Khảo sát chức năng tuyến giáp sau phẫu thuật cắt bán phần tuyến giáp

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Tác giả: Quang Huy Nguyễn, Bích Nga Vũ

Ngôn ngữ: Vie

Ký hiệu phân loại: 617 Miscellaneous branches of medicine Surgery

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam) 2023

Mô tả vật lý: 356-360

Bộ sưu tập: Metadata

ID: 408431

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Tóm tắt
Chủ đề

Khảo sát chức năng tuyến giáp sau phẫu thuật cắt bán phần tuyến giáp. 2. Nhận xét một số yếu tố liên quan đến suy giáp sau phẫu thuật cắt bán phần tuyến giáp. Đối tượng nghiên cứu: Bệnh nhân đã phẫu thuật cắt bán phần tuyến giáp và khám tại Bệnh viện Đại học Y Hà Nội từ tháng 2/2022 đến tháng 9/2022. Bệnh nhân có kết quả giải phẫu bệnh sau phẫu thuật, được làm xét nghiệm đánh giá chức năng tuyến giáp và Anti TPO. Phương pháp: Mô tả cắt ngang, tiến cứu. Kết quả: 199 bệnh nhân được đưa vào nghiên cứu trong đó 87% là nữ giới, tuổi trung bình: 44,1 ± 12,53 (17-91). Tất cả bệnh nhân có chức năng tuyến giáp bình thường trước phẫu thuật. Sau phẫu thuật cắt bán phần tuyến giáp ít nhất 8 tuần tỉ lệ cường giáp, bình giáp, suy giáp lần lượt là 1,5%, 69,35% , 29,15% (20,1% suy giáp rõ và suy giáp có triệu chứng
9,04% suy giáp cận lâm sàng) với thời gian theo dõi trung bình 16,59 ± 14,77 (2-86) tháng. Liều levothyroxine bổ sung trung bình là 0,91 ± 0,4 microg/kg. TSH trước phẫu thuật (1,55 ± 0,81 vs 2,87 ± 0,85
P <
0,05)
Anti TPO sau phẫu thuật (20,11 ± 33,44 vs 46,65 ± 95,82
P <
0,05)
thể tích tuyến giáp bảo tồn (10,02 ± 4,41 vs 7,31 ± 4,19
p <
0,05) là những yếu tố liên quan đến suy giáp sau phẫu thuật. Tuổi, giới, thời gian theo dõi sau phẫu thuật, FT4 trước phẫu thuật, chẩn đoán trước phẫu thuật, biến chứng phẫu thuật, kết quả giải phẫu bệnh và phương pháp phẫu thuật không liên quan đến suy giáp sau phẫu thuật. Kết luận: Tỉ lệ cường giáp, bình giáp, suy giáp sau phẫu thuật cắt bán phần tuyến giáp lần lượt là 1,5%, 69,35% , 29,15%. Nồng độ TSH trước phẫu thuật
nồng độ Anti TPO sau phẫu thuật
thể tích tuyến giáp bảo tồn là những yếu tố liên quan đến suy giáp sau phẫu thuật cắt bán phần tuyến giáp., Tóm tắt tiếng anh, To survey thyroid function after hemithyroidectomy. To determinethe some factors that involved in development of hypothyroidism after hemithyroidectomy. Research subjects: Patients who received hemithyroidectomy follow - up examination between February 2022 and September 2022 in Hanoi Medical University Hospital was conducted. Thyroid specimens were examined for pathological diagnosis and thyroid function and thyroperoxidase antibody serum was evaluated. Method: Cross-sectional description. Results: 199 patients included in the study, 87% were women, mean age: 44,1 ± 12,53 (17-91). All had normal preoperative thyroid function. 1,5% patients pressented subclinical hypothyroidism
69,35% patients remained euthyroid
29,15% patients developed hypothyroidism (20,1% overt or symptomatic hypothyroidism and 9,04% subclinical hypothyroidism) with an average follow-up time of 16,59 ± 14,77 (2-86) months. The mean levothyroxine supplement dose was 0,91 ± 0,4 microg/kg per day. Preoperative high thyroid-stimulating hormone (TSH) level (1,55 ± 0,81 vs 2,87 ± 0,85
P: 0,05)
thyroperoxidase antibody serum levels (25,58 ± 44,42 vs 73,82 ± 124,97
P <
0,05)
and thyroid remnant volume (10,02 ± 4,41 vs 7,31 ± 4,19
p <
0,05) were significantly associated with postoperative hypothyroidism. Age, gender, follow-up time, preoperative free thyroxine, preoperative diagnosis, surgical methods, surgical complications and pathological diagnosis were not significant risk factors for hypothyroidism. Conclusion: After hemithyroidectomy, the prevalence of hyperthyroidism, euthyroidism and hypothyroidism were 1,5%, 69,35% and 29,15%, respectively. Preoperative high thyroid-stimulating hormone (TSH) level
thyroperoxidase antibody (Anti TPO) serum levels
and thyroid remnant volume were significantly associated with postoperative hypothyroidism.

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