原发性甲状旁腺功能亢进的临床特点及其外科治疗  

Clinical characteristics and surgical treatment of primary hyperparathyroidism

作　　者：罗东林[1] 高博[1] 姜燕[1] 田武国 张姝[1] 郭翎佶 张晓华[1] 赵健洁[1] 严洁[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,乳腺甲状腺血管外科,重庆400042

出　　处：《中国耳鼻咽喉头颈外科》2016年第12期705-708,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨原发性甲状旁腺机能亢进症的临床特点及其外科处理方法。方法回顾性分析2000年1月~2014年12月在我科手术治疗的25例原发性甲状旁腺功能亢进症患者的临床资料,外科治疗方式以及术后随访情况。结果 24例患者均在术前确诊,1例甲状旁腺癌术中冰冻明确。2例双侧下甲状旁腺瘤行双侧探查及双侧下甲状旁腺瘤切除,18例单侧甲状旁腺瘤行单侧探查及切除;4例甲状旁腺增生行双侧探查加双侧甲状旁腺大部切除,仅保留0.5枚甲状旁腺,1例甲状旁腺癌行患侧甲状腺和甲状旁腺全切除、峡部切除、健侧甲状腺近全切除和患侧颈部中央区淋巴结清扫术。所有患者术后均恢复良好,甲状旁腺功能亢进症状得到有效控制,随访6个月~10年,无复发。结论影像学和实验室检查是诊断甲状旁腺亢进的有效方法,及时进行外科手术治疗可减少骨关节和泌尿系统损害等严重并发症的发生。OBJECTIVE To investigate the clinical characteristics and surgical treatment of primary hyperparathyroidism.METHODS Clinical data of 25 primary hyperparathyroidism patients underwent surgery in our department from January 2000 to December 2014 were retrospectively studied,including surgical procedures and postoperative follow-up information.RESULTS All24 cases were diagnosed definitely prior to the surgery,and one case of parathyroid carcinoma was diagnosed through intraoperative frozen-section examination.Surgical procedures：2 cases of bilateral parathyroid adenoma was explored bilaterally,and the bilateral parathyroid adenoma was removed;18 cases of unilateral parathyroid adenoma was explored unilaterally,and the unilateral parathyroid adenoma was removed;4 cases of parathyroid hyperplasia were explored bilaterally,and bilateral parathyroid glands were removed subtotally,and only half gland was reserved.The near total thyroidectomy and the parathyroidectomy of the affected side,and level VI lymphonode dissection of the affected side were performed in the parathyroid carcinoma case.All the 25 patients recovered well after operation,and symptoms of hyperparathyroidism were controlled.No relapse was found after follow-up of 6 months to 10 years.CONCLUSION Imaging and laboratory test were the effective methods for diagnosis of hyperparathyroidism,moreover,timely surgical treatment could reduce joint and urinary damage and other serious complications.

关 键 词：甲状旁腺功能亢进 原发性 外科手术 临床特点 

分 类 号：R653[医药卫生—外科学]