原发性甲状旁腺功能亢进症的诊断与治疗(附11例报告)

DIAGNOSIS AND TREATMENT OF PRIMARY HYPERPARATHYROIDISM (REPORT OF 11 CASES)

１９８９年６月～１９９８年３月，我院外科收治原发性甲状旁腺功能亢进症１１例。术前根据临床表现、实验室检查以及经Ｂ超、ＣＴ、彩色多普勒超声波及９９ｍＴｃＭＩＢＩ检查获定性定位诊断者９例。１１例均行手术治疗，手术成功１０例。病理检查结果：甲状旁腺腺瘤１０例，正常甲状旁腺１例。作者认为：①应提高对本病的认识以利早期诊断，术前联合应用无创性影像学检测手段以准确定位；②术者应熟悉局部解剖，尤其对异位甲状旁腺的充分认识，要有清晰的探查思路和高超的操作技巧，并结合术中常规冰冻切片检查以提高手术成功率；③术后加强内科治疗及随访，以全面提高甲状旁腺功能亢进症的诊治水平。

From June 1989 to March 1998, 11 cases of primary hyperparathyroidism (PHP) had been treated surgically in this hospital. The preoperative localization of 9 cases were achieved by one or two non invasive techniques including ultrasonography, computed tomography, color Doppler imaging and 99m Tc MIBI scintigraphy. Parathyroidectomy were done successfully in 10 of 11 cases with the pathological results of adenoma in 10 cases and one normal parathyroid. The authors emphasize ①early recognition and diagnosis which can be helped by the non invasive techniques mentioned above for localization, ②familiarity with the local anatomy especially for the ectopic parathyroid together with frozen section biopsy during operation, and ③intensive medical care after surgery and follow up so as to heighten the capacity of diagnosis and treatment of this disease.