甲状旁腺全切除术在继发性甲状旁腺功能亢进患者中的疗效评估

Therapeutic Effectiveness Total Parathyroidectomy for Secondary Hyperparathyroidism

评估继发性甲状旁腺功能亢进患者行甲状旁腺全切除术或甲状旁腺次全切除术的临床疗效。选取继发性甲状旁腺功能亢进患者40例,随机分为对照组和研究组,其中16例对照组行甲状旁腺次全切除术,其余24例研究组行甲状旁腺全切除术。观察两组患者围手术期临床参数,并随访观察其疗效。研究组症状缓解时间、iPTH、血磷及血钙恢复正常时间明显短于对照组,但术后泵钙时间与对照组相比相对长,其差异有统计学意义(P<0.05)。Kaplan-Meier法生存分析,发现研究组累计未复发率明显优于对照组,其差异有统计学意义(P<0.05)。甲状旁腺全切除术治疗继发性甲状旁腺功能亢进是一种安全有效的方法,建议选择积极的甲状旁腺全切除术。

To evaluate the therapeutic effectiveness of total parathyroidectomy （TPT） or subtotal parathyroidectomy （SPT） for secondary hyperparathyroidism （SHP）, Of 40 patients who underwent SPT or TPT for SHP, 16 treated by SPT with control group and 24 treated by TPT with study group were selected using the stochastic approach. The perioperative clinical parameter of two groups were compared, and their efficacy from follow-up. The study group had a significantly shorter symptoms remission time, iPTH of recovery time, serum phosphate of recovery time, and serum calcium of recovery time, hut showed significantly longer postoperative pump into the calcium ions of time （P〈0.05）. Kaplan-Meier survival curves showed that control group of the cumulative without recurrence rate is inversely correlated with study group （P〈0. 05）. The TPT in the treatment of SHP is a safe and effective approach, and TPT＇should be considered secondary hyperparathyroidism.