超声引导下微波消融治疗12例原发性甲状旁腺功能亢进症的疗效及安全性  

Effectiveness and safety of ultrasound-guided microwave ablation for the treatment of primary hyperparathyroidism in 12 patients with parathyroid adenoma

作　　者：倪文婧 褚晓秋[1] 陆晨雅 陈国芳[1] 韩雪 许洋 武心萍[2] 王建华[3] 刘超[1] 徐书杭[1] Ni Wenjing;Chu Xiaoqiu;Lu Chenya;Chen Guofang;Han Xue;Xu Yang;Wu Xinping;Wang Jianhua;Liu Chao;Xu Shuhang(Department of Endocrinology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Department of Ultrasound,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Department of General Surgery,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China)

机构地区：[1]南京中医药大学附属中西医结合医院内分泌科,210028 [2]南京中医药大学附属中西医结合医院超声科,210028 [3]南京中医药大学附属中西医结合医院普外科,210028

出　　处：《中华内科杂志》2021年第10期904-907,共4页Chinese Journal of Internal Medicine

摘　　要：为探讨微波消融(MWA)治疗原发性甲状旁腺功能亢进症(PHPT)的有效性和安全性,选择2019年5月至2021年2月在南京中医药大学附属中西医结合医院行MWA的PHPT患者12例,观察治疗前后及随访期的甲状旁腺激素(PTH)、血钙磷变化;比较术前及末次随访病灶体积及体积缩小率。观察临床治愈率和技术成功率。末次随访时,PTH[66.60(42.21,80.03)ng/L比169.90(89.01,396.50)ng/L]和血钙[2.39(2.32,2.49)mmol/L比2.75(2.57,2.96)mmol/L]水平与术前相比均有显著下降(P值均<0.05)。6例PTH和血钙水平在正常范围内,4例仅血清PTH轻度高于正常参考范围上限。2例血清PTH和血钙均未恢复正常。临床治愈率50%。所有患者病灶体积较术前显著缩小(P<0.05),技术成功率92.3%。无患者出现严重并发症。超声引导下MWA治疗PHPT有效且安全。To investigate the effectiveness and safety of ultrasound-guided microwave ablation(MWA)in treatment of primary hyperparathyroidism(PHPT).A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021.The patients were followed up once every 3 months for 3-12 months.Levels of serum parathyroid hormone(PTH),calcium and phosphorus were detected before and 20 min,4h and 1day after ablation,and during follow-up period.The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up.The technical and clinical success of MWA were assessed as well.At the end of follow-up,median serum PTH[66.60(42.21,80.03)ng/L vs.169.90(89.01,396.50)ng/L]and calcium[2.39(2.32,2.49)mmol/L vs.2.75(2.57,2.96)mmol/L]levels in 12 patients decreased significantly(all P<0.05).A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients,while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range,and 2 of the patients remained abnormal PTH and calcium levels.The clinical cure rate was 50%.The volumes of all lesion after ablation were significantly decreased(P<0.05),with the technical success rate reaching 92.3%.No serious complications were observed.Ultrasound-guided MWA,thus,is safe and effective in the treatment of PHPT.

关 键 词：甲状旁腺功能亢进症 原发性 微波消融 

分 类 号：R582.1[医药卫生—内分泌]