手术与拟钙剂治疗难治性SHPT的短期疗效比较

发布时间：2018-08-26 20:32

【摘要】：目的探讨甲状旁腺全切术(t-PTX)与拟钙剂治疗难治性继发性甲状旁腺功能亢进(SHPT)的短期疗效。方法对2012年1月至2015年9月该院收治的118例难治性SHPT患者的临床资料进行回顾性分析,根据治疗方法不同将118例患者分为A(行冲击治疗效果不佳后常规内科治疗,n=62)、B(行t-PTX治疗,n=26)、C(口服拟钙剂治疗,n=30)3组,所有患者均进行常规内科治疗。3组患者均完成第0、1天及1、3、6个月的钙、磷、钙磷乘积、甲状旁腺激素(iPTH)随访。结果 3组患者性别、年龄、透析时间和第0天钙、磷、钙磷乘积及iPTH水平比较,差异均无统计学意义(P0.05)。A、B、C 3组患者疼痛缓解率分别为0、92.31%、60.00%;与A组比较,B、C组磷、钙磷乘积、iPTH在处理后各时点均明显降低(P0.01);与C组比较,B组的钙、磷、钙磷乘积、iPTH在处理后各时点均明显减少(P0.05)。结论对于难治性SHPT能耐受外科手术的患者应首选t-PTX治疗;而口服拟钙剂治疗为难治性SHPT患者提供了非手术治疗的可能。
[Abstract]:Objective to investigate the short-term efficacy of total parathyroidectomy (t-PTX) and calcium-like agent in the treatment of refractory secondary hyperparathyroidism (SHPT). Methods the clinical data of 118 patients with refractory SHPT from January 2012 to September 2015 were retrospectively analyzed. According to the different treatment methods, 118 patients were divided into three groups: group A (routine medical treatment after shock therapy was not good) and group B (treated with t-PTX) C (oral calcitonin 30). All the patients were treated with routine medical therapy. 3 patients were followed up with (iPTH) of parathyroid hormone and calcium, phosphorus, calcium and phosphorus products at the 1st day and 3rd and 6th month after routine medical treatment. Results there was no significant difference in sex, age, dialysis time, calcium, phosphorus, calcium and phosphorus product and iPTH level among the three groups (P0.05). Compared with group C, the calcium, phosphorus, calcium and phosphorus product of iPTH in group B were significantly decreased at each time point after treatment (P0.05). Conclusion t-PTX should be the first choice for patients with refractory SHPT who can tolerate surgery, while oral calcitonin therapy may provide non-operative treatment for patients with refractory SHPT.
【作者单位】：新疆医科大学第一附属医院血管甲状腺外科;
【分类号】：R692.5

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