超声引导下经皮穿刺微波热消融治疗对维持性血液透析继发性甲状旁腺功能亢进患者生活质量的影响

Effect of ultrasound-guided percutaneous transluminal microwave thermal ablation therapy on quality of life in patients with secondary hyperparathyroidism after maintenance hemodialysis

目的 探究超声引导下经皮穿刺微波热消融治疗对维持性血液透析(MHD)继发性甲状旁腺功能亢进患者生活质量的影响。方法 选取2017年1月至2022年12月梅州市人民医院收治的80例MHD继发性甲状旁腺功能亢进患者作为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组采用甲状旁腺全切除联合自体前臂移植术治疗,观察组采用超声引导下经皮穿刺微波热消融治疗。评估两组患者治疗前后各个时间点的血清甲状旁腺激素(i PTH)、钙磷水平、生活质量及睡眠质量。结果 两组患者术后各个时间点的血清iPTH、钙磷水平低于本组术前,且观察组指标低于对照组,差异有统计学意义(P<0.05);术后,观察组患者的生理功能、生理职能、社会功能、躯体疼痛、精神健康、情感职能、活力、总体健康等评分均高于对照组,差异有统计学意义(P<0.05)。术后,两组患者的生理功能、生理职能、社会功能、躯体疼痛、精神健康、情感职能、活力、总体健康等评分高于本组术前,差异有统计学意义(P<0.05)。术后,两组患者的睡眠质量评分低于本组术前,差异有统计学意义(P<0.05)。术后,观察组患者的睡眠质量评分低于对照组,差异有统计学意义(P<0.05)。结论 超声引导下经皮穿刺微波热消融治疗可提高MHD继发性甲状旁腺功能亢进患者生活质量,提高患者的睡眠质量,调节机体血清iPTH、钙磷水平。

Objective To explore the effect of ultrasound-guided percutaneous puncture microwave thermal ablation therapy on the quality of life of patients with secondary hyperparathyroidism after maintenance hemodialysis(MHD).Methods A total of 80 patients with MHD secondary hyperparathyroidism admitted to the Meizhou People's Hospital from January 2017to December 2022 were selected as study subjects.The patients were divided into control group and observation group according to random number table method,with 40 cases in each group,using the random number method.Patients in the control group were treated with total parathyroidectomy combined with autologous forearm transplantation.In the observation group,they were treated with ultrasound-guided percutaneous puncture microwave thermal ablation.Intact parathyroid hormone in serum(i PTH),calcium and phosphorus levels,quality of life,and quality of sleep were assessed at various time points before and after treatment in both two groups.Results Compared with the preoperative,the i PTH in serum and calcium and phosphorus levels were lower at all time points after operation in both groups,and the indexes of the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After operation,the scores of physiological function,physiological function,social function,physical pain,mental health,emotional function,vitality and overall health in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).The scores of physiological function,physiological function,social function,physical pain,mental health,emotional function,vitality and general health in the two groups after operation were higher than those before operation,and the differences were statistically significant(P<0.05).The sleep quality scores of the two groups after operation were lower than those before operation,and the differences were statistically significant(P<0.05).After operation,the sleep quality score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided percutaneous puncture microwave thermal ablation therapy can improve the quality of life of patients with secondary hyperparathyroidism after MHD,improve the quality of sleep,and regulate the i PTH in serum,calcium and phosphorus levels.