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原发性甲状腺功能障碍症及其变体的算法外科管理:一个范围审查
Fleur Kabala1, Todd Falcone2, Kourosh Parham2
1University of Connecticut School of Medicine, Farmington, Connecticut, USA.
The Laryngoscope
|January 23, 2026
概括
这项研究比较了经典和变异性原发性副甲状腺症 (PHPT) 管理. 准确的成像和手术内甲状腺激素 (IOPTH) 监测对于所有PHPT表现中的成功手术结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 手术管理的手术管理.
- 医疗决策 - - 医疗决策
背景情况:
- 初级偏甲状腺症 (PHPT) 呈现出各种不同的临床表现.
- 成功的外科管理需要将当前的文献纳入决策框架.
- 变体形式,包括常态血性甲状腺功能障碍症 (NCPHPT) 和常态荷尔蒙性甲状腺功能障碍症 (NHPHPT),与经典的PHPT (CPHPT) 相比,存在独特的挑战.
研究的目的:
- 为了比较变体PHPT (NCPHPT,NHPHPT) 与经典PHPT (CPHPT) 的诊断工作和治疗策略.
- 评估局部化研究,外科考虑,手术内甲状腺激素 (IOPTH) 监测的实用性,以及监测协议.
- 识别阻碍变种PHPT呈现的最佳管理的知识差距.
主要方法:
- 从2024年6月11日到2025年3月17日,PubMed和谷歌学者进行了系统的文献搜索.
- 包括对成人PHPT手术管理进行同行评审的英语研究,遵守PRISMA ScR指南.
- 在由两位审查员进行独立选后,包括了27项研究;数据被综合起来以指导未来的研究.
主要成果:
- 4D计算机断层扫描 (4DCT) 和正子发射断层扫描 (PET) 扫描在经典和变体PHPT中显示出成像的最高准确性,特别是在多腺体疾病中.
- 手术后未能达到IOPTH水平降低≥50%或维持水平低于40 pg/mL,这些都是持续性或复发性甲状腺功能障碍症的风险因素.
结论:
- PHPT展示了各种各样的演示方式,需要定制的管理方法.
- 本次审查确定了需要进一步调查的关键知识差距,以提高PHPT变体患者的护理.
- 建议对总结的算法方法进行前性验证,以改善长期患者的治疗结果.
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