期刊文献+
共找到1,112篇文章
< 1 2 56 >
每页显示 20 50 100
Secondary Hyperparathyroidism in Dialysis Patients: Short- and Long-Term Outcomes of Conservative Parathyroidectomy
1
作者 Imane Saidi Sara Elmaakoul +1 位作者 Naima Ouzeddoun Loubna Benamar 《Open Journal of Nephrology》 2024年第2期147-156,共10页
Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX bet... Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period. 展开更多
关键词 secondary hyperparathyroidism DIALYSIS Chronic Kidney Disease Conservative Subtotal Parathyroidectomy
下载PDF
难治性SHPT患者行tPTX+AT术后复发的研究进展
2
作者 卢东军(综述) 刘天奇(审校) 《现代医药卫生》 2024年第5期845-848,853,共5页
继发性甲状旁腺功能亢进症(SHPT)是尿毒症患者进行长时间血液透析治疗过程中较为常见的并发症之一,SHPT患者经长时间的透析治疗最终发展为难治性SHPT,此时内科治疗效果较差甚至无效,手术治疗可使患者症状得到快速改善。目前,甲状旁腺全... 继发性甲状旁腺功能亢进症(SHPT)是尿毒症患者进行长时间血液透析治疗过程中较为常见的并发症之一,SHPT患者经长时间的透析治疗最终发展为难治性SHPT,此时内科治疗效果较差甚至无效,手术治疗可使患者症状得到快速改善。目前,甲状旁腺全切除术联合自体移植术(tPTX+AT)是难治性SHPT患者主要的手术方式之一。然而近年来难治性SHPT患者行tPTX+AT后的康复管理问题日益突出,怎样降低其复发率是该领域研究的难点。该文对可能影响tPTX+AT术后复发的因素进行总结和讨论,为临床工作者进一步提高手术成功率,降低手术复发率,提高患者术后的生活质量,加强术后管理提供临床思路。 展开更多
关键词 继发性甲状旁腺功能亢进症 维持性血液透析 并发症 甲状旁腺全切除手术 自体移植术 手术治疗 复发 综述
下载PDF
术中及围手术期血清iPTH监测对501例继发性甲状旁腺功能亢进患者手术效果的精准诊断研究——“Diagnostic Accuracy Study of Intraoperative and Perioperative Serum Intact PTH Level for Successful Parathyroidectomy in 501 Secondary Hyperparathyroidism Patients”的二 被引量:5
3
作者 张丽娜 邢昌赢 +12 位作者 沈冲 曾鸣 杨光 毛慧娟 张波 俞香宝 孙彬 欧阳春 葛益飞 江瑶 尹彩霞 查小明 王宁宁 《中国血液净化》 2017年第4期227-233,共7页
目的甲状旁腺切除术(parathyroidectomy,PTX)是继发性甲状旁腺功能亢进患者(secondary hyperparathyroidism,SHPT)的有效治疗方式,然而由于甲状旁腺位置和数目异常的存在,部分患者术后SHPT仍持续存在。本研究探讨PTX患者术中及围手术期... 目的甲状旁腺切除术(parathyroidectomy,PTX)是继发性甲状旁腺功能亢进患者(secondary hyperparathyroidism,SHPT)的有效治疗方式,然而由于甲状旁腺位置和数目异常的存在,部分患者术后SHPT仍持续存在。本研究探讨PTX患者术中及围手术期血清全段甲状旁腺激素(intact parathyroid hormone,iPTH)监测对手术效果精准诊断的意义。方法记录501例行甲状旁腺全切+自体前臂移植术(不伴胸腺切除)的慢性肾脏病患者的术中及围手术期血清iPTH值。术后一周内患者血清iPTH≤50 pg/ml为手术成功;若>50 pg/ml则在6月内进行随访,随访血清iPTH<300 pg/mL即为手术成功,否则为SHPT持续存在。结果 433例(86.4%)患者手术成功,49例(9.8%)患者SHPT持续存在,19例(3.8%)患者缺乏有效随访归为手术效果未知组。肝炎(n=204)与非肝炎(n=297)患者比较,基线血清iPTH水平及术中血清iPTH下降百分比无显著统计学差异(P>0.05)。受试者工作特征(receiver operating characteristic,ROC)曲线结果表明术后20分钟血清iPTH下降≥88.9%提示手术成功(曲线下面积0.909,敏感度78.6%,特异度88.5%)。术后4天血清iPTH≥147.4 pg/ml提示SHPT持续存在(曲线下面积0.998,敏感度100%,特异度99.5%)。结论甲状旁腺切除术中血清iPTH监测能提示甲状旁腺切除是否彻底,避免对患者不必要的探查,降低手术并发症的发生率。围手术期血清iPTH监测提示SHPT是否持续存在,对此类患者需密切随访、及时开始药物治疗或必要时再次手术。 展开更多
关键词 术中 围手术期 甲状旁腺激素 甲状旁腺切除术 继发性甲状旁腺功能亢进
下载PDF
Paricalcitol in hemodialysis patients with secondary hyperparathyroidism and its potential benefits 被引量:7
4
作者 Xiu Chen Feng Zhao +4 位作者 Wei-Juan Pan Jia-Mei Di Wei-Nan Xie Ling Yuan Zhi Liu 《World Journal of Clinical Cases》 SCIE 2021年第33期10172-10179,共8页
BACKGROUND Secondary hyperparathyroidism(SHPT)is a common complication in patients with end-stage renal disease and it is also common in hemodialysis patients.SHPT can increase bone fragility and calcification of bloo... BACKGROUND Secondary hyperparathyroidism(SHPT)is a common complication in patients with end-stage renal disease and it is also common in hemodialysis patients.SHPT can increase bone fragility and calcification of blood vessels and soft tissues,which greatly increases the risk of death.AIM To discuss the outcome,safety and other potential benefits of paricalcitol injection in hemodialysis patients with SHPT.METHODS We recruited 40 patients who received hemodialysis at our hospital for chronic renal failure with SHPT between March and December 2019.They received paricalcitol injection for 24 wk(starting dose,0.06–0.08μg/kg),three times per week.They were followed up at the baseline(week 0),week 4,week 12 and week 24.The primary outcome indicator was the percentage of patients with a>30%decrease in intact parathyroid hormone(iPTH)levels at week 24 compared with the baseline.The secondary outcome indicators included percentage decrease in iPTH levels at week 24,standard-reaching rate of iPTH(percentage of patients with iPTH down to 130–585 pg/mL),changes in serum levels of calcium(Ca),phosphate(P),Ca×P product,alkaline phosphatase(ALP),creatinine(Cre),hemoglobin(Hb),and C-reactive protein(CRP),and incidence of adverse events(AEs).RESULTS After 24 wk of treatment,iPTH levels decreased significantly(598.88±381.29 pg/mL vs 888.84±376.88 pg/mL,P<0.05).More than 30%decrease of iPTH was found in 21 of 36(58.33%)patients.The average decrease in iPTH levels was 32.16±4.33%;the standard-reaching rate of iPTH levels was 66.67%(24/36);and ALP levels decreased significantly compared with the baseline(113.72±41.73 IU/L vs 133.45±56.86 IU/L)(t=2.798,P<0.05).There were no significant differences in the serum levels of calcium,Hb,Cre and CRP compared with the baseline(P>0.05).After 24 wk of treatment,serum P levels decreased compared with the baseline(1.91±0.40 mmol/L vs 2.16±0.66 mmol/L)(t=2.830,P<0.05).Ca×P product decreased significantly compared with the baseline(56.38±13.22 mg2/dL2 vs 63.97±20.30 mg2/dL2)(t=2.717,P<0.05).No serious adverse events occurred.CONCLUSION Paricalcitol was a safe and effective treatment for hemodialysis patients with SHPT.It decreased serum levels of iPTH,ALP and P and maintained stability of serum Ca levels. 展开更多
关键词 PARICALCITOL HEMODIALYSIS secondary hyperparathyroidism Drug efficacy Drug safety
下载PDF
帕立骨化醇治疗血液透析患者SHPT12周疗效观察及iPTH与腹主动脉钙化评分的特点分析 被引量:3
5
作者 刘音 赵彬 +2 位作者 刘丽芳 胡普平 杨涛 《中国血液净化》 CSCD 2023年第7期508-511,528,共5页
目的探讨帕立骨化醇治疗维持性血液透析(maintenance hemodialysis,MHD)伴继发性甲状旁腺功能亢进症患者的临床疗效,分析全段甲状旁腺激素(iPTH)水平与腹主动脉钙化(abdominal aortic calcification,AAC)评分的相关性。方法研究纳入2019... 目的探讨帕立骨化醇治疗维持性血液透析(maintenance hemodialysis,MHD)伴继发性甲状旁腺功能亢进症患者的临床疗效,分析全段甲状旁腺激素(iPTH)水平与腹主动脉钙化(abdominal aortic calcification,AAC)评分的相关性。方法研究纳入2019年4月~2020年6月在北京市海淀医院接受维持性血液透析继发性甲状旁腺功能亢进治疗的门诊患者。在MHD治疗基础上予以静脉帕立骨化醇治疗12周,比较治疗前后的血钙、血磷和iPTH以及AAC评分以评估帕立骨化醇治疗12周的临床疗效,并随访12个月后患者iPTH水平与AAC情况的关系。结果入选患者40例(24例男性和16例女性)经帕立骨化醇治疗12周后,患者血磷(t=2.192,P=0.047)、iPTH水平(t=3.026,P=0.014)均低于治疗前,血钙水平较治疗前水平升高(t=4.188,P=0.001),但仍维持在正常范围内(2.1~2.5mmol/L)。比较治疗前后iPTH降低情况,应用帕立骨化醇的治疗总有效率达到95%。AAC轻度组、中度组和重度组患者iPTH水平差异具有统计学意义(F=150.400,P<0.001),其中重度AAC患者伴有高水平iPTH。随访12个月后的AAC评分较治疗前有所降低,但差异无统计学意义(t=0.504,P=0.617)。结论本研究证实帕立骨化醇可显著降低血液透析患者的iPTH和血磷水平,且血钙磷水平始终维持在正常范围内。血液透析患者出现重度腹主动脉钙化,可能与高iPTH水平相关。 展开更多
关键词 血液透析 继发性甲状旁腺功能亢进症 帕立骨化醇 腹主动脉钙化
下载PDF
Effect of calcium supplementation on severe hypocalcemia in patients with secondary hyperparathyroidism after total parathyroidectomy 被引量:2
6
作者 Jun Liu Xue-Feng Fan +2 位作者 Meng Yang Lin-Ping Huang Ling Zhang 《World Journal of Clinical Cases》 SCIE 2022年第13期4033-4041,共9页
BACKGROUND Severe hypocalcemia(SH)is a dreaded complication of total parathyroidectomy(TPTX)without auto-transplantation.AIM To compare conventional and preventive calcium supplementation(CS)regimens in terms of SH oc... BACKGROUND Severe hypocalcemia(SH)is a dreaded complication of total parathyroidectomy(TPTX)without auto-transplantation.AIM To compare conventional and preventive calcium supplementation(CS)regimens in terms of SH occurrence after TPTX.METHODS This retrospective study included patients who underwent TPTX between January 2015 and May 2018 at the China-Japan Friendship Hospital.From January 2015 to May 2016,conventional CS was performed in patients who underwent TPTX,with calcium amounts adjusted according to postoperative serum calcium levels.From October 2016 to May 2018,preventive CS was performed according to preoperative alkaline phosphatase(ALP)levels.The patients were defined as lowrisk(ALP<500 U/L)and high-risk(ALP>500 U/L)for SH.All preoperative blood samples were collected in the fasting state on the day before surgery.Postoperative blood samples were obtained at 6-7 AM from the first postoperative day.RESULTS A total of 271 patients were included.These patients were 47.7±11.1 years old,and 57.6%were male.Their mean body mass index(BMI)was 22.9±3.8 kg/m^(2).There were no significant differences in sex,age,BMI,preoperative ALP,serum calcium,serum phosphorus,calcium-phosphorus ratio,and intact parathyroid hormone(iPTH)between the two CS groups.Compared with conventional CS,preventive CS led to lower occurrence rates of hypocalcemia within 48 h(46.0%vs 74.5%,P<0.001)and SH(31.7%vs 64.1%,P<0.001).Multivariable analysis showed that preoperative iPTH levelsodds ratio(OR)=1.001,95%confidence interval(CI:1.000-1.001,P=0.009),preoperative ALP amounts(OR=1.002,95%CI:1.001-1.003,P=0.002),preoperative serum phosphorus levels(OR=8.729,95%CI:1.518-50.216,P=0.015)and preventive CS(OR=0.132,95%CI:0.067-0.261,P<0.001)were independently associated with SH.In patients with preoperative ALP≥500 U/L,only preventive CS(OR=0.147,95%CI:0.038-0.562.P=0.005)was independently associated with SH.CONCLUSION This study suggests that preventive CS could reduce the occurrence of SH,indicating its critical value for hypocalcemia after TPTX. 展开更多
关键词 End-stage renal disease secondary hyperparathyroidism PARATHYROIDECTOMY HYPOCALCEMIA Calcium supplementation
下载PDF
血液透析SHPT患者应用低钙透析液联合活性维生素D治疗对其血清iPTH及钙磷代谢水平的影响 被引量:2
7
作者 王善平 蓝炉山 +2 位作者 张秀华 丘珍玉 苏健忠 《中外医学研究》 2023年第21期5-8,共4页
目的:探究血液透析继发性甲状旁腺功能亢进症(SHPT)患者应用低钙透析液联合活性维生素D治疗对其血清全段甲状旁腺激素(iPTH)及钙磷代谢水平的影响。方法:选择2021年3月—2022年3月上杭县医院收治的78例血液透析SHPT患者为研究对象,按随... 目的:探究血液透析继发性甲状旁腺功能亢进症(SHPT)患者应用低钙透析液联合活性维生素D治疗对其血清全段甲状旁腺激素(iPTH)及钙磷代谢水平的影响。方法:选择2021年3月—2022年3月上杭县医院收治的78例血液透析SHPT患者为研究对象,按随机数表法将其分为试验组(n=39)和对照组(n=39),对照组给予活性维生素D联合常规透析液治疗,试验组给予活性维生素D联合低钙透析液治疗。比较治疗前后两组血清iPTH、钙磷代谢指标(血钙、血磷和钙磷乘积)、肾功能指标[血肌酐(Scr)、尿素氮(BUN)和尿素清除指数(KT/V)]水平,记录两组治疗6个月期间不良反应发生情况。结果:治疗后,两组iPTH、血磷和钙磷乘积水平均较同组治疗前明显下降,且同一时间试验组低于对照组,差异有统计学意义(P<0.05);治疗后,两组血钙水平均较同组治疗前升高,且同一时间试验组高于对照组,差异有统计学意义(P<0.05)。两组治疗前、治疗后Scr、BUN和KT/V水平比较,差异无统计学意义(P>0.05)。试验组治疗6个月不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:低钙透析液联合活性维生素D治疗血液透析SHPT患者可有效减少i PTH分泌,进而改善钙磷代谢紊乱,且不良反应少。 展开更多
关键词 继发性甲状旁腺功能亢进症 血液透析 低钙透析液 活性维生素D
下载PDF
Sagliker syndrome: A case report of a rare manifestation of uncontrolled secondary hyperparathyroidism in chronic renal failure
8
作者 Yu Yu Chen-Fang Zhu +1 位作者 Xiao Fu Hua Xu 《World Journal of Clinical Cases》 SCIE 2019年第22期3792-3799,共8页
BACKGROUND Sagliker syndrome(SS)resulting from uncontrolled secondary hyperparathyroidism(SHPT)in chronic renal failure(CRF)is seldom reported.CASE SUMMARY A 24-year-old woman presented with asymmetric facial deformit... BACKGROUND Sagliker syndrome(SS)resulting from uncontrolled secondary hyperparathyroidism(SHPT)in chronic renal failure(CRF)is seldom reported.CASE SUMMARY A 24-year-old woman presented with asymmetric facial deformity and stature shortening.She was diagnosed with SS,SHPT,CRF,and thyroid cancer.The patient underwent a total parathyroidectomy and thyroidectomy with central lymph node dissection.The patient’s condition was stable and was discharged from the hospital.CONCLUSION Undergoing dialysis vintage,presenting high serum phosphate levels,and female gender may be risk factors for SS.Intramembranous ossification in the craniomaxillofacial region is possibly activated in this special pathophysiological condition.What’s more,the choice of surgery mainly depends on the treatment goal and the experience of the individual surgeon. 展开更多
关键词 Sagliker SYNDROME secondary hyperparathyroidism Chronic RENAL failure UREMIC leontiasis ossea Case report
下载PDF
Surgical Treatment of Secondary Hyperparathyroidism in Surgery B of Chu of Point G
9
作者 S. Diallo O. Sacko +7 位作者 M. Sissoko A. Kanté A. Coulibaly L. Soumaré B. Coulibaly M. Camara D. Traoré N. Ongoiba 《Surgical Science》 2019年第10期355-361,共7页
Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to rena... Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to renal failure terminal operated in the Service of surgery B of the Central Hospital University of Point G between December 2016 and November 2018. Results: The sex ratio was 0.22 in favor of women. The average age of the patients was 43 or 27 years with extremes of 63 and 25 years. Secondary hyperparathyroidism in renal failure chronic represented 1.9% of interventions to cold in the Service of surgery B. 100% of patients (11/11) were haemodialysis. 100% of the patients had clinical and biological signs. 45.5% (5/11) had radiological signs. The average rate of parathyroid hormone was 2413.51 pg/ml with extremes of 1264 pg/ml and 3616 pg/ml. The reference value was 15 - 65 pg/ml. The surgical technique of choice was the 7/8th parathyroidectomy in 100% of cases. The postoperative were simple in 81.8%, and complicated in 18.2%. There were no death. The average duration of postoperative follow-up was 6 months. After surgery, 50% of patients (5/10) had normal levels of parathyroid hormone and 50% (5/10) made a persistent hyperparathyroidism. Conclusion: Secondary hyperparathyroidism is a frequent complication in renal insufficient chronic in hemodialysis. Surgery is indicated in the resistant cases of medical treatment. The 7/8th parathyroidectomy is the surgical technique of choice. The rate of post operative complications is higher in our context. 展开更多
关键词 secondary hyperparathyroidism TREATMENT SURGERY
下载PDF
Secondary hyperparathyroidism associated with multiple brown tumor:a case report
10
作者 Li Kangfeng Chen Zhou +4 位作者 Zhao Xuezhi Zhou Yukun Zhang Dechang Yang Guanhu Tang Xiaofang 《Journal of Medical Colleges of PLA(China)》 CAS 2011年第6期360-366,共7页
Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours... Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients. 展开更多
关键词 Brown tumour secondary hyperparathyroidism HEMODIALYSIS
下载PDF
Bone Dysmorphia-Induced Blindness Following a Secondary Hyperparathyroidism: A Case Report
11
作者 Gael Honal Mahoungou Daniel Tony Eyeni Sinomono +6 位作者 Ghislain Armel Mpandzou Regis Franck Moyikoua Josue Euberma Diatewa Dinah Happhia Motoula Benedicte Diatewa Helena Botokoto Bothard Richard Loumingou 《Open Journal of Nephrology》 2021年第4期489-494,共6页
<strong>Introduction:</strong> Conjunctival-corneal or choroidal calcifications are frequent in SHPT, blindness is however exceptional. We report a case of blindness secondary to compressive ischemic optic... <strong>Introduction:</strong> Conjunctival-corneal or choroidal calcifications are frequent in SHPT, blindness is however exceptional. We report a case of blindness secondary to compressive ischemic optic neuropathy. <strong>Case Report:</strong> Mr. B.E.K., 49 years old, has a chronic renal failure secondary to unlabeled glomerular nephropathy for 17 years. He has been on chronic hemodialysis for 12 years and has had SHPT for nine years. He secondarily developed disabling segmental osteoarticular deformities associated with kyphoscoliosis, “drumstick” fingers and facial dysmorphism. Five months before admission he developed eye pain and reduced visual acuity progressing within one month to blindness. Biology noted: serum creatinine at 726 umol/l (60 - 120 umol/L), azotemia at 14.3 mmol/l (2.5 - 7.5 mmol/L), serum calcium at 2.25 (2.25 - 2.55 mmol/L), phosphatemia at 1.13 (0.8 - 1.35 mmol/L), alkaline phosphatases at 2196 (5 - 270 IU/L) and parathyroid hormone level at 2257 (10 - 60 pg/mL). Retinal angiography revealed lesions suggestive of ischemic neuropathy. The orbit CT scan with 3D coronal reconstruction revealed narrowing of the caliber of the optical channels with dystrophic thickening of the skull base and cranial vault. Cranioencephalic and orbital MRI revealed diffuse brown tumors and pre-chiasmatic optic atrophy. <strong>Discussion:</strong> The most frequent ocular complications of SHPT are conjunctival-corneal or sclero-choroidal calcifications, asymptomatic, associated with hypercalcemia. Compressive manifestations are rarer, represented mainly by an amputation of the visual field, diplopia, ptosis or blindness, as described in our patient. The main cause is osteodystrophy and brown tumors of the skull base (1% - 2%). <strong>Conclusion:</strong> This case report underlines the importance of early detection of SHPT, in order to avoid its major complications, such as blindness, especially since current preventive and curative measures have proven their effectiveness. 展开更多
关键词 BLINDNESS secondary hyperparathyroidism Bone Dysmorphism
下载PDF
甲状旁腺全切除术联合甲状旁腺自体移植术治疗尿毒症SHPT的效果与安全性 被引量:1
12
作者 杨徐雄 王强 +1 位作者 顾伟青 欧贵雪 《中外医学研究》 2023年第1期139-143,共5页
目的:探讨甲状旁腺全切除术(TPTX)联合甲状旁腺自体移植术(TPTX+AT)治疗尿毒症继发性甲状旁腺功能亢进症(SHPT)的效果与安全性。方法:选取2018年12月-2021年5月福建医科大学附属闽东医院就诊的62例尿毒症SHPT患者作为试验对象。根据随... 目的:探讨甲状旁腺全切除术(TPTX)联合甲状旁腺自体移植术(TPTX+AT)治疗尿毒症继发性甲状旁腺功能亢进症(SHPT)的效果与安全性。方法:选取2018年12月-2021年5月福建医科大学附属闽东医院就诊的62例尿毒症SHPT患者作为试验对象。根据随机数字表法将其分为联合组(n=31)和对照组(n=31)。对照组给予TPTX治疗。联合组给予TPTX+AT治疗。比较两组围手术期指标,术前及术后1 d、1周、1个月生化指标、临床症状,并发症及术后3个月复发率。结果:联合组手术时长显著长于对照组(P<0.05),两组术中出血量和住院时长比较差异均无统计学意义(P>0.05)。术后1 d,两组甲状旁腺激素(PTH)、血磷及血钙水平均显著降低,两组比较差异均无统计学意义(P>0.05);术后1周、1个月,联合组PTH和血磷水平均显著低于对照组(P<0.05),术后1周,联合组血钙水平显著低于对照组(P<0.05),术后1个月,两组血钙水平比较差异无统计学意义(P>0.05)。术后1周、1个月两组皮肤瘙痒、骨痛、肌无力占比均较术前显著降低,且联合组皮肤瘙痒、骨痛、肌无力占比均显著低于对照组(P<0.05)。两组术后声音嘶哑、伤口感染发生率及术后3个月复发率比较差异均无统计学意义(P>0.05)。结论:TPTX+AT可更快速改善尿毒症SHPT患者临床症状,恢复其生化指标,有助于患者预后。 展开更多
关键词 尿毒症继发性甲状旁腺功能亢进症 甲状旁腺全切除术 甲状旁腺自体移植术
下载PDF
Surgical Treatment of Hyperparathyroidism Secondary to Chronic Renal Failure: Our Experience with the 7/8 Subtotal Parathyroidectomy Technique
13
作者 Ahmadou C. Sall Mame S. Diouf +11 位作者 Houra Ahmed Ngor Ndour Ciré Ndiaye Abdou Sy Richard E. A. Deguenonvo Evelyne S. Diom Malick Ndiaye Abdourahmane Tall Bay K. Diallo Issa C. Ndiaye Raymond Diouf 《International Journal of Otolaryngology and Head & Neck Surgery》 2022年第1期25-30,共6页
<strong>Introduction:</strong> Surgical management takes place, after a certain period of evolution, on particularly severe forms of secondary hyperparathyroidism, resistant to medical treatment. Subtotal ... <strong>Introduction:</strong> Surgical management takes place, after a certain period of evolution, on particularly severe forms of secondary hyperparathyroidism, resistant to medical treatment. Subtotal parathyroidectomy is an effective technique in the treatment of these disorders. <strong>Method:</strong> Our study is retrospective of 33 cases of hyperparathyroidism secondary to chronic renal failure in dialysis patients operated by the 7/8 technique. Identified over a period of 10 years (January 2010 to December 2019), in the ENT department of the Fann University Hospital. <strong>Results:</strong> Out of 33 cases of secondary hyperparathyroidism, the average age of our patients was 51.24 years with a sex ratio of 0.43. Causal nephropathy was dominated by nephro-angiosclerosis, which was found in 27.27% of cases. Bone pain found in 23 patients or 69.69% was the predominant clinical sign. The average calcemia was 92.7 mg/l. Parathormone was dosed in all our patients and the average was 1611.05 ng/l. The consequences were clinically marked by recurrent paresis in one patient. No case of hematoma or postoperative infection was found. On the biological level 10 patients or 30.30% had a transient hypocalcaemia. The results were marked by a drop in PTH in 23 patients or 78.78% of cases. <strong>Conclusion:</strong> Subtotal parathyroidectomy remains an effective and beneficial therapeutic method for kidney failure patients with secondary hyperparathyroidism. 展开更多
关键词 secondary hyperparathyroidism 7/8 Parathyroidectomy Transient Hypocalcemia Persistent hyperparathyroidism
下载PDF
依特卡肽治疗糖尿病肾病维持性血液透析继发甲状旁腺功能亢进的疗效观察 被引量:1
14
作者 马世兴 仇琳 王勤超 《川北医学院学报》 CAS 2024年第8期1049-1051,1055,共4页
目的:探究依特卡肽治疗糖尿病肾病维持性血液透析(MHD)继发性甲状旁腺功能亢进(SHPT)的疗效。方法:根据治疗药物不同将92例糖尿病肾病MHD引起的SHPT患者分为研究组和对照组,每组各46例。研究组给予依特卡肽治疗;对照组给予西那卡塞治疗... 目的:探究依特卡肽治疗糖尿病肾病维持性血液透析(MHD)继发性甲状旁腺功能亢进(SHPT)的疗效。方法:根据治疗药物不同将92例糖尿病肾病MHD引起的SHPT患者分为研究组和对照组,每组各46例。研究组给予依特卡肽治疗;对照组给予西那卡塞治疗,两组均持续治疗3个月。比较治疗前后的两组患者的甲状旁腺指标、生化指标、成纤维细胞生长因子23(FGF23)水平、骨代谢指标差异;记录并比较两组患者不良反应发生情况。结果:治疗后,两组患者甲状旁腺指标、生化指标、FGF23水平、骨代谢指标均降低(P<0.05),且研究组低于对照组(P<0.05);研究组患者不良反应发生率低于对照组(P<0.05)。结论:依特卡肽治疗糖尿病肾病MHD继发SHPT患者可有效改善患者甲状旁腺功能。 展开更多
关键词 糖尿病肾病 维持性血液透析 继发性甲状旁腺功能亢进 甲状腺指标
下载PDF
维持性血液透析患者甲状旁腺切除术后早期骨饥饿综合征风险预测模型的构建与验证
15
作者 王露芳 李远明 +2 位作者 刘新新 侯蓓 徐勇 《中南大学学报(医学版)》 CAS CSCD 北大核心 2024年第5期784-794,共11页
目的:甲状旁腺切除术(parathyroidectomy,PTX)是治疗难治性继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的有效方法,但PTX后极易出现骨饥饿综合征(hungry bone syndrome,HBS),严重威胁维持性血液透析(maintenance hemod... 目的:甲状旁腺切除术(parathyroidectomy,PTX)是治疗难治性继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的有效方法,但PTX后极易出现骨饥饿综合征(hungry bone syndrome,HBS),严重威胁维持性血液透析(maintenance hemodialysis,MHD)患者的生命健康。目前已有研究分析PTX后并发HBS的风险因素,但风险预测模型的预测性能和临床适用性仍待进一步验证。本研究旨在构建MHD伴SHPT患者PTX后并发HBS的风险预测模型,并验证其预测效果。方法:回顾性收集2020年1月至2021年12月在长沙捷奥肾病医院行PTX的MHD伴SHPT的368例患者为训练集,按照是否发生HBS分为HBS组和non-HBS组,对2组的一般资料、手术相关信息、生化指标等进行比较,应用多因素logistic回归筛选HBS的影响因素,建立风险预测模型。采用受试者操作特征(receiver operator characteristic,ROC)曲线、决策曲线、校准曲线对模型进行评价。收集2022年1至12月在中南大学湘雅三医院行PTX的MHD伴SHPT的170例患者为验证集进行外部验证。结果:MHD伴SHPT患者PTX后HBS发生率为60.60%,logistic回归分析结果显示:术前骨骼受累(OR=3.908,95%CI 2.179~7.171)、术前血钙(OR=7.174,95%CI 2.291~24.015)、术前全段甲状旁腺激素(intact parathyroid hormone,i PTH)(OR=1.001,95%CI 1.001~1.001)、术前碱性磷酸酶(alkaline phosphatase,ALP)(OR=1.001,95%CI 1.000~1.001)、术后第1天血钙(OR=0.006,95%CI0.001~0.038)是MHD患者伴SHPT行PTX后并发HBS的独立危险因素(均P<0.01)。构建的风险预测模型在内部训练集和外部验证集中均表现出良好的预测结果,内部验证集的准确度为0.821,灵敏度为0.890,特异度为0.776,约登指数为0.666,曲线下面积(area under curve,AUC)为0.882(95%CI 0.845~0.919);外部验证集的准确度为0.800,灵敏度为0.806,特异度为0.799,约登指数为0.605,AUC为0.863(95%CI 0.795~0.932)。结论:术前骨骼受累、术前血钙、术前iPTH、术前ALP、术后第1天血钙水平是MHD伴SHPT患者行PTX后并发HBS的影响因素,基于上述因素构建的风险预测模型可靠。 展开更多
关键词 维持性血液透析 继发性甲状旁腺功能亢进症 甲状旁腺切除术 骨饥饿综合征 风险预测模型
下载PDF
快速康复方案在继发性甲状旁腺功能亢进患者中的应用效果
16
作者 冯文静 梁建璟 +3 位作者 李曼 李洁 房轩 金秋 《中国医药导报》 CAS 2024年第18期61-64,共4页
目的探讨快速康复方案在继发性甲状旁腺功能亢进患者中的应用效果。方法选取2020年1月至2023年6月于河北医科大学第三医院行甲状旁腺切除术治疗的200例继发性甲状旁腺功能亢进患者为研究对象,按照随机数字表法将其分为观察组与对照组,各... 目的探讨快速康复方案在继发性甲状旁腺功能亢进患者中的应用效果。方法选取2020年1月至2023年6月于河北医科大学第三医院行甲状旁腺切除术治疗的200例继发性甲状旁腺功能亢进患者为研究对象,按照随机数字表法将其分为观察组与对照组,各100例。观察组给予快速康复策略,对照组给予常规护理。比较两组手术时间、住院时间、术后卧床时间、住院费用。比较两组不同时间点C反应蛋白(CRP)、白细胞介素-1(IL-1)、转化生长因子-β_(1)(TGF-β_(1))、血钙、视觉模拟评分法(VAS)评分、医学研究理事会评估表(MRC)评分、体重指数。结果两组手术时间比较,差异无统计学意义(P>0.05);观察组住院时间、术后卧床时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05)。两组术后1、3、5 d CRP、IL-1、TGF-β_(1)水平均高于术前,术后3、5 d CRP、IL-1、TGF-β_(1)水平低于术1 d,术后5 d CRP、IL-1、TGF-β_(1)水平低于术后3 d,差异有统计学意义(P<0.05);观察组术后3、5 d CRP、IL-1、TGF-β_(1)水平均低于对照组,差异有统计学意义(P<0.05)。两组术后1、3、5 d血钙水平均低于术前,差异有统计学意义(P<0.05);观察组术后1、3、5 d血钙水平均高于对照组,差异有统计学意义(P<0.05)。两组术后3、5 d VAS评分均低于术后1 d(P<0.05);观察组术后1、3、5 d VAS评分低于对照组,差异有统计学意义(P<0.05)。术前与术后,两组MRC评分、体重指数比较,差异无统计学意义(P>0.05)。观察组总并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论快速康复策略在继发性甲状旁腺功能亢进患者中有利于控制炎症和降低并发症发生率,对促进早期康复具有重要意义。 展开更多
关键词 继发性甲状旁腺功能亢进 快速康复策略 应用效果
下载PDF
热消融治疗继发性甲状旁腺功能亢进症术后严重低钙血症的危险因素
17
作者 邓兆燕 李秋林 +3 位作者 杨雪群 覃莹莹 蒋远霞 甘剑光 《中国医学影像学杂志》 CSCD 北大核心 2024年第6期547-552,共6页
目的 探讨超声引导下热消融治疗继发性甲状旁腺功能亢进症术后严重低钙血症的危险因素。资料与方法 采用回顾性病例对照研究,选取2019年5月—2023年5月玉林市第一人民医院91例尿毒症合并继发性甲状旁腺功能亢进症患者,均行超声引导下热... 目的 探讨超声引导下热消融治疗继发性甲状旁腺功能亢进症术后严重低钙血症的危险因素。资料与方法 采用回顾性病例对照研究,选取2019年5月—2023年5月玉林市第一人民医院91例尿毒症合并继发性甲状旁腺功能亢进症患者,均行超声引导下热消融术,根据术后血钙水平,分为严重低钙血症组与非严重低钙血症组。比较两组临床资料差异,采用多因素Logistic回归分析探讨严重低钙血症的独立危险因素。结果 91例患者中,实施微波消融49例,射频消融42例,共消融317个腺体,术后发生严重低钙血症57例(62.64%)。两组术前全段甲状旁腺激素(iPTH)、iPTH 1 d下降率、术前血清碱性磷酸酶、甲状旁腺腺体≥4个比例和腺体总体积差异有统计学意义(P均<0.05)。对iPTH 1 d下降率使用受试者工作特征曲线分析获取最佳截点为74.59%,曲线下面积为0.866(95%CI 0.787~0.945,P<0.05),敏感度为84.2%,特异度为78.1%。多因素Logistic回归分析显示术前血清碱性磷酸酶(OR=1.015,95%CI 1.005~1.025,P=0.030)、iPTH 1 d下降率≥74.59%(OR=30.423,95%CI 5.938~155.858,P<0.001)、甲状旁腺腺体≥4个(OR=4.355,95%CI 1.027~18.469,P=0.046)是术后发生严重低钙血症的独立危险因素。结论 术前血清碱性磷酸酶、iPTH 1 d下降率≥74.59%、甲状旁腺腺体≥4个是热消融术后发生严重低钙血症的独立危险因素。 展开更多
关键词 超声引导下热消融 甲状旁腺功能亢进症 继发性 严重低钙 危险因素
下载PDF
继发性甲状旁腺功能亢进症患者加速康复外科护理服务需求的项目特征与关联性分析
18
作者 冯文静 许润涛 +2 位作者 房轩 金秋 王丽 《保健医学研究与实践》 2024年第2期28-33,共6页
目的探讨继发性甲状旁腺功能亢进症(SHPT)患者加速康复外科(FTS)护理服务需求的项目特征与关联性,以期为临床治疗提供参考。方法将2021年1月—2023年1月于河北医科大学第三医院接受FTS护理服务的100例SHPT患者作为研究对象,收集患者FTS... 目的探讨继发性甲状旁腺功能亢进症(SHPT)患者加速康复外科(FTS)护理服务需求的项目特征与关联性,以期为临床治疗提供参考。方法将2021年1月—2023年1月于河北医科大学第三医院接受FTS护理服务的100例SHPT患者作为研究对象,收集患者FTS护理服务项目需求;并以资料饱和为原则对患者进行半结构式访谈,采用Python中Apriori模块分析不同SHPT患者FTS护理服务需求项目的特征及关联性,计算项/项集的支持度、置信度和提升度;使用Colaizzi分析法进行质性研究分析。结果量性研究显示:FTS护理服务需求总数为52项,包括健康教育、心理护理、饮食护理、康复训练、用药护理、并发症预防护理6类;各项集支持度均>0.02,用药护理和康复训练支持度最高。质性研究结果显示:患者FTS护理服务需求共凝练出4个主题,分别为疾病知识技能需求、用药知识需求、康复护理需求、心理社会支持需求。结论SHPT患者存在不同的FTS护理服务需求,各项目间具有促进作用,管理过程中可根据项目关联特点,设置合理的服务项目,提高FTS护理服务水平。 展开更多
关键词 继发性甲状旁腺功能亢进症 快速康复外科 护理服务需求
下载PDF
维持性血液透析继发性甲状旁腺功能亢进患者甲状旁腺增生超声临床特点及误诊原因分析
19
作者 徐蓉 田慧 +1 位作者 吴迎春 吕康泰 《临床误诊误治》 CAS 2024年第10期16-22,共7页
目的探讨维持性血液透析继发性甲状旁腺功能亢进(SHPT)患者甲状旁腺增生超声临床特点及误诊原因。方法选择2021年4月至2023年2月维持性血液透析SHPT 190例为研究对象,比较不同程度SHPT患者超声特征,分析超声对SHPT患者甲状旁腺增生的诊... 目的探讨维持性血液透析继发性甲状旁腺功能亢进(SHPT)患者甲状旁腺增生超声临床特点及误诊原因。方法选择2021年4月至2023年2月维持性血液透析SHPT 190例为研究对象,比较不同程度SHPT患者超声特征,分析超声对SHPT患者甲状旁腺增生的诊断效能,多因素Logistic回归分析超声误诊的相关影响因素。再根据甲状旁腺是否增生分为增生组(n=127)和对照组(n=63),建立多因素Logistic回归模型分析SHPT患者甲状旁腺增生的独立危险因素,并分析不同方法对甲状旁腺增生的诊断效能。结果随SHPT严重程度的加重,多枚增生、低回声、结节形态不规则、结节血供丰富、内部回声不均匀、出现钙化的比例也随之升高。超声检查甲状旁腺增生的敏感度为0.881,特异度为0.657,误诊率为34.29%,漏诊率为11.86%。结节最大径、结节形态及结节血供均为超声误诊SHPT患者甲状旁腺增生的影响因素(P<0.05)。透析时间、碱性磷酸酶、血磷及甲状旁腺素水平是影响SHPT患者甲状旁腺增生的独立危险因素(P<0.01)。超声检查、Logistic回归模型及联合诊断甲状旁腺增生的受试者工作特征曲线下面积分别为0.773、0.754、0.889,其中联合诊断最高,并且准确性(0.840)和约登指数(0.679)均高于其他方法。结论随着维持性血液透析患者SHPT严重程度的加重,甲状旁腺形态结构改变越发显著,超声检查甲状旁腺增生误诊率较高,结节形态、结节最大径及结节血供对超声检查诊断结果具有显著影响。超声联合Logistic回归模型诊断SHPT患者甲状旁腺增生,具有较高价值。 展开更多
关键词 维持性血液透析 甲状旁腺功能亢进 继发性 甲状旁腺素 超声检查 误诊 增生 危险因素 诊断
下载PDF
弥散张量成像评估终末期肾病继发甲状旁腺功能亢进症患者认知及脑白质损伤
20
作者 单艳棋 徐佳佳 +3 位作者 苏莲子 赵茹 邹立巍 王龙胜 《中国医学影像技术》 CSCD 北大核心 2024年第3期341-345,共5页
目的 采用弥散张量成像(DTI)评估终末期肾病(ESRD)继发甲状旁腺功能亢进症(SHPT)患者认知及脑白质微结构损伤。方法 回顾性分析50例ESDR患者,以其中25例SHPT者为SHPT组,以25例非SHPT者为对照组,记录其简易精神状态检查(MMSE)评估结果及... 目的 采用弥散张量成像(DTI)评估终末期肾病(ESRD)继发甲状旁腺功能亢进症(SHPT)患者认知及脑白质微结构损伤。方法 回顾性分析50例ESDR患者,以其中25例SHPT者为SHPT组,以25例非SHPT者为对照组,记录其简易精神状态检查(MMSE)评估结果及相关临床血清学指标;比较颅脑DTI所示组间各向异性分数(FA)、平均弥散率(MD)、轴向弥散率(AD)及径向弥散率(RD),分析SHPT组MMSE评分及血清学指标与上述指标组间存在差异脑区DTI参数的相关性。结果 相比对照组,SHPT组MMSE评分明显减低、血清钙水平略升高(P均<0.05);包括大脑半球、小脑及脑干的多个脑区FA及AD减低,且大脑异常以右侧为主,部分脑区RD升高。SHPT组MMSE评分与全段甲状旁腺激素(iPTH)水平呈负相关(r=-0.800,P<0.01);血清钙、磷酸盐及肌酐水平与部分脑区FA及AD呈负相关(r均<0,P均<0.05),血清磷酸盐水平与部分脑区RD呈正相关(r均>0,P均<0.05)。结论 ESRD SHPT患者存在认知功能障碍;其脑白质微结构广泛损伤并以轴突损伤为主,具有右侧大脑半球偏侧性,且与血清钙、磷酸盐及肌酐水平相关。 展开更多
关键词 肾功能不全 慢性 继发性甲旁亢 磁共振成像
下载PDF
上一页 1 2 56 下一页 到第
使用帮助 返回顶部