甲状旁腺近全切加自体移植治疗肾源性甲状旁腺功能亢进初步疗效研究

doi:10.3969/j.issn.1005-6483.2021.08.018

临床外科杂志 ›› 2021, Vol. 29 ›› Issue (8): 757-760.doi: 10.3969/j.issn.1005-6483.2021.08.018

甲状旁腺近全切加自体移植治疗肾源性甲状旁腺功能亢进初步疗效研究

武汉大学中南医院甲状腺乳腺外科

出版日期:2021-08-20 发布日期:2021-08-20

A preliminary study on the efficacy of Subtotal Parathyroidectomy with Autotransplantation in renal secondary hyperparathyroidism

Online:2021-08-20 Published:2021-08-20

摘要/Abstract

摘要： 目的：探讨甲状旁腺近全切除+自体移植术（subtotal parathyroidectomy with autotransplantation,SPTX+AT）治疗继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的安全性及有效性。方法：2019年1月~2019年10月收治的SHPT病人54例，行SPTX+AT治疗。收集病人术前及术后临床症状、甲状旁腺激素（parathyroid hormone,PTH）水平、血电解质水平信息，术后每3个月对上述指标进行随访，为期至少1年，判断手术安全性及有效性。结果：54例病人均顺利完成手术，术后症状有所好转，PTH、血钙、血磷水平均下降，差异有统计学意义（P<0.05）。以PTH低于150pg/ml或下降幅度超过70%为有效进行判断，51例（94.4%）手术有效。8例（14.8%）出现低钙血症，随访第3个月时均稳定至正常范围。随访1年，共4例（7.4%）复发。结论：SPTX+AT治疗SHPT疗效确切，具有可行性；术后低钙血症发生率较低，复发后再次手术相对简单，手术安全性较好，相较于现有术式有一定优势。

关键词: 继发性甲状旁腺功能亢进, 甲状旁腺切除术, 慢性肾病

Abstract: Objective：To investigate the safety and effectiveness of subtotal parathyroidectomy with autotransplantation (SPTX+AT) for the treatment of secondary hyperparathyroidism.Methods：Fiftyfour patients with SHPT from January 2019 to October 2019 were collected and treated with SPTX+AT.Information on patients' preoperative and postoperative clinical symptoms,PTH levels,and blood electrolyte levels were collected,and the above indicators were followed up every 3 months after surgery for a period of at least 1 year to judge the safety and effectiveness of the surgery.Results：Fiftyfour patients who met the inclusion criteria successfully completed the surgery,and their postoperative symptoms improved and their PTH,blood calcium and blood phosphorus levels decreased(P<0.05).The surgery was effective in 51(94.4%) cases with PTH below 150 pg/ml or a decrease of more than 70%.8(14.8%) patients developed hypocalcemia,which was stabilized to normal range in the third month of followup.There were 4(7.4%) cases of recurrence at 1 year of followup.Conclusion：The efficacy of SPTX+AT in treating SHPT is accurate and feasible; the incidence of hypocalcemia after surgery is low,and reoperation after recurrence is relatively simple and safe,which has certain advantages over the existing procedures.

Key words: secondary hyperparathyroidism, parathyroidectomy；chronic kidney disease

廖亦秦, 袁芊芊, 郑乐葳等. 甲状旁腺近全切加自体移植治疗肾源性甲状旁腺功能亢进初步疗效研究[J]. 临床外科杂志, 2021, 29(8): 757-760.

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甲状旁腺近全切加自体移植治疗肾源性甲状旁腺功能亢进初步疗效研究

A preliminary study on the efficacy of Subtotal Parathyroidectomy with Autotransplantation in renal secondary hyperparathyroidism

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