难治性SHPT患者行PTX的短期和长期疗效观察

发布时间：2018-11-22 09:22

【摘要】：目的:探讨难治性继发性甲状旁腺功能亢进患者行甲状旁腺切除术的短期和长期疗效观察。方法:选取在我院行甲状旁腺切除术的继发性甲状旁腺功能亢进患者75例,比较术后不同时间点血液生化指标、症状VAS评分与手术前的差异,分析患者术后不同时间点并发症发生率以及复发和死亡情况。结果:血清甲状旁腺素(iPTH)、血磷、血钙含量在术后不同时间点均低于术前,且差异具有统计学意义(P0.05)。血ALP含量在术后1、7 d高于术前,在术后3、12、24个月时均低于术前,且差异具有统计学意义(P0.05)。骨痛、瘙痒症状和肌无力VAS评分在术后1、7 d和3、12、24个月时均低于术前,且差异具有统计学意义(P0.05)。术后最常见的并发症为低血钙,在术后7 d时发生低血钙62例,发生率为82.67%;在术后12个月仍然有14例患者发生了低血钙,发生率为18.67%。术后7 d发生手足或头面部麻木7例,发生率为9.33%,术后1个月发生手足或头面部麻木2例,发生率为2.67%;术后7 d发生一过性声嘶3例,发生率为4.0%;术后7 d发生低血磷5例,发生率为6.67%。术后随访有9例患者复发,复发率为12.0%;有4例患者死亡,死亡率为5.33%。结论:甲状旁腺切除术治疗难治性继发性甲状旁腺功能亢进有较好的短期和长期疗效。
[Abstract]:Objective: to investigate the short-and long-term efficacy of parathyroidectomy in patients with refractory secondary hyperparathyroidism. Methods: 75 patients with secondary hyperparathyroidism who underwent parathyroidectomy in our hospital were selected to compare the blood biochemical indexes, symptom VAS scores and pre-operation scores at different time points after operation. The incidence of complications, recurrence and death were analyzed at different time points after operation. Results: the levels of serum phosphorus and calcium in serum parathyroid hormone (iPTH),) were significantly lower than those before operation at different time points (P0.05). The level of serum ALP was significantly higher than that before operation on the 7th day after operation and at 312,24 months after operation, and the difference was statistically significant (P0.05). The VAS scores of bone pain, pruritus and myasthenia were significantly lower than those before operation at 1d and 312,24 months after operation (P0.05). The most common complication was hypocalcemia in 62 cases (82.67%) at 7 days after operation, and in 14 cases (18.67%) at 12 months after operation. There were 7 cases of numbness of hand, foot or head and face 7 days after operation (9.33%), 2 cases (2.67%) of numbness of hand, foot or head and face 1 month after operation, 3 cases (4.0%) of transient hoarseness 7 days after operation. Low blood phosphorus occurred in 5 cases 7 days after operation, the incidence was 6.67. The recurrence rate was 12.0 and the mortality rate was 5.33 in 4 patients. Conclusion: parathyroidectomy for refractory secondary hyperparathyroidism is effective in both short and long term.
【作者单位】：沧州市人民医院甲状腺乳腺外科;中日友好医院肾内科;中日友好医院外科;沧州市人民医院肾内科;
【基金】：河北省科技计划项目(15277792D)
【分类号】：R653

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