CAJ | 학술논문

目的本文就国内七所甲状旁腺功能亢进症病例较集中的医院的诊治状况进行分析.方法回顾分析自1965年至2005年间国内七所医院手术治疗甲状旁腺功能亢进症730例,就其临床特征以及诊治资料进行分析.结果 730例甲状旁腺功能亢进症患者中有临床症状者652例(89.3%),无症状者78例(10.7%),99mTc-MIBI扫描阳性442例;双侧甲状旁腺探查术377例,常规颈横部切口单侧甲状旁腺探查204例,小切口单个腺体探查甲状旁腺瘤切除术143例,腔镜辅助颈部小切口单个腺体探查6例.腺瘤632例(86.6%),甲状旁腺增生58例(8.3%),甲状旁腺癌40例(5.5%).手术后无严重并发症,20例患者持续甲状旁腺功能亢进,其余患者血钙降低或恢复正常.结论手术前定位检查很有帮助;单侧甲状旁腺探查对甲状旁腺瘤是合适的手术方法;颈部小切口甲状旁腺瘤切除适用于术前有明确定位诊断的病例.
목적 본문취국내칠소갑상방선공능항진증병례교집중적의원적진치상황진행분석.방법 회고분석자1965년지2005년간국내칠소의원수술치료갑상방선공능항진증730례,취기림상특정이급진치자료진행분석.결과 730례갑상방선공능항진증환자중유림상증상자652례(89.3%),무증상자78례(10.7%),99mTc-MIBI소묘양성442례;쌍측갑상방선탐사술377례,상규경횡부절구단측갑상방선탐사204례,소절구단개선체탐사갑상방선류절제술143례,강경보조경부소절구단개선체탐사6례.선류632례(86.6%),갑상방선증생58례(8.3%),갑상방선암40례(5.5%).수술후무엄중병발증,20례환자지속갑상방선공능항진,기여환자혈개강저혹회복정상.결론 수술전정위검사흔유방조;단측갑상방선탐사대갑상방선류시합괄적수술방법;경부소절구갑상방선류절제괄용우술전유명학정위진단적병례.
Objective In China primary hyperparathyroidism is not a kind of common disease as in the wesyrn countries.This article reports the current status in the diagnosis and treatment of primary hyperparathyroidism in the mainland of China. Methods We collected 730 cages of primary hyperparathyroidism diagnosed and treated in 7 top hospitals for endocrine surgery from 1965 to 2005.Results In this study.652(89.3%)cases were clinically symptomatic while 78(10.7%)cases were asymptomatic:442 cases were positive on 99mTc-MIBI scanning.Bilateral explorations were undertaken in 377 patients and unilateral or uni-gland exploration through the conventional incision in 204 cases.Minimally invasive parathyroidectomy in 143 cases.Endoscopically assisted 2 cm incision was taken in 6 cases for unilateral gland exploration.Pathologically 632(86.6%)cases were identified as adenoma,58(8.3%)cases were of hyperplasia and 40(5.5%)cases were of carcinoma.There were no major postoperative complications.While 20 patients suffering from recurrence or persistent postoperative hyperparathyroidism,the others are of normal or depressed serum level of calcium. Conclusions Preoperative localization is very helpful: Unilateral exploration for parathyroid adenoma is feasible; minimally invasive parathyroidectomy throush minimal incision is a kind of improving procedure for the localized parathyroid adenoma.