慢性肾病患者继发性甲状旁腺功能亢进的外科治疗现状  

Current surgical treatment of secondary hyperthyroidism of chronic kidney disease patients

作　　者：李敏 李峰[1] 高鑫[1] 

机构地区：[1]解放军88医院肾内科,山东泰安271000

出　　处：《实用医药杂志》2016年第7期653-655,共3页Practical Journal of Medicine & Pharmacy

摘　　要：继发性甲状旁腺功能亢进(SHPT)是慢性肾病(CKD)最常见、最严重的并发症之一,可引起肾性骨营养不良,血管和心脏瓣膜钙化和免疫紊乱,增加心血管疾病的发病率和病死率,严重影响患者的生活质量,是导致慢性肾病患者死亡的独立因素。在甲状旁腺功能亢进的早期,药物治疗能有效地降低血钙、血磷、甲状旁腺激素(iPTH)水平。对于药物难治性肾性SHPT患者须手术治疗。手术方式包括甲状旁腺次全切除术(sPTX)、甲状旁腺全切除术+自体移植术(tPTX+AT)、甲状旁腺全切除术(tPTX)。该文对治疗外科的现状做一简要综述。Secondary hyperthyroidism （SHPT） is one of the most common and serious complications of Chronic kidney disease （CKD）,can cause renal bone malnutrition,vascular and cardiac valve calcification and immune disorders,so that increase the incidence of cardiovascular disease and mortality,it is an independent factor that causes the death of patients. In early stage of hyperparathyroidism,drug treatment has achieved good results, which can effectively decrease the level of serum calcium,serum phosphorus,parathyroid hormone（iPTH） level. For the treatment of the patients with refractory renal SHPT,surgical treatment is necessary. The operation includes subtotal thyroidectomy（sPTX）,total thyroidectomy with autologous transplantation（tPTX＋AT）,and total thyroidectomy （tPTX）. This paper reviews their current status.

关 键 词：慢性肾病 外科治疗 继发性甲状旁腺功能亢进 甲状旁腺次全切除术 甲状旁腺全切除术+自体移植术 甲状旁腺全切除术 

分 类 号：R582.1[医药卫生—内分泌] R692[医药卫生—内科学]