甲状旁腺肿瘤临床分析  

作　　者：周晓聪[1] 叶正亮[2] 周宏[2] 倪耀忠[2] 

机构地区：[1]温州医学院定理临床学院,325000 [2]浙江省温州市第二人民医院肿瘤外科,325000

出　　处：《浙江临床医学》2009年第10期1035-1038,共4页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨甲状旁腺肿瘤的诊断及外科治疗。方法回顾性分析12例甲状旁腺肿瘤的临床资料。结果12例患者中，腺瘤9例（75％），囊肿3例（25％）；6例腺瘤（4例伴有甲状旁腺功能亢进症状，2例为无症状甲旁亢）血钙和血清甲状旁腺素（PTH）均高于正常，另3例腺瘤及3例囊肿血钙均正常范围。术前定位检查方法的敏感性和阳性预测值分别为：B超100％（11／11）和91．67％（11／12），CT83．33％（10／12）和100％（10／10）。9例行单侧颈部探查，3例行双侧颈部探查。结论临床医生应提高对甲状旁腺肿瘤的认识，血钙和血清PTH测定是可靠的定性诊断方法。B超和CT相结合，必要时结合99TmC—MIBI可获得准确的定位诊断。手术切除是治疗甲状旁腺肿瘤最佳的治疗手段，对于定位明确的单侧肿瘤，结合术中冰冻病理检查行单侧颈部探查是可行的。Objective To explore the diagnosis and surgical treatment of parathyroid tumor. Methods To analyze retrospectively the clinical data of 12 cases of parathyroid tumor. Results Among the 12 cases, 9 cases were of parathyroid adenoma（75% ）and 3 cases were of parathyroid cyst（25% ） ; the serum calcium and parathyroid hormone（PTH） level elevated in 6 cases of parathyroid adenoma, among the 6 cases of parathyroid adenoma,4 cases with the symptoms of hyperparathyroidism, and 2 cases with no symptoms of hyperparathyroidism. The serum calcium of the other 3 cases of parathyroid adenoma and 3 cases of parathyroid cyst were all normal range. The sensitivity and positive predict value of preoperative localization methods were： uhrasonography ： 100% （ 11/11 ） and 91.67% （ 11/12 ）, CT： 83.33% （ 10/12 ） 和 100% （ 10/10 ）. Unilateral neck exploration was performed in 9 cases and bilateral neck exploration was performed in 3 cases. Conclusion Clinicians should heighten their vigilance for parathyroid tumor. Serum calcium and PTH assays are both reliable methods for the qualitative diagnosis. Ultrasonography and CT, combine with 99Tmc - MIBI seintigraphy necessarily can acquire accurate localization. Surgery is the best treatment for parathyroid tumor. Accompanied by intraoperative freezing pathological examination, unilateral neck exploration is acceptable approach for the patients of unilateral tumor with definitive preoperative localization.

关 键 词：甲状旁腺肿瘤 甲状旁腺功能亢进症 诊断 外科治疗 

分 类 号：R736.2[医药卫生—肿瘤] R448[医药卫生—临床医学]