超声引导下经皮射频消融治疗慢性肾衰继发性甲状旁腺功能亢进疗效分析  

The efficacy of ultrasound guided radiofrequency ablation for chronic renal failure with secondary hyperparathyroidism

作　　者：程艳[1] 孙长丽[1] 樊一筠 孙永强[2] 陈正雷[3] CHENG Yan;SUN Chang-li;FAN Yi-yun(Second Department of Nephrology, the Third Hospital of Zhengzhou, Zhengzhou, Henan 450000, Chin)

机构地区：[1]郑州市第三人民医院肾内二科,河南郑州450000 [2]郑州市第三人民医院甲状腺乳腺外科 [3]郑州市第三人民医院超声科

出　　处：《中华全科医学》2018年第8期1300-1302,共3页Chinese Journal of General Practice

基　　金：河南省科技厅科技攻关计划项目(162102310216)

摘　　要：目的探讨超声引导下经皮射频消融术治疗慢性肾衰继发性甲状旁腺功能亢进(SHPT)的有效性及安全性。方法选取郑州市第三人民医院的SHPT患者30例为研究对象,术前超声检查均证实有1~4枚增生的甲状旁腺组织,在超声引导下对增生的甲状旁腺组织进行射频消融治疗,检测消融前及消融后10 min、1 d、1周、1个月、6个月及1年的PTH、血Ca、血P水平,观察临床症状的改善及并发症的发生情况。结果 (1)患者消融术后10 min、1 d、1周、1个月、6个月及1年的血PTH水平与消融前相比均明显下降(P<0.05);消融后10 min、1 d、1周、1个月、6个月及1年的血Ca水平与消融前相比,均明显下降(P<0.05);消融后10 min、1 d、1周、1个月、6个月及1年的血P水平与消融前相比,均明显下降(P<0.05);(2)消融后患者骨痛、皮肤瘙痒、肌无力、纳差等症状明显改善,出现声音嘶哑者3例,发生率为10%,均在术后1周内自行缓解;出现严重低钙血症者2例,发生率为6.6%,经及时补钙后得到缓解,术后所有患者均未复发。结论超声引导下经皮射频消融是治疗SHPT的一种安全有效的方法,能明显改善患者肾性骨病症状,提高生活质量。Objective To explore the effectiveness and safety of ultrasound guided radiafrequency ablation for chronic renal failure with secondary hyperparathyroidism （SHPT）. Methods Thirty SHPT patients treated in our hospital were selected. All patients were confirmed with 1 -4 hyperplasia parathyroid tissues by ultrasound, and accepted ultrasound guided radiofrequency ablation. Serum parathyroid hormone, serum calcium, and serum phosphorus were measured before and after radiofrequency ablation for 10 minutes, one day, one week, one month, six months and one year. Their clinical symptoms and complications were recorded. Results （1） Serum PTH after radiofrequency ablation for 10 minites, one day, one week, one month, six months and one year were （533.4 ± 101.1 ） pg/ml, （461.2 ± 125.8） pg/ml, （302.3 ± 99.8） pg/ml, （ 311.6 ± 138.1 ） pg/ml, （ 201.9 ± 115.7 ） pg/ml and （ 189.4 ± 162.9 ） pg/ml, decreased as compared with those before radiofrequency ablation （P 〈 0.05 ） ; Serum Ca after radiofrequency ablation for 10 minites, one day, one week, one month, six months and one year were （2.31 ± 0.13） mmol/L, （ 1.76 ± 0.97 ） mmol/L, （ 1.99 ± 0.54） mmol/L, （2.00 ±0. 11 ）mmol/L, （2.05 ±0. 10）mmol/L and （2. 16 _± 0.59）mmol/L decreased as compared with thosed before radiofrequency ablation （P 〈 0.05 ） ; and Serum P after radiofrequency ablation for 10 minites, one day, one week, one month, six months and one year were （2.23 ± 0.22） mmol/L, （ 2.01 ± 0.11 ） mmol/L, （ 1.99 ± 0.32） mmol/L, （ 1.87 ±0.97） mmol/L, （ 1.68 ± 0.77） mmol/L and （ 1.65 ± 0. 15） mmol/L, decreased as compared with thosed before radiofrequency ablation （P 〈 0.05）. （2） After radiofrequency ablation, bone pain, itching, weakness, anorexia, improved rapidly. Hoarseness was found in 3 cases in postoperative period, the occurrence rate was 10.0%, and improved spontaneously within one week. Hypocalcemia was found in 2 cases, the occurrence rate was 6.6% , a

关 键 词：射频消融术 超声检查 慢性肾衰 继发性甲状旁腺功能亢进 

分 类 号：R692.5[医药卫生—泌尿科学] R581.1[医药卫生—外科学]