影响原发性甲状旁腺机能亢进手术治疗预后的因素分析

Analysis of the factors affecting the prognosis of surgical treatment of primary hyperparathyroidism

目的探讨原发性甲旁亢病理性骨折及其手术时机对甲旁亢手术预后的影响。方法总结甲旁亢手术后13例患者的随访结果。结果有病理性骨折者预后比没有者明显差;有病理性骨折的,在旁腺切除的围手术期内骨折矫形者预后较好;因骨质疏松严重、担心矫形后骨折不愈为由、推迟骨折处理时机者预后差。结论病理性骨折出现前切除旁腺能改善预后外,已有病理性骨折的、应在切除旁腺的同时或旁腺切除术后的围手术期内处理骨折也是改善预后的重要因素。

Objective To study the pathologic fracture of primary hyperparathyroidism and the effect of the timing of operation of the prognosis of the surgical treatment for hyperparathyroidism. Methods Analysis of the postoperative follow-up data of 13 hyperparathyroidic cases were analyzed. Results The prognosis of ~hyperpathyroidic cases without pathologic fracture was better than cases with concurrent fracture; Orthomorphia of fracture during perioperative period of parathyroidectomy showed a good prognosis,but those who had delayed treatment of fracture owing to concern of malunion due to severe osteoporosis showed a poor prognosis.~Conclusions Resection of the parathyroid gland before the appearance of pathologic fracture has a good ~proguosis .For those who present with associated pathologic fracture,treatment of the fracture at the time of parathyroidectomy or during the perioperative period of the parathyroidectomy are important factors that can ~improve the prognosis of hyperparathyroid patients.