甲状旁腺全切加前臂移植术治疗尿毒症继发性甲状旁腺功能亢进的临床研究

Clinical Study about Treatment of Secondary Hyperparathyroidism by Total Parathyroidectomy and Forearm Autotransplantation

目的研究甲状旁腺全切加前臂种植术治疗继发性甲状旁腺功能亢进症的临床疗效。方法回顾性分析韶关市第一人民医院于2014年6月-2015年6月期间收治的28例行甲状旁腺全切加前臂种植术治疗继发性甲状旁腺功能亢进的病例,对术前及术后3天、1周、1个月、3个月、6个月、1年的全段甲状旁腺激素(i PTH)、血钙、血磷、钙磷乘积、症状缓解情况、并发症等进行统计学分析。结果所有病例均顺利完成手术,术后骨骼关节疼痛均明显缓解,平均缓解时间1.5天,术后均未出现并发症;除2例复发外,术后3天、1周、1个月、3个月、6个月、1年的i PTH、血钙、血磷、钙磷乘积均较术前明显下降,有统计学意义;术后1年复发2例。结论甲状旁腺全切加前臂移植术能有效治疗继发性甲状旁腺功能亢进,手术安全,短期复发率低。

Objective To study the clinical efficacy of the treatment of secondary hyperparathyroidism by total para- thyroidectomy and forearm autotransplantation. Methods 28 patients with secoondary hyperparathyroidism were analyzed, who were accepted total parathyroidectomy and forearm autotransplantation in the first people＇s hospital of shaoguan from June 2014 to June 2015. And then compare the iPTH, calcium, phosphorus, calcium -phosphate product, and clinical symptoms between preoperative and postoperative. Results All patients were successfully operated. Bone and joint pain were signifi- cantly alleviated after surgery, the average remission time were 1.5 days. The iPTH, calcium, phosphorus and calcium - phosphate product after surgery were obviously reduced, except 1 patient. Conclusion Total parathyroidectomy and forearm autotransplantation could cure secoondary hyperparathyroidism, and this surgical approach was safe and had a low short - term recurrence rate.