甲状旁腺肃清术对继发性甲状旁腺功能亢进的疗效评价

doi:10.16139/j.1007-9610.2019.04.011

摘要/Abstract

摘要： 目的： 比较甲状旁腺肃清术(PPTX)与传统术式治疗继发性甲状旁腺功能亢进（SHPT）的临床疗效。方法： 对2010年1月至2017年11月期间在我院手术治疗的49例SHPT病人进行回顾性分析,比较PPTX组与传统术式组,甲状旁腺全切除和甲状旁腺全切除加自体甲状旁腺移植的手术效果及发生的手术并发症。结果： 两组术后持续性SHPT发生率及复发率差异无统计学意义（P>0.05）。对手术成功病人进行分析,发现PPTX组术后6个月血全段甲状旁腺素（iPTH）显著低于传统手术组（P=0.013）。两组病人术后暂时性及持续性低iPTH发生率差异无统计学意义（P>0.05）。PPTX组钙剂补充量更高（P=0.003）,但两组低钙血症程度差异无统计学意义（P>0.05）。结论： PPTX持续降低iPTH的效果更优,相应地病人术后钙剂需求量更高。

关键词: 甲状旁腺肃清术, 继发性甲状旁腺功能亢进, 甲状旁腺素, 复发

Abstract: Objective To compare the results after purge parathyroidectomy (PPTX) and traditional approaches performed for secondary hyperparathyroidism (SHPT). Methods A total of 49 patients with SHPT who underwent parathyroidectomy from January 2010 to November 2017 were retrospectively analyzed. We compared outcomes between PPTX group and traditional parathyroidectomy group including total parathyroidectomy and total parathyroidectomy with autotransplantation. Results There was no difference in the rate of persistent or recurrent SHPT between 2 groups during follow-up (P>0.05). Analysis of the patients with successful surgery revealed that patients in PPTX group had a lower level of intact parathyroid hormone (iPTH) at 6 months postoperatively compared with that in traditional parathyroidectomy group (P=0.013). No significant difference was found between 2 groups in the rate of transient or persistent lower iPTH (P>0.05). Patients in PPTX group required more calcium supplementation(P=0.003), while no difference was present in the extent of hypocalcemia between 2 groups (P>0.05). Conclusions PPTX would be more effective in lowering iPTH. However, the patients need more calcium supplementation to prevent hypocalcemia after PPTX.

Key words: Purge parathyroidectomy, Secondary hyperparathyroidism, Parathyroid hormone, Recurrence

中图分类号:

R653

李伟, 刘冰洋, 单成祥, 饶文胜, 张伟, 仇明. 甲状旁腺肃清术对继发性甲状旁腺功能亢进的疗效评价[J]. 外科理论与实践, 2019, 24(04): 325-329.

LI Wei, LIU Bingyang, SHAN Chenxiang, RAO Wensheng, ZHANG Wei, QIU Ming. Evaluation of purge parathyroidectomy in treatment of secondary hyperparathyroidism[J]. Journal of Surgery Concepts & Practice, 2019, 24(04): 325-329.

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