原发性甲状旁腺机能亢进症的诊断和治疗  

Diagnosis and Surgical Treatment of 33 Patients with Primary Hyperparathyroidism

作　　者：姜兆明 

机构地区：[1]蒙阴人民医院,山东蒙阴276200

出　　处：《实用医技杂志》2006年第3期338-339,共2页Journal of Practical Medical Techniques

摘　　要：目的:探讨原发性甲状旁腺机能亢进症的诊断和手术方法。方法:对33例原发性甲状旁腺机能亢进症的患者的临床表现、实验室检查和术前、术中定位方法及手术治疗进行了回顾性分析总结。结果:持重部位骨关节疼痛、多发骨折为其主要征象,实验室检查有血钙、血PTH、血碱性磷酸酶及尿钙、尿磷升高和血磷降低。X线主要表现为骨质疏松、骨质变薄。B超、CT及99mTc造影三项结合可使术前定位准确率达90.9%。结论:原发性甲状旁腺机能亢进症需结合临床症状及辅助检查。术前、术中的准确定位及冰冻病理的定性检查是手术成功的关键。一侧甲状旁腺中仅有一个病变者可只行单侧探查。Objective To study the diagnosis and surgical treatment of primary hyperparathroidism. Methods 33 patients with primary hyperparathroidism treated in our hospital were included in this study. Clinical symptom, results of laboratory and surgical treatment were analyzed retrospectively. Results The main clinical manifestation was symmetrical pain of the supporting bones and joins, hypercalcemia, hypercalnuria, hypophosphatemia and hyperalkalinc phosphatasemia,and increase of PTH in peripheral blood. X-ray examination showed ostroporosis and decalcification, accopanied with multiple fracture. The accuracy of parathyroid tumor localization was above 90.9% by B ultrasound CT scan and 99mTc examination preoperation. Conclusion The key procedure of the operation was to search for tumor of parathyroid. If one abnormal parathyroid gland and a normal gland are found on the first side of the neck that is explored, the other should not be explored.

关 键 词：甲状旁腺 甲状旁腺机能亢进症 诊断 手术 

分 类 号：R582.1[医药卫生—内分泌]