甲状旁腺危象19例诊治分析

发布时间：2018-02-13 01:00

本文关键词： 甲状旁腺危象高钙血症甲状旁腺切除术　出处：《中国实用外科杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨甲状旁腺危象的治疗方法。方法回顾性分析自2003年1月至2016年2月于中山大学附属第一医院诊断并行手术治疗的19例甲状旁腺危象病人的临床资料。结果 19例病人术前均行定位检查,准确率为:超声87.5%(14/16),核素显像100.0%(16/16),CT 85.7%(6/7),最常用的联合检查为超声联合核素显像(8/19,42.1%),准确率达100.0%(8/8)。14例病人术前行非手术降钙治疗,治疗前平均血钙水平为(3.8±0.3)mmol/L,至术前为(3.4±0.6)mmol/L,术后为(2.0±0.4)mmol/L。手术治疗能显著降低病人血钙,效果优于非手术治疗(t=2.893,P=0.013)。9例(47.4%)病人术前血钙仍3.75 mmol/L,14例(73.7%)病人术前血钙3.50 mmol/L,仅1例病人因术后甲状旁腺危象引起的全身器官功能障碍死亡。结论手术是甲状旁腺危象有效的治疗方法,术前准备目的是明确定性及定位诊断,不应片面追求降低术前血钙水平,以免延误手术时机。
[Abstract]:Objective to investigate the treatment of parathyroid crisis. Methods the clinical data of 19 patients with parathyroid crisis diagnosed and operated from January 2003 to February 2016 in the first affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. All 19 patients underwent localization examination before operation. The accuracy rate is: ultrasound 87.5% / 14% 16%, radionuclide imaging 100.010 0 / 16% CT 85.75.70%, the most commonly used joint examination is ultrasound combined radionuclide imaging 8 / 19% 42.1%, the accuracy rate is up to 100.080% / 8% .14 cases of patients received non-operative calcium reduction before operation. The mean serum calcium level was 3.8 卤0.3 mmol/ L before treatment, 3.4 卤0.6 mmol / L before operation and 2.0 卤0.4 mmol / L after operation. The effect was better than that of non-operative treatment (2.893%, 0.013.9 cases, 47.4%) the preoperative calcium was still 3.75 mmol / L (14 cases, 73.7 mmol / L). Only one patient died of systemic organ dysfunction caused by postoperative parathyroid crisis. Conclusion the operation is a parathyroid crisis. Effective treatment, The purpose of preoperative preparation is to make definite qualitative and locative diagnosis, so that the preoperative calcium level should not be reduced one-sidedly, so as to avoid the delay of operation time.
【作者单位】：中山大学附属第一医院甲状腺乳腺外科;
【分类号】：R653

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