Department of Otolaryngology, Augusta University, Augusta, Georgia.
Department of Nephrology, Augusta University, Augusta, Georgia.
Head Neck. 2019 Apr;41(4):880-884. doi: 10.1002/hed.25413. Epub 2019 Jan 21.
Patients who require surgery for renal hyperparathyroidism represent a special population that is at high risk for postoperative complications. To optimize their treatment, we developed a multidisciplinary approach to the perioperative management of these patients undergoing parathyroidectomy.
The Augusta University endocrine surgery parathyroid database was interrogated to identify dialysis-dependent patients undergoing parathyroidectomy from 2005 to 2015. Numerous clinical parameters were quantified. Patients were stratified into protocol patients and nonprotocol patients.
A total of 42 patients undergoing renal parathyroidectomy who met the inclusion criteria were identified. Serious adverse events were nearly twice as common in the patients not treated on protocol. The length of stay was nearly 2 days shorter in the protocol group. Lowest calcium level and ionized calcium was higher in the protocol cohort despite a lower postoperative parathyroid hormone. The protocol group had fewer laboratory draws.
Implementation of a multidisciplinary renal hyperparathyroidism protocol has resulted in improved perioperative outcomes.
需要手术治疗肾性甲状旁腺功能亢进症的患者是术后并发症风险较高的特殊人群。为了优化他们的治疗效果，我们制定了多学科方法来管理接受甲状旁腺切除术的此类患者。
我们查询了奥古斯塔大学内分泌外科的甲状旁腺数据库，以确定 2005 年至 2015 年期间正在接受透析的甲状旁腺切除术患者。对众多临床参数进行了量化。患者分为协议患者和非协议患者。
确定了符合纳入标准的 42 名接受肾甲状旁腺切除术的患者。未按方案治疗的患者发生严重不良事件的可能性几乎是方案治疗患者的两倍。协议组的住院时间缩短了近 2 天。尽管术后甲状旁腺激素水平较低，但方案组的血钙和离子钙水平更高。协议组的实验室检测次数更少。
实施多学科肾性甲状旁腺功能亢进症方案已改善了围手术期结果。
