诊断评估,风险分层和甲状腺疾病的外科手术前管理策略
Oskar Patryk Gąsiorowski1, Joanna Kaszczewska1, Julia Tarnowska1
1DEPARTMENT OF GENERAL, VASCULAR, ENDOCRINE AND TRANSPLANT SURGERY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND.
概括
本综述概述了什么时候进行选择性甲状腺手术以及手术前后管理患者的最佳策略. 最佳的结节管理受到先进诊断的有限访问的挑战.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 甲状腺疾病,包括格雷夫斯病和各种形式的甲状腺功能过高和甲状腺功能低下症,需要谨慎的管理策略.
- 甲状腺疾病的外科干预适用于有症状的结节,不确定的或恶性细胞学结果 (Bethesda III-VI) 和压缩症状.
研究的目的:
- 为了划出选择性甲状腺手术的指示.
- 为患有甲状腺疾病的患者定义外科临床策略.
主要方法:
- 对2005年6月至2024年1月的出版物进行了全面的文献审查.
- 搜索的数据库包括PubMed,Scopus,科学网和科克兰图书馆.
- 评估涉及超声导向细针吸收 (FNA) 和EU-TIRADS风险分层,并补充了对不确定的细胞学的分子测试.
主要成果:
- 甲状腺切除术的关键指示包括症状结节,不确定的/恶性细胞学和压缩症状.
- 管理策略应对潜在的并发症,如出血,小甲状腺功能障碍和喉神经复发性损伤.
- 术后监测对于低热血症,声音变化和出血至关重要.
结论:
- 先进的甲状腺诊断的广泛采用受到资源限制的限制.
- 这些局限性给实现最佳甲状腺结节管理带来了挑战.
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