手术治疗继发性甲状旁腺功能亢进25例临床分析  

Surgical treatment for secondary hyperparathyroidism: An analysis of 25 cases

作　　者：李朋[1] 梁伟[2] 姜蕾[2] 胡正明[3] 王东来[1] 崔军威[1] 于志强[1] 韦伟[1] 

机构地区：[1]北京大学深圳医院甲状腺外科,广东深圳518036 [2]北京大学深圳医院肾内科,广东深圳518036 [3]北京大学深圳医院超声影像科,广东深圳518036

出　　处：《中国实用外科杂志》2015年第2期205-207,共3页Chinese Journal of Practical Surgery

摘　　要：目的 探讨手术治疗继发性甲状旁腺功能亢进的适应证及临床疗效。方法 回顾性分析2013年7月至2014年1月北京大学深圳医院甲状腺外科收治的25例继发性甲状旁腺功能亢进病人的临床资料,均行甲状腺全切除＋自体移植术,分析手术适应证、手术时间、术后并发症和手术疗效。结果 手术均顺利完成,其中22例病人各切除4枚甲状旁腺,1例切除5枚甲状旁腺,2例各切除3枚甲状旁腺。平均手术时间为115.5（56-182）min。术后1例发生颈部血肿,1例发生前臂移植处皮下血肿,1例病人出现声音嘶哑,1例病人出现了声音低沉,12例病人手术后第2天发生了手足麻木,均给予对症治疗后好转或恢复。随访6个月,血PTH、血钙和血磷均处于正常参考值范围,术前的各种不适症状均有不同程度好转。结论 对于继发性甲状旁腺功能亢进病人,外科手术治疗可达到控制钙磷水平和改善生活质量的目的。Objective To explore the indications and perioperative management of surgical treatment for secondaryhyperparathyroidism （SPHT）. Methods The clinical data of 25 cases of SHPT underwent parathyroidectomy betweenJuly 2013 and January 2014 in Department of Thyroid Surgery, Peking University Shenzhen Hospital were analyzedretrospectively. The indications, operation time, postoperative complications and surgery effects were summarized andanalyzed retrospectively. Results The operation for 25 cases of SHPT were successful. Among them, each of 22 caseswas resected 4 parathyroids, 1 case was reseeted 5 parathyroids, and 2 eases each were resected 3 parathyroids. Theaverage operation time was 115.5 （56-182）min. The postoperative complications included subcutaneous hematoma for 1case, hoarseness for 1 cases, low voice for 1 case and numbness of limbs for 12 cases. The 6 months follow-up BloodPTH, blood calcium and phosphorus levels were all in the normal range; Various preoperative symptoms were improvedin varying degrees; No new case of cardiac valvular calcification occurred. Conclusion It can achieve the goal ofcontrol calcium and phosphorus and improve quality of life by surgical operation for patients with SPHT.

关 键 词：继发性甲状旁腺功能亢进 手术 围手术期处理 

分 类 号：R6[医药卫生—外科学]