原发性甲状旁腺功能亢进症36例临床分析

发布时间：2018-10-12 19:34

【摘要】：目的研讨原发性甲状旁腺功能亢进症的临床特点、诊断方案、相关治疗策略及延误原因。方法回顾性分析在我院2009年1月至2014年10月收治的36例原发性甲状旁腺功能亢进症的患者资料。结果原发性甲状旁腺功能亢进症的临床表现具有显著多样性,误诊率高,占25.0%(9/36)。36例患者中男：女比例为1：1。36例患者首发症状中,骨关节疼痛9例、消化道(恶心,呕吐)症状7例、颈部包块6例(其中3例为B超检查时发现)、泌尿系结石5例、乏力4例、骨质疏松及泌尿系结石2例、骨折1例,无症状者2例。36例患者实验室检查,血清钙(至少有一次)、甲状旁腺激素值均升高。所有患者行颈部彩超检查,部分联合CT/99mTc-MIBI检查,联合后检查的准确率分别提高到85.2%、93.1%。其中,术后患者的症状有一定程度的改善,血清钙、甲状旁腺素水平明显降低。另外8例未采取手术治疗,其中7例缓解,1例因难以纠正的高钙危象而死亡。结论在临床工作中,应提高对原发性甲状旁腺功能亢进症的识别,更加重视血钙检查,对疑似病例应早期行颈部彩超、甲状旁腺素等检查,争取早期手术治疗,改善预后及提高生存质量。
[Abstract]:Objective to investigate the clinical features, diagnostic scheme, treatment strategies and causes of delay in primary hyperparathyroidism. Methods 36 patients with primary hyperparathyroidism admitted in our hospital from January 2009 to October 2014 were retrospectively analyzed. Results the clinical manifestations of primary hyperparathyroidism were significantly diverse, with a high misdiagnosis rate of 25.0% (9 / 36). There were 7 cases of vomiting, 6 cases of neck mass (3 cases found by B-ultrasound), 5 cases of urinary tract stones, 4 cases of fatigue, 2 cases of osteoporosis and urinary calculi, 1 case of fracture, 2 cases of asymptomatic cases, 36 cases of laboratory examination. Serum calcium (at least once), parathyroid hormone levels increased. All patients were examined by color Doppler ultrasonography, some of them were examined with CT/99mTc-MIBI, and the accuracy of the combined examination was increased to 85.2 and 93.1, respectively. The symptoms were improved and serum calcium and parathyroid hormone levels were significantly decreased. The other 8 cases were not treated surgically, 7 cases were relieved and 1 case died because of the difficult to correct high calcium crisis. Conclusion in clinical work, we should improve the recognition of primary hyperparathyroidism and pay more attention to the examination of blood calcium. Improve prognosis and quality of life.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R582.1

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