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甲状腺切除术后暂时性甲状旁腺功能减退的真实发生率是多少?这是一个定义问题:系统评价。

What are the real rates of temporary hypoparathyroidism following thyroidectomy? It is a matter of definition: a systematic review.

机构信息

Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Heath Park Way, Cardiff, CF14 4XW, UK.

Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.

出版信息

Endocrine. 2021 Jul;73(1):1-7. doi: 10.1007/s12020-021-02663-8. Epub 2021 Mar 2.

Abstract

INTRODUCTION

Post-operative hypoparathyroidism is the most encountered complication of thyroid surgery and is classified as temporary or permanent. However, its incidence varies greatly in the literature ranging from 0.5% to 65%. This can be mainly attributed to the different definition of hypoparathyroidism used in each study and especially to the different time cutoff applied to distinguish temporary from permanent hypoparathyroidism.

METHODS

We conducted a systematic literature search in PubMed, Scopus, Cochrane and GoogleScholar databases, as well as grey literature. Ultimately, 45 articles with 23,164 patients in total were included in this review. These articles used either the cutoff of six or twelve post-operative months to distinguish temporary from permanent hypoparathyroidism.

RESULTS

The overall incidence of permanent hypoparathyroidism diagnosed at 6 months post-operatively was 4.11% and 4.08% at 12 months post-operatively. There was no statistically significant difference between the two groups (p = 0.92).

CONCLUSIONS

We suggest that adhering to the current guidelines that recommend diagnosing temporary hypoparathyroidism when recovery is made within 6 months after surgery is important when conducting future research in order to narrow the gap that exists currently in the literature, as well as when deciding to put patients on long-term calcium supplements.

摘要

简介

甲状旁腺功能减退症是甲状腺手术后最常见的并发症,可分为暂时性或永久性。然而,其在文献中的发生率差异很大,范围从 0.5%到 65%。这主要归因于每个研究中使用的不同甲状旁腺功能减退症定义,尤其是用于区分暂时性和永久性甲状旁腺功能减退症的不同时间截止点。

方法

我们在 PubMed、Scopus、Cochrane 和 GoogleScholar 数据库以及灰色文献中进行了系统的文献检索。最终,共有 45 篇文章,总计 23,164 例患者纳入本综述。这些文章使用术后 6 个月或 12 个月的时间截止点来区分暂时性和永久性甲状旁腺功能减退症。

结果

术后 6 个月诊断为永久性甲状旁腺功能减退症的总发生率为 4.11%,术后 12 个月为 4.08%。两组之间无统计学差异(p=0.92)。

结论

我们建议在进行未来研究时,遵循建议在手术后 6 个月内恢复时诊断为暂时性甲状旁腺功能减退症的现行指南非常重要,以便缩小目前文献中的差距,并在决定为患者长期补充钙时。

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