Amit Ritter, Yonatan Reuven, Nir Tsur, Dean Dudkiewicz, Aviram Mizrachi, Thomas Shpitzer, Gideon Bachar, Roy Hod
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引用次数: 0
摘要
目的：很少有研究报道儿童甲状腺切除术后甲状旁腺功能低下（HPT）的危险因素。我们的目的是确定儿科患者甲状腺全切除术后短暂性和永久性HPT的预测因素。研究设计：回顾性分析医学图表。单位：第三大学附属医疗中心。方法：对2001年至2019年间接受甲状腺手术的所有儿童进行回顾性研究。结果：纳入70例患者。16例（23%）患者术后发生HPT: 10例（14%）暂时性HPT， 6例（9%）永久性HPT。中央室颈部剥离、较大结节大小、恶性疾病和甲状腺外展（ETE）与总体HPT相关。te （p = 0.034）和诊断时年龄较小（中位数10.5 vs 14.5岁，p = 0.035）与永久性HPT相关。一些钙指标与永久性HPT相关，包括首次钙水平、最低钙水平和术后钙水平下降。结论：年龄在10.5岁以下的患者和那些表现为ETE的患者在全甲状腺切除术后有发生永久性HPT的潜在风险。术后钙水平可能作为永久性HPT的预测指标，在决定钙监测和补充时应予以考虑。
Potential determinants and predictors of hypoparathyroidism after total thyroidectomy in pediatric patients.
Objective: Few studies have reported risk factors for post-thyroidectomy hypoparathyroidism (HPT) in children. We aimed to identify predicting factors for transient and permanent HPT after total thyroidectomy in pediatric patients.
Study design: Retrospective review of medical charts.
Setting: A tertiary university-affiliated medical center.
Methods: A retrospective study of all children who underwent thyroid surgery between 2001 and 2019.
Results: The study included 70 patients. Sixteen patients (23%) had postoperative HPT: 10 transient (14%) and 6 permanent (9%). Central compartment neck dissection, larger nodular size, malignant disease, and extrathyroidal extension (ETE) were associated with overall HPT. ETE (p = 0.034) and younger age at diagnosis (median 10.5 vs. 14.5 years, p = 0.035) were associated with permanent HPT. Several calcium indices were associated with permanent HPT, including first calcium level, minimal calcium level, and the decrease in calcium level after surgery.
Conclusions: Patients under 10.5 years of age and those presenting with ETE are at potential risk of developing permanent HPT after total thyroidectomy. Postoperative calcium levels may have a role as a predictor of permanent HPT and should be considered in the decision on calcium monitoring and supplementation.
期刊介绍：
Official Journal of
European Union of Medical Specialists – ORL Section and Board
Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery
"European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level.
European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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