中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2013年
4期
309-311
,共3页
继发性甲状旁腺功能亢进%尿毒症%甲状旁腺次全切除术
繼髮性甲狀徬腺功能亢進%尿毒癥%甲狀徬腺次全切除術
계발성갑상방선공능항진%뇨독증%갑상방선차전절제술
Secondary hyperparathyroidism%Uremia%Subtotal parathyroidectomy
目的 研究甲状旁腺次全切除术对尿毒症维持性血液透析继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)患者的临床疗效.方法 对2006年6月至2011年6月在江西省赣州市人民医院接受甲状旁腺次全切除术治疗的尿毒症维持性血液透析SHPT 10例行回顾性分析,对术前及术后1周、1个月、3个月、6个月的全段甲状旁腺激素(iPTH)、血钙、血磷及钙磷乘积行统计学分析,统计术前及术后骨关节痛缓解情况及手术并发症.结果 ①10例手术均成功,术中甲状旁腺位置与术前B超定位一致,术后均未出现明显并发症；②患者术后骨关节疼痛明显缓解,瘙痒感明显减轻；③术后1周、1个月、3个月、6个月的iPTH、血钙、血磷及钙磷乘积较术前明显下降(P＜0.05),差异有统计学意义.结论 术前颈部甲状旁腺B超定位指导手术是可行的方法.甲状旁腺次全切除术能有效治疗尿毒症维持性血液透析SHPT患者,手术安全,治疗效果满意.
目的 研究甲狀徬腺次全切除術對尿毒癥維持性血液透析繼髮性甲狀徬腺功能亢進(secondary hyperparathyroidism,SHPT)患者的臨床療效.方法 對2006年6月至2011年6月在江西省贛州市人民醫院接受甲狀徬腺次全切除術治療的尿毒癥維持性血液透析SHPT 10例行迴顧性分析,對術前及術後1週、1箇月、3箇月、6箇月的全段甲狀徬腺激素(iPTH)、血鈣、血燐及鈣燐乘積行統計學分析,統計術前及術後骨關節痛緩解情況及手術併髮癥.結果 ①10例手術均成功,術中甲狀徬腺位置與術前B超定位一緻,術後均未齣現明顯併髮癥；②患者術後骨關節疼痛明顯緩解,瘙癢感明顯減輕；③術後1週、1箇月、3箇月、6箇月的iPTH、血鈣、血燐及鈣燐乘積較術前明顯下降(P＜0.05),差異有統計學意義.結論 術前頸部甲狀徬腺B超定位指導手術是可行的方法.甲狀徬腺次全切除術能有效治療尿毒癥維持性血液透析SHPT患者,手術安全,治療效果滿意.
목적 연구갑상방선차전절제술대뇨독증유지성혈액투석계발성갑상방선공능항진(secondary hyperparathyroidism,SHPT)환자적림상료효.방법 대2006년6월지2011년6월재강서성공주시인민의원접수갑상방선차전절제술치료적뇨독증유지성혈액투석SHPT 10례행회고성분석,대술전급술후1주、1개월、3개월、6개월적전단갑상방선격소(iPTH)、혈개、혈린급개린승적행통계학분석,통계술전급술후골관절통완해정황급수술병발증.결과 ①10례수술균성공,술중갑상방선위치여술전B초정위일치,술후균미출현명현병발증；②환자술후골관절동통명현완해,소양감명현감경；③술후1주、1개월、3개월、6개월적iPTH、혈개、혈린급개린승적교술전명현하강(P＜0.05),차이유통계학의의.결론 술전경부갑상방선B초정위지도수술시가행적방법.갑상방선차전절제술능유효치료뇨독증유지성혈액투석SHPT환자,수술안전,치료효과만의.
Objective To study the clinical effect of subtotal parathyroidectomy on secondary hyperparathyroidism(SHPT) in uremic patients undergoing hemodialysis.Methods The data of 10 uremic patients undergoing hemodialysis who received subtotal parathyroidectomy from Jun.2006 to Jun.2011 in our hospital were retrospectively analyzed.Intact parathyroid hormone (iPTH),serum calcium,phosphorus and calcium-phosphorus product were analyzed statistically before operation,1 week,1 month,3 months,and 6 months after the operation.The joint pain relief and postoperative complications were studied.Results ①All of the 10 patients were successfully operated.No complication occurred.The intraoperative site of the parathyroid was consistent with that positioned by the preoperative B ultrasound guidance.②Postoperative bone pain and pruritus were obviously relieved.③iPTH decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance(P ＜ 0.05).④Postoperative serum calcium,serum phosphorus and calcium-phosphorus product decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance (P ＜ 0.05).Conclusions Preoperative localization for neck parathyroid by ultrasound scan is feasible.Subtotal parathyroidectomy can be effective in treatment of SHPT in uremic patients.The surgery were safe and with satisfactory treatment outcome.
