尿毒症患者继发甲状旁腺功能亢进合并甲状腺癌的临床特点及诊治

发布时间：2018-04-08 07:12

本文选题：尿毒症　切入点：甲状旁腺功能亢进　出处：《重庆医学》2017年25期

【摘要】：目的探讨尿毒症规律血液透析患者继发甲状旁腺功能亢进(SHPT)合并甲状腺癌的临床特点及诊治。方法回顾性分析2013年1月至2016年4月在该院肾科因尿毒症SHPT接受甲状旁腺切除术(n=55)的患者中合并甲状腺癌的7例患者临床资料。结果 55例因尿毒症SHPT行甲状旁腺切除术的患者中发现有7例合并甲状腺癌,发生率为12.7%,术前甲状腺彩超均提示甲状腺癌,敏感性100%。7例患者均成功接受手术治疗,术后病理:1例为甲状腺滤泡状癌(FTC),6例为甲状腺乳头状癌(PTC);7例均为甲状旁腺腺瘤。随访时间6~40个月无SHPT复发,无甲状腺癌局部或远处复发。结论尿毒症患者SHPT合并甲状腺癌发病率有明显增高趋势,应加强对该类患者的彩超筛查,尽可能减少医疗辐射、碘摄入过多等甲状腺癌的高危因素,早期手术预后良好。
[Abstract]:Objective to investigate the clinical features, diagnosis and treatment of secondary hyperparathyroidism (SHPTT) combined with thyroid carcinoma in patients with uremia.Methods from January 2013 to April 2016, 7 patients with thyroid carcinoma were treated with parathyroidectomy and parathyroidectomy (SHPT) for uremia in our hospital from January 2013 to April 2016. The clinical data of 7 patients with thyroid carcinoma were analyzed retrospectively.Results among 55 patients with uremia SHPT underwent parathyroidectomy, 7 cases were found to be complicated with thyroid carcinoma, the incidence rate was 12.7.The preoperative thyroid color ultrasound showed thyroid carcinoma, and the sensitivity of 100.7 cases was successfully treated by operation.One case of thyroid follicular carcinoma, 6 cases of thyroid papillary carcinoma, and 7 cases of parathyroid adenoma.No recurrence of SHPT or local or distant recurrence of thyroid carcinoma was observed during the follow-up period of 6 to 40 months.Conclusion the incidence of SHPT combined with thyroid carcinoma in uremic patients is obviously increasing. Color ultrasound screening should be strengthened to minimize the high risk factors of thyroid cancer such as medical radiation excessive iodine intake and so on. The prognosis of early operation is good.
【作者单位】：第三军医大学西南医院肾科;
【分类号】：R582.1;R692.5;R736.1

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