继发性甲状旁腺功能亢进症患者甲状旁腺全切术后甲状旁腺功能的变化

发布时间：2019-07-30 17:40

【摘要】：目的观察继发性甲状旁腺功能亢进症患者甲状旁腺全切加腹壁皮下移植术后的甲状旁腺功能。方法回顾性分析25例药物保守治疗无效,行甲状旁腺全切加自体旁腺腹壁皮下移植术的继发性甲状旁腺功能亢进症患者,移植物为所切除旁腺中无明显腺体增生的旁腺组织,切成30小块,移植于左侧腹壁皮下。收集术中(甲状旁腺全切术后10 min)、术后24 h、1、5、15、30周血全段甲状旁腺激素(i PTH)数据。结果每一例接受了手术的患者生活质量都得到明显提高。术前i PTH平均为(1 832±189.4)pg/mL,术中为(120.3±67.7)pg/mL;术后24 h为(17.4±18.7)pg/mL;1周为(17.9±21.7)pg/mL;5周为(36.3±36.4)pg/mL;15周为(76.2±76.9)pg/mL;30周为(102.3±85.5)pg/mL;82.6%患者自体移植物在第5周时即可具备功能。所有患者均没有行移植物清除术。结论腹壁皮下自体甲状旁腺移植是一种有效、简单、快捷的手术方式,且避免了前臂自体甲状旁腺移植所导致的潜在的并发症。
[Abstract]:Objective To observe the parathyroid function of the secondary hyperparathyroidism in patients with secondary hyperparathyroidism. Methods A retrospective analysis of 25 cases of secondary hyperparathyroidism, which was not effective in conservative treatment of the primary and secondary hyperparathyroidism, was performed in 25 cases of hyperparathyroidism. The graft was a tissue with no obvious glandular hyperplasia and was cut into 30 small pieces. The graft was implanted subcutaneously in the left abdominal wall. The total parathyroid hormone (i-PTH) data were collected at 24 h,1,5,15 and 30 minutes after the operation (10 min after the total hypoparathyroidism). Results The quality of life of every patient was significantly improved. The pre-operative i PTH was (1 832 to 189.4) pg/ mL, and was (120.3 to 67.7) pg/ mL in the operation; (17.4 to 18.7) pg/ mL for 24 h, and (36.3 to 36.4) pg/ mL for the first week; and (76.2 to 76.9) pg/ mL for 15 weeks, and (102.3 to 85.5) pg/ mL for 30 weeks; 82.6% of the patient's autograft was functional at Week 5. No graft removal was performed for all patients. Conclusion Autologous parathyroid transplantation in the abdominal wall is an effective, simple and rapid method of operation, and avoids the potential complications caused by the auto-parathyroid transplantation of the forearm.
【作者单位】：广东省中医院耳鼻咽喉科;广州医科大学附属肿瘤医院头颈肿瘤外科;
【分类号】：R653;R692.5

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