高频超声在血透患者继发性甲状旁腺功能亢进症手术治疗中的应用

Application of high frequency ultrasound in the surgical treatment of secondary hyperparathyroidism in hemodialysis patients

目的探讨高频超声在继发性甲状旁腺功能亢进症(Secondary Hyperparathyroidism,SHPT)手术治疗中的应用效果。方法选取2021年1月-2022年10月于本院行甲状旁腺全切除术(Parathyroidectomy PTX)治疗并长期随访的SHPT患者作为研究对象。通过术前对患者甲状旁腺进行高频超声检查并记录相关数据,分析术前及术后血全段甲状旁腺激素(iPTH)、血钙、血磷等实验室检查指标,分析甲状旁腺超声诊断结果与各项生化指标的相关性。结果术前37位患者超声检查提示145枚可能增生的甲状旁腺,手术后病理结果证实148枚,检出率为97.97%(145/148)。37名患者术后iPTH、血钙、血磷均较术前明显降低,差异具有统计学意义(P<0.05),但甲状旁腺总体积与术前iPTH相关关系不显著(P>0.05)。结论SHPT患者手术效果显著,高频超声对SHPT患者术前的甲状旁腺定位准确度高,灵敏度强,但术前甲状旁腺体积对SHPT患者严重程度的判断需待进一步研究。

Objective To investigate the effect of high-frequency ultrasound in the surgical treatment of secondary hyperparathyroidism(SHPT).Methods From January 2021 to October 2022,SHPT patients who were treated with parathyroidectomy(PTX)in our hospital and followed up for a long time were selected as the study objects.The parathyroid glands of patients were examined by highfrequency ultrasound before operation and the relevant data were recorded.Blood parathyroid hormone(iPTH),blood calcium,blood phosphorus and other laboratory examination indicators before and after operation were examined,and the correlation between the ultrasonic diagnosis results of parathyroid glands and various biochemical indicators was analyzed.Results Ultrasonography showed 145 pieces of hyperplastic parathyroids in 37 patients before operation,and pathology confirmed 148 pieces of hyperplastic parathyroids after operation,and the detection rate was 97.97%(145/148).The iPTH,blood calcium and blood phosphorus of 37 patients after operation were significantly lower than those before operation(P<0.05),but the correlation between the total parathyroid volume and the preoperative iPTH was not significant(P>0.05).Conclusion The surgical effect of SHPT patients is significant.High frequency ultrasound has high accuracy and sensitivity in the preoperative localization of parathyroid glands in SHPT patients.However,the preoperative parathyroid volume should be further studied to determine the severity of SHPT patients.