原发性甲状旁腺功能亢进症66例分析

Analysis of 66 Cases of Hyperparathyroidism

目的:探讨原发性甲状旁腺功能亢进症及合并高钙危象的诊断与治疗。方法:66例原发性甲状旁腺功能亢进症患者均经手术治疗,59例甲状旁腺腺瘤、4例甲状旁腺增生仅行肿物切除,3例甲状旁腺癌同时切除同侧甲状腺、峡部及周围软组织。结果:66例患者均治愈,术后无甲状旁腺功能减低或喉返神经损伤等并发症。合并高钙危象患者经快速大量补液、利尿、降钙并结合手术治疗,术后血钙下降至正常水平。结论:血钙和甲状旁腺素可作为初步诊断方法,B超及99mTc-MIBI可做出定位诊断,甲状旁腺肿物切除术是有效治疗手段。

Objective To explore the diagnosis and surgical treatment of hyperparathyroidism and hyperparathyroid crisis.Methods Tumorectomy was performed on 59 cases of parathyroid adenoma and 4 cases of parathyroid hyperplasia.In surgical treatment of 3 cases of parathyroid carcinoma,a concurrent resection of homolateral thyroid gland lobectomy and isthemectomy as well as removal of peripheral soft tissues was completed.Results All of the 66 cases were cured.There was no permanent hypoparathyroidism nor recurrent nerve injury and other complication.The patients with parathyroid crisis could be dealed with quickly fluid perfusion,diuresis,dropping calcium and operation.Conclusion Serum calcium and parathyroid hormone（PTH） assays are the methods of preliminary diagnosis.Doppler ultrasound and 99mTc-MIBI are location diagnosis examination methods.Parathyroidectomy is an effective approach to moat patients.According to intraoperative frozen section pathology and the rapid PTH determination,precise diagnosis could be made.The serum calcium level could recover to normal after the operation.