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先天性甲状腺功能减退症初始诊断与治疗中的医疗服务提供者差异。

Provider variability in the initial diagnosis and treatment of congenital hypothyroidism.

作者信息

Cielonko Luke, Hamby Tyler, Dallas John S, Hamilton Luke, Wilson Don P

出版信息

J Pediatr Endocrinol Metab. 2017 May 1;30(5):583-586. doi: 10.1515/jpem-2016-0326.

Abstract

BACKGROUND

Early diagnosis and expeditious treatment of newborns with congenital hypothyroidism (CH) is necessary to avoid mental retardation.

METHODS

A survey of 44 practitioners in the southern US was conducted to better understand common practices regarding neonatal CH and the findings were compared with current guidelines in the US and Europe.

RESULTS

Responses indicated some consensus that 10-15 μg of thyroid hormone/kg/day was the appropriate dosage. However, despite guidelines advocating their use, practitioners reported that they did not commonly use imaging or laboratory tests, though experienced providers apparently used them more often.

CONCLUSIONS

Together, these results show moderate adherence to published guidelines for treating and diagnosing CH. Further research is needed to determine why providers deviate from these guidelines and to generalize these results to other populations.

摘要

背景

对先天性甲状腺功能减退症(CH)新生儿进行早期诊断和快速治疗对于避免智力发育迟缓是必要的。

方法

对美国南部的44名从业者进行了一项调查,以更好地了解关于新生儿CH的常见做法,并将结果与美国和欧洲的现行指南进行比较。

结果

调查结果显示,对于甲状腺激素每日剂量为10 - 15μg/千克体重这一适宜用量,存在一定共识。然而,尽管指南提倡使用影像学或实验室检查,但从业者报告称他们并不常用这些检查,不过经验丰富的从业者显然使用得更频繁一些。

结论

总体而言,这些结果表明在治疗和诊断CH方面对已发表指南的遵循程度一般。需要进一步研究以确定从业者偏离这些指南的原因,并将这些结果推广至其他人群。

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