甲状旁腺全切联合自体前臂移植术及护理对肾性甲状旁腺功能亢进患者的疗效分析  

Effect analysis of total resection of parathyroid glands combining with transplantation of autologous forearm and nursing in patients with renal hyperparathyroidism

作　　者：李永芳[1] 李辉文[1] 王彩萍[1] 赵妙凤[1] 

机构地区：[1]广东省珠海市中山大学附属第五医院眼耳鼻咽喉科,广东珠海519000

出　　处：《中国当代医药》2016年第25期189-191,共3页China Modern Medicine

摘　　要：目的研究肾性甲状旁腺功能亢进患者实施甲状旁腺全切联合自体前臂移植术的疗效并对护理措施进行分析。方法选取2014年3月~2016年2月我院接受治疗的52例肾性甲状旁腺功能亢进患者,进行甲状旁腺全切联合自体前臂移植术治疗,并且在治疗的基础上实施不同层次的护理措施。比较术前与术后1个月及术后3个月患者的收缩压、舒张压、平均动脉压、血钙、血磷、免疫反应性甲状旁腺激素（i PTH）、血红蛋白（Hb）、血细胞比容（Hct）、碱性磷酸酶（ALP）水平以及重组人促红细胞生成素（r Hu EPO）用量。结果术后1个月以及术后3个月患者收缩压、舒张压、平均动脉压均显著低于术前（均P〈0.05）。同时术后1个月以及术后3个月患者血钙、血磷、i PTH水平均显著低于术前（P〈0.05）;术前与术后1个月Hb与Hct比较,差异无统计学意义（P〉0.05）,而术后3个月患者Hb与Hct则显著高于术前（P〈0.05）;患者术后1个月以及术后3个月ALP、r Hu EPO用量均显著低于术前（P〈0.05）。结论甲状旁腺全切联合自体前臂移植术治疗肾性甲状旁腺功能亢进效果显著,而有效的护理可显著提高手术治疗效果,促进患者早日康复。Objective To study the effect of total resection of parathyroid glands combining with transplantation of autologous forearm on treating patients with renal hyperparathyroidism and analyze its corresponding nursing measures.Methods From March 2014 to February 2016,52 patients with renal hyperparathyroidism treated in our hospital were selected.All patients were performed with total resection of parathyroid glands combining with transplantation of autologous forearm,and nursing measures in different levels were applied.The systolic pressure,diastolic pressure,mean arterial pressure,blood calcium,serium inorganic phosphorus,immunoreactive parathyroid hormone（i PTH）,haemoglobin（Hb）,hematocrit（Hct）,alkaline phosphatase（ALP） and dosage of recombinant human erythropoietin（r Hu EPO） were compared before surgery one and three months after surgery.Results The systolic pressure,diastolic pressure and mean arterial pressure one and three months after surgery were greatly lower than those before surgery（all P〈0.05）.The levels of blood calcium,serium inorganic phosphorus and i PTH were also lower one and three months after surgery than those before surgery（P〈0.05）.There was no great difference in Hb or Hct between prior surgery and one month after surgery.However,the levels of Hb and Hct 3 months after surgery were remarkably higher than those before surgery（P〈0.05）.The level of ALP and dosage of r Hu EPO one and three months after surgery were both lower than those before surgery（P〈0.05）.Conclusion Combination of total resection of parathyroid glands and transplantation of autologous forearm can obtain a remarkable effect on treating renal hyperparathyroidism.Effective nursing can greatly improve the surgical effect and promote patient′s recovery as soon as possible.

关 键 词：肾性甲状旁腺功能亢进 甲状旁腺全切 自体前臂移植术 护理 

分 类 号：R473.6[医药卫生—护理学]