甲状旁腺切除术中术中甲状旁腺激素监测：预测三级甲状旁腺功能亢进的治愈和复发-系统综述

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2025-03-11 DOI:10.1016/j.amjoto.2025.104609

Kevin P.J. Finnegan, Gavin P. Dowling, Sami Abd El Wahab , Arnold D.K. Hill

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引用次数: 0

摘要

目的探讨术中监测甲状旁腺激素（IOPTH）对预测三期甲状旁腺功能亢进（THPT）患者的治愈和复发的价值。数据来源ovid， Embase， EBSCO主机，引文检查。方法本研究按照PRISMA指南进行。对文献进行了系统的检索，以确定评估THPT患者IOPTH监测的研究。我们只纳入了有记录的手术中使用IOPTH治疗THPT的研究。结果在本综述纳入的18项研究中，有11项研究的IOPTH监测通过发现切除不足或需要进一步切除的异位/多余腺体来影响手术。在规定的时间间隔内达到适当IOPTH滴注的患者复发率不存在或极低。结论iopth监测是预防增生腺体切除不足和鉴别异位/多余腺体的有效辅助手段。在特定的时间间隔内，中位PTH下降可以帮助预测甲状旁腺切除术中THPT的治愈和复发。

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Intraoperative parathyroid hormone monitoring in parathyroidectomy: Predicting cure and recurrence in tertiary hyperparathyroidism - systematic review

Objective

The aim of this systematic review was to investigate the value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for tertiary hyperparathyroidism (THPT) to predict cure and recurrence.

Data sources

Ovid, Embase, EBSCO Host, Citation Checking.

Methods

This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies evaluating IOPTH monitoring in patients with THPT. Only studies addressing THPT with documented use of IOPTH in their surgery were included.

Results

In 11 of the 18 studies included in this review IOPTH monitoring influenced the surgery by identifying insufficient resection or ectopic/supernumerary glands necessitating further resection to cure patients. Rates of recurrence were absent or minimal in patients who achieved appropriate IOPTH drops at specified time intervals.

Conclusion

IOPTH monitoring is a useful adjunct to prevent insufficient resection of hyperplastic glands and to identify ectopic/supernumerary glands. Median PTH drop at specified time intervals can help predict cure and recurrence in parathyroidectomy for THPT.

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来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

期刊介绍： Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.