原发性甲状旁腺功能亢进症的诊断与治疗(附20例临床分析)

Diagnosis and treatment of primary hyperparathyroidism (clinical analysis of 20 patients)

目的:回顾分析20例原发性甲状旁腺功能亢进症(PHPT)患者的诊断与治疗。方法:本组男性8例,女性12例,年龄23-63岁。病程短者3个月,最长者20年。临床有骨骼系统表现者17例,神经肌系统表现11例,泌尿系统表现者9例,术前发现颈部包块者5例。B超检查18例发现病变部位,CT检查9例发现病变部位。实验室检查血钙升高12例,16例碱性磷酸酶增高,7例甲状旁腺素(PTH)增高。结果:本组均采用手术治疗,14例为甲状旁腺腺瘤,6例为甲状旁腺增生。19例患者进行了随访,14例痊愈,4例症状明显缓解,1例自觉症状无明显缓解。结论:PHPT的定性诊断主要靠血钙和PTH检测,定位诊断则依靠B超和CT检查。手术是治疗PHPT的有效手段。

Objecive：To retrospectively analyze the diagnosis and treatment of patients with primary hyperparathyroidism （PHPT）. Methods：Among 20 cases ,8 cases were male and 12 were female. The age ranged from 23 to 63 years old. The course of the disease lasted from 3 months to 20 years. Seventeen cases had clinical performances of the skeletal system symptoms, 11 cases had neuromuscular system symptoms ,9 cases had urinary system symptoms, neck mass was on｜y found in 5 cases before operation. Eighteen cases were found the position of pathological changes through type - B ultrasonic exam,9 cases through CT examination. Twelve cases were found with high blood calcium, alkaline phosphatase increased in 16 cases ,7 cases had high level of parathyroid hormone （PTH）. Results：All the 20 cases received surgical operation. Fourteen cases were found to have parathyroid adenoma,6 cases parathyroid hyperplasia. Nineteen cases were followed -up, 14 cases were cured completely,4 cases were alleviated, and 1 case with no obvious symptoms alleviated. Conclusion：The diagnosis of PHPT mainly depends on calcium and PTH test, level diagnosis relies on type - B ultrasonic and CT examination. Surgical treatment is effective for PHPT.