化学性甲状旁腺切除术治疗慢性透析患者继发甲状旁腺功能亢进  

Chemical parathyroidectomy for secondary hyperparathyroidism in chromc dialysis patients.

作　　者：张凌[1] 刘亚绵[2] 卞维静[1] 李程[2] 赵丽[1] 杜学海[1] 

机构地区：[1]北京中日友好医院友好血液净化中心肾内科,100029 [2]北京中日友好医院友好血液净化中心超声科,100029

出　　处：《中国血液净化》2002年第2期31-35,共5页Chinese Journal of Blood Purification

摘　　要：目的 探讨化学性甲状旁腺切除术治疗慢性透析患者合并难治性继发甲状旁腺机能亢进(甲旁亢)的疗效,并结合继发甲旁亢的病理进行讨论。方法 对16例符合化学性甲状旁腺切除术指征的合并难治性甲旁亢慢性透析患者,在超声引导下向血流丰富并且直径>1cm的甲状旁腺腺体内注射无水酒精,同时结合药物治疗以降低甲状旁腺功能。结果 16例iPTH的改变,化学性甲状旁腺切除术前(1098.1±567.3pg/ml)与治疗后相比(550.5±515.pg/ml)显著降低(P<0.001);血清AKP亦显著降低(P<0.01)。1例发生一过性喉返神经麻痹。结论 化学性甲状旁腺切除术可作为难治性继发甲旁亢的一种安全有效治疗手段。Objective To investigate the effect of chemical parathyroidectomy in chronic dialysis patients with secondary hyperparathyroidism (SHPT), which was discussed on the basis of advanced pathophysiology of SHPT. Methods 10 case of ESRD patients on chronic dialysis with SHPT were selected based on the crite-rion for chemical parathyroidectomy.Ultrasound guided injection of ethanol into 23 enlarged ( >1 cm in diam-eter) and ample blood supply parathyroid glands was performed. Results After chemical parathyroidectomy, iPTH of the 10 patients reduced from 1098. 1 ± 567. 3 pg/ml to 550. 5 ± 515. pg/ml (P < 0. 001). Serum AKP decreased also significantly (P < 0. 01) Recurrent laryngeal nerve palsy was observed in 1 case.Conclusions This study indicated that chemical parathyroidectomy is an effective and safe therapy for patients with severe SHPT.

关 键 词：透析 甲状旁腺机能亢进 继发性 甲状旁腺化学性切除术 

分 类 号：R6[医药卫生—外科学] R45[医药卫生—临床医学]