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甲状腺切除术后慢性乏力的患病率:一项前瞻性队列研究。

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study.

作者信息

Scerrino Gregorio, Melfa Giuseppina, Raspanti Cristina, Attard Andrea, Mazzola Sergio, Gullo Roberto, Bonventre Sebastiano, Attard Marco, Cocorullo Gianfranco, Gulotta Gaspare

机构信息

Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.

Unit of General and Thoracic Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.

出版信息

Langenbecks Arch Surg. 2017 Nov;402(7):1095-1102. doi: 10.1007/s00423-017-1568-7. Epub 2017 Mar 15.

Abstract

PURPOSE

Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors.

METHODS

A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre- and post-operative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy.

RESULTS

One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery.

CONCLUSIONS

CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.

摘要

目的

一些接受甲状腺手术的患者会主诉慢性乏力(CA)。我们评估其对接受单侧或双侧甲状腺切除术患者的影响、1年随访期间的变化趋势以及可能的风险因素。

方法

对2012年至2014年计划接受甲状腺切除术的263例患者进行了一项前瞻性队列研究。排除标准如下:格雷夫斯病、需要放射性碘治疗的恶性肿瘤、术后甲状旁腺功能减退、喉返神经麻痹、术前和术后甲状腺激素水平异常以及体重指数不在正常范围内。记录人口统计学资料;吸烟和酗酒情况;心脏、肺、肾和肝功能衰竭;糖尿病;焦虑和抑郁情况。采用简明疲劳量表(BFI)在甲状腺切除术后6个月和12个月评估CA及其与这些合并症的可能关联。

结果

177例患者接受了全甲状腺切除术(TT),54例接受了半甲状腺切除术(HT)。32例患者因出现排除标准而未记录。在甲状腺切除术后6个月,TT组有64例患者(36.16%)报告BFI评分受损,而HT组仅有1例。TT组的平均BFI评分从1.663(±1.191)变为2.16(±11.148),HT组从1.584(±1.371)变为1.171(±1.093)(p<0.001)。术后1年未报告BFI有进一步的显著变化。

结论

TT术后CA加重,但HT术后未加重。除手术操作本身外,未发现其他风险因素与甲状腺切除术后乏力显著相关。需要进一步研究以确定CA的原因。

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