强制性的.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 甲状腺手术 甲状腺手术
背景情况:
- 卢戈尔溶液 (LS) 传统上用于甲状腺在总甲状腺切除术前在Graves病 (GD) 和有毒多元 (TMNG) 中进行甲状腺准备.
- 对于LS前期治疗的必要性和有效性仍有争议,这促使人们对其对手术和术后结果的影响进行调查.
研究的目的:
- 评估和比较GD和TMNG全甲状腺切除术的患者的手术和术后结果,有或没有Lugol的溶液前期治疗.
- 确定是否常规的手术前LS准备对于优化这些特定甲状腺疾病患者的结果至关重要.
主要方法:
- 在2014年至2024年期间,对100名为GD和TMNG进行了全甲状腺切除术的患者进行了回顾性分析.
- 患者被分为两组:Lugol+ (用LS预先治疗,n=57) 和Lugol- (没有预先治疗,n=43).
- 分析的关键变量包括手术时间,甲状腺体重,手术后出血,低热血症,复发性喉神经麻和住院时间.
主要成果:
- 在Lugol+和Lugol-组之间,在术后出血,手术时间或短暂的缺甲状腺症和复发性喉神经麻等即时并发症方面没有观察到统计学上显著的差异.
- 术后出血 (1.7%对2.3%) 和过渡性RLN (3.5%对2.3%) 等特定并发症的发生率没有显著差异.
- 甲状腺直径,体重,停留时间和重新干预率的分析也显示,两组之间没有显著差异.
结论:
- 对于接受全甲状腺切除术的患有格雷夫斯病和有毒多节的患者,使用Lugol溶液进行例行手术前准备可能不是强制性的.
- 由于可用性,时间限制或合规问题无法接受LS的患者仍然可以被认为有资格接受手术,结果可比.
- 这项研究表明,在特定的甲状腺切除术患者群体中,可能会从强制使用LS转移.
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