原发性甲状旁腺机能亢进症101例分析  

Analysis of 101 cases of primary hyperparathyroidism.

作　　者：韩恩昆[1] 刘自宽 朱理玮 齐骏 王鹏志 高硕 周荫保 白人驹 

机构地区：[1]天津医科大学总医院

出　　处：《中国实用外科杂志》1998年第3期147-149,共3页Chinese Journal of Practical Surgery

摘　　要：１９６３～１９９７年共收治１０１例原发性甲状旁腺机能亢进症。临床特点为：病人年龄较轻，平均３４岁。骨病发生率高且严重，纤维囊性骨炎占６３３％。肾结石、肾钙化少，占３７６％。约４０％病人血钙不高或持续正常。术前颈部查体扪及肿物者１８例，１７例正确。间接定位体征５例均为阳性。这些病例均病程较长，腺体较大，最重１３ｇ，血钙均＞１２００ｍｇ／Ｌ。本组病理学特点腺瘤占９１例，腺癌６例，增生１例。比较了Ｂ超、ＣＴ、９９ｍＴｃＭＩＢＩ在术前定位诊断中的价值。结果表明，Ｂ超、ＣＴ、９９ｍＴｃＭＩＢＩ的灵敏性分别为４５％、８５％、９１％。特异性为９５％、９７％、１００％。准确性为８２％、９４％、９７％。目前在国内此类病例尚少，尤其是对再次手术者，这些非创伤性术前定位检查是有必要的。本组９８例探查，９６例获成功，手术成功率为９７９％。 In this artical,the therapeutic effects of 101 cases with primary hyperparathyroidism from 1963 to 1997 are reported,and related problems are discussed.This group of patients showed the following clinical features:most patients were young,with an average age 34;The incidence and severity of osteopathy was high,the incidence of cystic osteitis fibrosa was 63 3%;Renal stones and calcification occured infrequently,comprised about 37 6% of total patients;Serun calcium level in about 40% of the patients kept normal.Masses were found in 18 cases during neck examination before operation and 17 cases were confirmed as primary hyperparathyroidism.The above cases mentioned all had longer courses and massive glands with a maximum of 13g.The serum calcium levels were all above 1200mg/L.The pathological findings were as the following:adenoma comprising 91 cases.We also compared the value of BUS,CT and 99m TcMIBI image in preoperative location.The results revealed that:the sensitivity of BUS,CT and 99m TcMIBI in the diagnosis was 45%,55% and 91% respectively.While the specificity was 95%,97% and 100%.The accuracy was 82%,94%,97%.In this group,98 cases were explored,with mass resected in 96 cases,resulting in a successful rate 97 9%.

关 键 词：甲状旁腺 机能亢进 探查术 外科手术 

分 类 号：R653[医药卫生—外科学] R582.105[医药卫生—临床医学]