甲状旁腺全切术和甲状旁腺全切术加自体移植术治疗尿毒症继发性甲状旁腺功能亢进的临床分析  

Effect of Total Parathyroidectomy and Total Parathyroidectomy with Parathyroid Autotransplantation in Treatment of Uremic Secondary Hyperparathyroidism

作　　者：梁萌 尤燕华 黄雪蕾 龚春水 华锦程 李彩凤 胡玉清 LIANG Meng;YOU Yanhua;HUANG Xuelei(Department of Nephrology,Sccessfui Hospital Affiliated to Xiamen University,Xiamen(361000))

机构地区：[1]厦门大学附属成功医院肾内科,厦门361000 [2]厦门大学附属成功医院耳鼻喉科,厦门361000

出　　处：《中国中西医结合肾病杂志》2018年第10期866-869,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：厦门市科技计划项目(No.3502Z20144037);2015年度南京军区医学科技创新项目(No.15MS101)

摘　　要：目的:比较尿毒症继发性甲状旁腺功能亢进症(SHPT)进行甲状旁腺全切除术(tPTX)和甲状旁腺全切除加自体移植术(tPTX+AT)的临床疗效。方法:对2009年01月～2014年05月期间在我院接受tPTX(n=31)或tPTX+AT(n=33)手术治疗的尿毒症并发SHPT患者共64例进行回顾性分析,对比两组患者手术前后的甲状旁腺激素(iPTH)、血钙(Ca^(2+))、血磷(P^(3-))以及复发率,并比较两种方式的疗效。结果:tPTX和tPTX+AT组患者术后iPTH、Ca^(2+)、P^(3-)均较术前显著下降,症状明显缓解。与tPTX相比,采用tPTX+AT手术的患者Ca^(2+)值显著升高,但同时复发率也明显升高。结论:tPTX和tPTX+AT两种手术方式各有优劣,但均可以显著的改善SHPT患者的临床症状,提高患者的生活质量。Objective:To compare the efficacy of total parathyroidectomy(tPTX)and total parathyroidectomy(tPTX)with parathyroid autotransplantation(AT)in treatment of uremic patients with secondary hyperparathyroidism(SHPT).Methods:The clinical data of 64 patients of uremic SHPT who underwent with tPTX(n=31)and tPTX+AT(n=33)in our hospital from January 2009 to May 2014 were analyzed.Intact parathyroid hormone(iPTH),serum calcium,phosphorus and recurrence rate were compared before and after surgery.And compare the curative effect of two ways.Results:Compare with the preoperative patients,the iPTH,serum calcium and serum phosphorus were significant reduced,and the symptom was eased obviously in the postoperative patient in both tPTX and tPTX+AT group.Compared with tPTX group,tPTX+AT has higher serum calcium value,but also higher recurrence rate.Conclusion:Both tPTX and tPTX+AT surgical methods have their own advantages and disadvantages.Two methods are relatively safe and effective method in the treatment of uremic patients with SHPT.

关 键 词：甲状旁腺全切术 自体移植术 继发性甲状旁腺功能亢进 尿毒症 

分 类 号：R692.5[医药卫生—泌尿科学] R653[医药卫生—外科学]