College of Medicine, University of Nebraska, Omaha, Nebraska.
Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
J Surg Res. 2021 Aug;264:394-401. doi: 10.1016/j.jss.2021.02.039. Epub 2021 Apr 10.
After thyroidectomy some patients experience a chronic fatigue syndrome called asthenia. The purpose of this study was to determine the post-operative health related quality of life (HRQOL) and risk of asthenia in patients undergoing thyroidectomy.
A single institution prospective observational cohort study of adults undergoing thyroidectomy from September 2016 to July 2019 with four HRQOL surveys: preoperative baseline, 2 wk-, 6 mo- and 12 mo-postoperatively. Patients were surveyed using the Short Form 36 version 2 and Brief Fatigue Inventory. Asthenia was defined as Brief Fatigue Inventory > 60 at 12 mo. HRQOL was compared between patients undergoing thyroid lobectomy (TL) or total thyroidectomy (TT) with benign (-B) or malignant (-Ca) final pathology.
A total of 182 patients were included: 67 (37%) with TL-B, 32 (17%) with TL-Ca, 40 (22%) with TT-B, and 43 (24%) with TT-Ca. The incidence of asthenia was 42% for TT and 4% for TL. In the TL-B group, 2 patients (3%) developed asthenia, compared with 2 patients (6.25%) in the TL-Ca group, 14 patients (35%) in the TT-B group, and 21 (48.8%) in the TT-Ca group (P = 0.0001). The odds ratio of asthenia for TT compared to TL was 10.4 (95% CI 3.86-28.16) and for patients with malignancy compared to benign disease was 2.05 (95% CI 1.17-3.61).
Patients undergoing TT have a higher risk of developing asthenia than those undergoing TL, particularly if the final pathology shows malignancy.
甲状腺切除术后，一些患者会出现慢性疲劳综合征，称为乏力。本研究旨在确定行甲状腺切除术患者的术后健康相关生活质量（HRQOL）和乏力风险。
这是一项单中心前瞻性观察队列研究，纳入 2016 年 9 月至 2019 年 7 月期间行甲状腺切除术的成年人，共进行了 4 次 HRQOL 调查：术前基线、术后 2 周、6 个月和 12 个月。使用简明 36 项健康调查量表第 2 版和简短疲劳量表对患者进行调查。12 个月时使用简短疲劳量表评分>60 定义为乏力。比较甲状腺叶切除术（TL）或全甲状腺切除术（TT）与良性（-B）或恶性（-Ca）最终病理患者的 HRQOL。
共纳入 182 例患者：67 例（37%）行 TL-B、32 例（17%）行 TL-Ca、40 例（22%）行 TT-B 和 43 例（24%）行 TT-Ca。乏力的发生率为 TT 组 42%，TL 组 4%。在 TL-B 组中，2 例（3%）患者出现乏力，TL-Ca 组 2 例（6.25%），TT-B 组 14 例（35%），TT-Ca 组 21 例（48.8%）（P=0.0001）。与 TL 相比，TT 发生乏力的比值比为 10.4（95%CI 3.86-28.16），与良性疾病相比，恶性疾病的比值比为 2.05（95%CI 1.17-3.61）。
与 TL 相比，TT 患者发生乏力的风险更高，尤其是最终病理为恶性肿瘤时。
