腔镜与开放手术治疗继发性甲状旁腺功能亢进的疗效对比  

Comparison of Endoscopic and Open Parathyroidectomy in the Treatment of Secondary Hyperparathyroidism

作　　者：金昌国[1] 易文 艾向南[1] 魏小军[1] 胡浩[1] 王腾飞 欧阳才国[1] 

机构地区：[1]航天中心医院肝胆外科,北京100049

出　　处：《中国急救复苏与灾害医学杂志》2018年第1期36-39,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 比较腔镜甲状旁腺切除（endoscopic parathyroidectomy,EPTX）与开放甲状旁腺切除（open parathyroidectomy,OPTX）治疗继发性甲状旁腺功能亢进（secondary hyperparathyroidism,SHPT）的近远期疗效.方法 回顾性分析2014年6月-2016年5月在航天中心医院行手术治疗的SHPT病例资料,收集术前、术后1周、3月、12月的血清全段甲状旁腺激素（intact parathyroid hormone,iPTH）、血钙、血磷、血碱性磷酸酶数值,观察术后并发症、颈部外观满意率、手术成功率及复发率.结果 共收集26例EPTX病例和30例OPTX病例.EPTX组术后镇痛药需求低于OPTX组（P〈0.01）,术后住院时间短于OPTX组（P=0.01）,颈部外观满意率大于OPTX组（P〈0.01）,而手术时间长于OPTX组（P=0.01）.两组间术中出血量、引流量、并发症发生率、手术成功率、复发率差异无统计学意义（P〉0.05）.结论 EPTX治疗SHPT安全,具有OPTX相当的远期疗效,具有术后疼痛轻,恢复快的优势,同时具有美容效果,可以在合适的病例中采用.Objective To compare the short and long-term outcome between endoscopic parathyroidectomy（EPTX）and open parathyroidectomy（OPTX）in the treatment of secondary hyperparathyroidism（SHPT）.Methods Clinical data of SHPT patients undergoing surgical treatment in Aerospace Central Hospital between June 2014 and May 2016 were analyzed retrospectively. Serum intact parathyroid hormone （iPTH）, calcium, phosphorus, alkaline phosphatase level were tested preoperatively and postoperatively at one week,3 months,12months respectively,and the results of these tests were collected.Postoperative complications were carefully observed,satisfaction in the cosmetic result,successful rate and recurrence rate were calculated. Results Clinical data of 26 cases of EPTX and 30cases of OPTX were collected. Less analgesic requirement（P〈0.01）, shortened length of post-operative hospital stay（P=0.01）, more satisfaction with the cosmetic result（P〈0.01）and longer operation time（P=0.01）was found in EPTX group. In addition, he amount of intraoperative blood loss and postoperative drainage, complication rate, successful rate and recurrence rate were similar between the two groups（P〉0.05）.Conclusions For SHPT patients, EPTX with similar long-term outcome to OPTX,is safe and has advantages of less pain,faster recovery and better cosmetic effect,which makes it worthy of conduct for properly selected cases.

关 键 词：继发性甲状旁腺功能亢进症 甲状旁腺切除术 内窥镜检查 并发症 复发率 

分 类 号：R335.3[医药卫生—人体生理学]