超声引导下PTC针穿刺无水乙醇注射治疗继发性甲状旁腺功能亢进的临床观察

Clinical observation of percutaneous ethanol injection by PTC needle under ultrasonic guidance treating secondary hyperparathyroidism

目的观察终末期肾衰竭患者继发性甲状旁腺功能亢进使用超声引导下PTC针穿刺无水乙醇注射治疗的疗效。方法选择28例维持性血液透析继发性甲状旁腺功能亢进(iPTH≥44 pmol/mL)的患者,在超声引导下使用PTC针进行甲状旁腺穿刺,无水乙醇注射治疗,观察注射前后iPTH、碱性磷酸酶、血清钙、磷及多普勒超声甲状旁腺血流的变化。结果 PEITP治疗前后对比iPTH明显下降,皮肤瘙痒明显缓解,骨关节痛减轻,甲状旁腺增生腺体的血流明显减少。有明显统计学差异。结论 PEITP技术目前在开展甲状旁腺切除(PTX)条件不够的单位依然是治疗难治性SHPT的有效方法。

Objective To observe effect of percutaneous ethanol injection therapy（PEITP） by PTC needle under ultrasonic guidance treating for secondary hyperparathyroidism（SHPT） of end-stage renal disease.Methods Twenty-eight hemodialysis patients with secondary hyperparathyroidism were treated with percutaneous ethanol injection by PTC needle under ultrasonic guidance.The parathyroid hormone,alkaline phosphatase,serum calcium,phosphorus,and blood flow signals of the gland under ultrasonic guidance were observed before and after treatment.Results The levels of iPTH and the blood flow signals of the gland were significantly decreased while the symptoms such as the skin pruritus,bone-arthrosis pain were improved significantly after treatment.There are significant differences.Conclusion PEITP is an efficient treatment for SHPT while not every hospital has enough facility to support parathyroidectomy（PTX）.