原发性甲状旁腺功能亢进症的外科治疗体会

Surgical treatment experience of primary hyperparathyroidism

目的:对原发性甲状旁腺功能亢进症(PHPT)的临床诊断和外科治疗等问题进行的研究和讨论。方法:对1996年7月~2006年1月收治的22例PHPT患者治疗资料进行回顾性分析总结。结果:本组病例中以骨骼、泌尿系病变为主要症状,生化检查中血钙、碱性磷酸酶、血甲状旁腺激素(PTH)高于正常值,17例为甲状旁腺腺瘤,5例为甲状旁腺增生,22例术后均出现低血钙症状。结论:PHPT发病率较低,临床表现多样易误诊,B超、骨X线、CT检查,结合血钙、磷、甲状旁腺激素测定对本病做出正确诊断,诊断明确的PHPT患者,手术的疗效确切。

Objective To discuss the clinical diagnosis and surgical treatment of primary hyperparathyroidism （PHPT）. Method The clinical data of 22 cases of PHPT treated surgically between July 1996 and Jan 2006 were analyzed. Results Abnormalities in skeletal or urinary systems were tile most noticeable symptoms in most patients. SeL＇um calcium,serum alk＇,dinc pho^phatasc （AKI？）a,d lJaraLhytoid hormone（PTIt） were all over the upper limit. The adenoma of parathyroid was proven in 17 cases, hyperplasia in 5, 22 suffered from hy- pocalcemia after removal of the sick parathyroids, and calcium was given to ameliorate hypocalcemia. Conclusion The incidence of PHPT is low, and its clinical manifestations vary greatly, which easily lead to misdiagnosis. Ultrasound, X- ray changes of bones, CT, together with clinical manifestation, detection of blood calculus, phosphor and parathyrine, may make an accurate diagrosis of the disease. The operative effect is good for an accurate diagnosis of PHPT patients.