CAJ | 학술논문

目的探讨异位甲状旁腺功能亢进症的特征及外科治疗方法.方法 1982-2010年间,北京协和医院共收治575例甲状旁腺功能亢进症患者,其中66例为异位甲状旁腺功能亢进症,本文对其临床资料进行回顾性研究,包括临床表现、实验室检查、影像学检查、手术、病理、术后处理及随访等.结果异位甲状旁腺功能亢进症的发生率为11.5％(66/575),其中异位于纵隔的发生率为71.2％(47/66),而异位于前上纵隔最多,达65.2％(43/66);异位于颈部非典型部位的为28.8％(19/66);常规定位检查中,甲状旁腺核素显像的敏感度最高(87.0％);平均手术次数为1.47次,所有病灶均得以完整切除;术后49例出现短期低血钙症状,经钙剂治疗后血钙恢复正常;随访到52例,仅1例移植的甲状旁腺腺体再次出现功能亢进.结论异位甲状旁腺功能亢进症的诊治关键在于术前明确定位,减少误诊误治,避免术中损伤.
목적 탐토이위갑상방선공능항진증적특정급외과치료방법.방법 1982-2010년간,북경협화의원공수치575례갑상방선공능항진증환자,기중66례위이위갑상방선공능항진증,본문대기림상자료진행회고성연구,포괄림상표현、실험실검사、영상학검사、수술、병리、술후처리급수방등.결과 이위갑상방선공능항진증적발생솔위11.5％(66/575),기중이위우종격적발생솔위71.2％(47/66),이이위우전상종격최다,체65.2％(43/66);이위우경부비전형부위적위28.8％(19/66);상규정위검사중,갑상방선핵소현상적민감도최고(87.0％);평균수술차수위1.47차,소유병조균득이완정절제;술후49례출현단기저혈개증상,경개제치료후혈개회복정상;수방도52례,부1례이식적갑상방선선체재차출현공능항진.결론 이위갑상방선공능항진증적진치관건재우술전명학정위,감소오진오치,피면술중손상.
Objective To discuss the features and surgical management of ectopic hyperparathyroidism.Methods Clinical data of 66 cases of ectopic hyperparathyroidism were retrospectively analyzed.Results There were 66 cases of ectopic hyperparathyroidism accounting for 11.5％ (66/575) of all ectopic hyperparathyroid cases admitted during the period from 1982-2010.Prevalence of mediastinal ectopic lesions was 71.2％ (47/66),among those 65.2％ (42/66) was in anterosuperior mediastinum,and 28.8％ (19/66) in the non-typical loci of the neck.Radionuclide imaging of parathyroid glands was the most sensitive (87.0％) method among all common positioning examinations.Average number of operation episode was 1.47,and all lesions were finally resected.After surgery 49 cases presented with transient hypocalcemia,and were cured by calcium administration.52 cases were followed up,with recurrent hyperparathyroidism in 1 case.Conclusions Diagnosis and treatment of ectopic hyperparathyroidism are dependent on the understanding of common locations of ectopic parathyroid glands.Preoperative correct location and surgical expertise are helpful for successful resection.