甲状旁腺次全切除术治疗肾性甲状旁腺功能亢进症的临床分析

发布时间：2018-04-11 01:02

  本文选题：甲状旁腺次全切除术 + 肾性甲状旁腺功能亢进症　； 参考：《苏州大学》2015年硕士论文

【摘要】：目的:探索甲状旁腺次全切除术(Subtotal parathyroidectomy,SPTX)治疗肾性甲状旁腺功能亢进(renal hyperparathyroidism,r HPT)的临床疗效。方法:回顾分析自2012年2月至2014年9月在本院行甲状旁腺次全切术的肾性甲旁亢患者共22例,收集患者手术前、后甲状旁腺激素(Parathyroid-hormone,PTH)、血钙、血磷、碱性磷酸酶(Alkaline phosphatase,ALP)等实验室检查数据,患者术后症状缓解情况以及有无甲状旁腺功能亢进复发的情况,并进行统计学分析。结果:本组22例患者中手术成功21例(成功率为95.4%);术后随访6个月至2年内各时段PTH、血钙、血磷较术前比较皆明显下降(P0.05);术后1月内ALP呈上升趋势,随后下降至正常水平,差异有统计学意义(P0.05);患者术后皆出现低钙血症,其中2例患者出院后1月余再次入院行静脉补钙治疗一周;术后19例患者骨关节酸痛均有不同程度好转,3例患者术后骨关节酸痛较术前严重;术后所有患者皮肤瘙痒均有不同程度好转;术后6个月至2年暂未发现有患者复发。结论:1.术中PTH监测条件下甲状旁腺次全切除术是治疗RHPT安全有效的手术方式,可有效改善患者症状及相关实验室指标。2.患者年龄是术后低钙血症严重程度的一项预测指标。3.术中PTH下降率直接影响术后各阶段PTH值。
[Abstract]:Objective: to investigate the clinical effect of subtotal parathyroidectomyne (SPTX) in the treatment of renal hyperparathyroidismr (HPTT).Methods: from February 2012 to September 2014, 22 patients with renal parathyroid hyperthyroidism underwent subtotal parathyroid thyroidectomy in our hospital.Alkaline phosphatase (ALP) and other laboratory data, symptom relief and recurrence of hyperparathyroidism were analyzed statistically.Results: among the 22 patients, 21 cases were successfully operated (the success rate was 95.4%), and the levels of PTH, serum calcium and phosphorus were significantly decreased in each period from 6 months to 2 years after operation compared with those before operation, and the ALP increased in one month after operation, and then decreased to normal level.The difference was statistically significant (P 0.05), hypocalcemia was found in all the patients after operation, 2 of them were re-admitted for one week after being discharged from hospital.19 cases of postoperative osteoarticular soreness were improved in varying degrees. 3 cases of postoperative osteoarticular soreness were more serious than those before operation, all postoperative skin pruritus were improved in varying degrees, and no recurrence was found from 6 months to 2 years after operation.Conclusion 1.Subtotal parathyroidectomy under the condition of intraoperative PTH monitoring is a safe and effective method for the treatment of RHPT.Age is a predictor of the severity of hypocalcemia.The decrease rate of PTH during operation directly affected the PTH value in all stages after operation.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R653

【参考文献】

中国期刊全文数据库 前1条

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