甲状旁腺全消融与部分消融对继发甲状旁腺功能亢进疗效的观察

发布时间：2018-03-28 19:20

本文选题：继发性甲状旁腺功能亢进　切入点：消融技术　出处：《介入放射学杂志》2015年06期

【摘要】：目的比较甲状旁腺全消融和甲状旁腺部分消融的2种消融方式对超声引导下经皮微波消融(MWA)或射频消融(RFA)治疗继发性甲状旁腺功能亢进(SHPT)疗效的影响方法回顾分析2012年10月至2013年9月尿毒症SHPT患者行MWA或RFA治疗且随访9个月以上26例患者,比较2种消融方式的疗效及对血钙水平的影响。结果从甲状旁腺激素(PTH)水平分析:全消融组术后PTH水平较术前逐渐下降并保持正常水平,且无复发;部分消融组术后PTH水平先下降并于术后9个月出现反弹,并高于全消融组和正常水平(P0.05),15例中有5例复发。从血钙水平分析:2种消融术后较术前血钙水平均下降,但部分消融组术后3、9个月血钙水平高于全消融组(P0.05),11例全消融组中4例发生低钙血症。结论全消融方式术后不易复发但有发生低钙血症风险,部分消融方式术后易复发但血钙控制良好,从控制血钙水平考虑部分消融可能更适合临床需要。
[Abstract]:Objective to compare the effects of total parathyroid ablation and partial parathyroid ablation in the treatment of secondary hyperparathyroidism by ultrasound guided percutaneous microwave ablation (MWA) or radiofrequency ablation (RFA) in patients with secondary hyperparathyroidism. From October 2012 to September 2013, 26 patients with uremia SHPT were treated with MWA or RFA and followed up for more than 9 months. Results the level of parathyroid hormone (PTH) was analyzed: the level of PTH decreased gradually and kept normal after ablation, and there was no recurrence. In partial ablation group, the level of PTH decreased first and rebounded 9 months after operation, which was higher than that in the total ablation group and normal level in 5 out of 15 cases. However, 3 and 9 months after operation, the level of serum calcium in partial ablation group was higher than that in total ablation group (P 0.05 or P 0.05). Conclusion hypocalcemia occurred in 4 out of 11 patients with total ablation. Conclusion Total ablation is not easy to recur after operation, but it is at risk of hypocalcemia. Partial ablation is easy to recur after operation, but blood calcium is well controlled. Considering the level of blood calcium, partial ablation may be more suitable for clinical needs.
【作者单位】：台州医院超声科;
【分类号】：R582.1;R445.1

【参考文献】