原发性甲状旁腺功能亢进的外科治疗及评价

Primary hyperparathyroidism:Surgical treatment and evaluation

随着人们对甲状旁腺疾病认识的不断深入,临床诊断原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)的病例日趋增多。PHPT是导致血钙升高的最常见原因之一。由于甲状旁腺自身过度分泌甲状旁腺素从而引起血清钙水平升高,并导致全身多个系统出现损害,其中包括神经肌肉、消化道、心血管、关节及软组织、泌尿及骨骼系统。外科手术是治疗PHPT的重要手段,手术成败的关键在于术前精确定位,术中仅切除病变旁腺组织而保留正常旁腺组织,同时不破坏正常旁腺组织血供并保护周围重要组织,特别是喉返神经。

Abstract With the deeper understanding of parathyrnid disease, the clinical diagnosed cases of primary hyperparathyroidisn （PHPT） increased gradually. PHPT is the most common cause of hypercalcemia, which result from an autonomous overproduction of parathyroid hormone, and lead to damage of multiple organs and systems including neuromuscular and neuropsychiatric, gastrointestinal, cardiovascular symptoms, joints and soft tissues, bone disease, and kidney stones and nephrocalcinosis. Surgery is an important treatment for PHPT. Accurate targeting of glandular tissue lesion is one of the key to success of surgery. Moreover, only ablating glandular tissue lesion during operation without damaging normal glandular tissue and its blood supply,meanwhile proteeting Surrounding tissues, especially the recurrent laryngeal nerve, are important.