129例甲状旁腺肿瘤的诊断及外科治疗

Diagnosis and surgical treatment of parathyroid tumors in 129 cases

目的探讨甲状旁腺肿瘤的诊断及外科治疗。方法回颐性分析1999年1月至2015年5月我院收治的129例甲状旁腺肿瘤患者的临床资料。结果129例甲状旁腺肿瘤均行手术治疗，病理诊断甲状旁腺囊肿9例，甲状旁腺腺瘤75例，甲状旁腺癌16例，甲状旁腺腺瘤伴生长活跃29例。术前B超定位诊断准确率为82．9％，甲状旁腺显像定位诊断准确率为94．3％。患者术后血清钙（t=16．864，P=0．000）、甲状旁腺激素水平（t=8．640，P=0．000）显著降低。结论血钙及甲状旁腺激素检测，B超及甲状旁腺显像对甲状旁腺肿瘤的诊断有重要价值，手术切除是最佳的治疗方式。

Objective To discuss the diagnosis and surgical treatment of parathyroid tumor. Methods Clinical data of 129 cases with parathyroid tumor undergoing surgical treatment at Tianjin Medical University Cancer Institute and Hospital between 1999 and 2015 were analyzed retrospectively. Results All patients underwent resection. 9 were diagnosed as cysts, 75 were diagnosed as adenoma, 16 were diagnosed as carcinoma and 29 were diagnosed as adenoma with active proliferation. The accuracy rate of preoperative B-US and radioactive scanning on location diagnosis was 82. 9% and 94. 3%. Postoperative serum calcium level （t = 16. 864, P = 0. 000 ） , and serum PTH level were significantly lower （t = 8. 640, P =0. 000）. Conclusions Serum calcium, PTH examination, B-US and parathyroid radioactive scanning are helpful for preoperative diagnosis and localization. Resection offers a definite cure for patients with parathyroid tumors.