原发性甲状旁腺功能亢进症手术疗效分析

The clinic research of surgical therapy for primary hyperparathyroidism

目的探讨原发性甲状旁腺功能亢进症（primary hyperparathyroidism,PHPT）手术方式,比较手术前后血清钙、甲状旁腺素变化及临床症状的改善情况。方法 2006—2011年共手术治疗PHPT患者20例,其中甲状旁腺瘤12例行单纯腺瘤切除,甲状旁腺增生8例行甲状旁腺全部切除,将部分较正常甲状旁腺切割成直径为1 mm的15~25块埋藏缝合于胸锁乳突肌内。检测手术前后血清钙、甲状旁腺素水平,术后随访部分患者。结果术后血清钙、甲状旁腺素较术前明显降低,差异有统计学意义（P〈0.01）,其中血清钙于术后1~8 d恢复正常。随访10例,泌尿系结石、病理性骨折症状及骨骼畸形明显改善。结论手术治疗能明显改善PHPT患者临床症状,提高生活质量。

Objective To discuss the operation mode for primary hyper parathyroidism（PHPT）, and evaluate the difference of clinic symptoms and the change of serum calcium, parathyroid hormone before and after the surgical therapy. Methods In this study, 20 patients with PHPT who received surgical therapy between 2006 and 2011 were selected. Among them, 12 cases of parathyroid adenoma received adenoma resection, 8 cases of parathyroid hyper plasia received total resection（part of the relatively normal parathyroid gland were cut into 1 mm diameter size, and 15 to 25 pieces of gland were bu r ied within the ster nocleidomastoid）. Ser um calcium and parathy roid hor mone were detected af ter the surgery and follow-up were achieved in some of the patients. Results Serum calcium, parathyroid hormone significantly decreased（P〈0.01）, and serum calcium retur ned to normal in 1~8 d af ter surgery. Among the 10 follow-up patients, symptoms of urinary calculi, pathological fractures and bone defects were significantly improved. Conclusion Surgical therapy can obviously improve clinical symptoms and quality of life in patients with PHPT.