完全消融治疗难治性继发性甲状旁腺功能亢进的临床效果分析  

Clinical effect of complete ablation in treatment of refractory secondary hyperparathyroidism

作　　者：曾福强[1] 瞿国萍[1] 罗明[1] 邹斌[1] 陈华彬[1] ZENG Fuqiang;QU Guoping;LUO Ming;ZOU Bin;CHEN Huabin(Department of Ultrasound, Zhongshan TCM Hospital Affiliated to Guangzhou University of TCM, Zhongshan 528400, P.R.China)

机构地区：[1]广州中医药大学附属中山市中医院超声科,广东中山528400

出　　处：《医学影像学杂志》2021年第11期1859-1863,共5页Journal of Medical Imaging

基　　金：广东省中山市科技计划项目(编号:2017B1041)。

摘　　要：目的探讨完全消融治疗难治性继发性甲状旁腺功能亢进的临床效果。方法选取2016年12月~2017年12月中山市中医院SHPT并发甲状旁腺腺体增生患者50例,按随机数表法分为对照组和观察组各25例,其中对照组采用不完全消融方法,观察组采用完全消融方法。观察两组患者手术成功率以及临床症状改善情况,比较两组消融术前、术后即刻(10 min内)、1天、1周、1月、3月、6月及1年血清甲状旁腺激素(PTH)、血钙、血磷浓度,统计两组并发症发生率。结果观察组消融病灶数量为100枚,对照组为84枚,观察组手术成功率均高于对照组(P<0.05);两组术后骨关节痛、瘙痒、肌无力改善情况相当(P>0.05);两组患者术后各时间血清PTH、血钙、血磷浓度均明显低于术前(P<0.05),观察组术后各时间血清PTH、血钙、血磷浓度均明显低于对照组(P<0.05);两组术后并发症发生率相当(P>0.05)。结论完全消融方法治疗难治性SHPT临床效果良好。Objective To explore the clinical curative effect of complete ablation on refractory secondary hyperparathyroidism(SHPT).Methods Fifty patients with SHPT complicated with parathyroid gland hyperplasia in Zhongshan TCM Hospital during the period from December 2016 to December 2017 were enrolled.They were divided into control group and observation group by random number table method,with 25 cases in each group.The control group was given incomplete ablation method,while observation group was given complete ablation method.The surgical success rates and improvement of clinical subjective symptoms in both groups were observed.Before ablation,immediately after ablation(within 10 minutes),after 1 d,1 week,1 month,3 months,6 months and 1 year of ablation,concentration of serum parathyroid hormone(PTH),serum calcium and serum phosphorus was compared between the two groups.The incidence of complications in both groups was statistically analyzed.Results The number of ablation lesions in observation group and control group were 100 and 84,respectively.The surgical success rate in observation group was higher than that in control group(P<0.05).After surgery,there was no significant difference in improvement of clinical subjective symptoms such as bone joint pain,itching and myasthenia between the two groups(P>0.05).After surgery,concentration of serum PTH,serum calcium and serum phosphorus in both groups was significantly lower than that before surgery(P<0.05).After surgery,concentration of the above indexes in observation group was significantly lower than that in control group(P<0.05).There was no significant difference in incidence of postoperative complications between the two groups(P>0.05).Conclusion The clinical curative effect of complete ablation is good on refractory SHPT.

关 键 词：继发性甲状旁腺功能亢进 慢性肾脏病 超声引导 射频消融术 介入性 放射学 

分 类 号：R581.1[医药卫生—内分泌] R815[医药卫生—内科学]