Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Endocrine Surgery, National University Hospital, Singapore.
Head Neck. 2019 May;41(5):1463-1467. doi: 10.1002/hed.25592. Epub 2018 Dec 30.
Thyroxine replacement following a hemithyroidectomy is not commonly discussed during consent for the procedure as the risk of hypothyroidism is perceived to be low.
Retrospective review of 901 patients who underwent hemithyroidectomy at a tertiary referral institution during the period January 2000 to December 2015. The main outcome studied was the overall incidence of hypothyroidism and the associated risk factors.
Hypothyroidism developed in 123 (13%) patients and 94 patients (10%) required hormone supplementation over a mean follow up of 21 months (range 1-168 months). Preoperative TSH of more than 2.5 was seen in 38 of 123 (31%) of patients. Presence of diffuse thyroiditis was the only independent risk factor on multivariate analysis (P = 0.002) found to be associated with the development of hypothyroidism.
After thyroid lobectomy, approximately one in 10 patients requiring thyroid hormone treatment for hypothyroidism. Presence of diffuse thyroiditis is a significant risk factor for hypothyroidism.
甲状腺叶切除术后的甲状腺素替代治疗在该手术的知情同意过程中通常不被讨论，因为人们认为甲状腺功能减退症的风险较低。
回顾性分析了 2000 年 1 月至 2015 年 12 月期间在一家三级转诊机构接受甲状腺叶切除术的 901 例患者。主要研究结果是甲状腺功能减退症的总发生率及其相关危险因素。
123 例（13%）患者出现甲状腺功能减退症，94 例（10%）患者在平均 21 个月（范围 1-168 个月）的随访中需要激素补充治疗。123 例患者中有 38 例（31%）术前 TSH 超过 2.5。多变量分析发现弥漫性甲状腺炎是唯一与甲状腺功能减退症发生相关的独立危险因素（P=0.002）。
甲状腺叶切除术后，约每 10 例患者中就有 1 例需要甲状腺激素治疗甲状腺功能减退症。弥漫性甲状腺炎是甲状腺功能减退症的一个重要危险因素。
