超声引导下甲状旁腺微波消融治疗继发性甲状旁腺功能亢进的疗效  

Efficacy of ultrasound-guided microwave ablation of parathyroid glands in the treatment of secondary hyperparathyroidism

作　　者：彭云[1] 温美玲 倪军[1] 刘康 李俊韬[1] PENG Yun;WEN Meiling;NI Jun;LIU Kang;LI Juntao(Department of Thyroid and Breast Surgery,Ganzhou People′s Hospital in Jiangxi Province,Ganzhou 341000,China;Department of Anesthesiology,Ganzhou People′s Hospital in Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院甲状腺乳腺外科,江西赣州341000 [2]江西省赣州市人民医院麻醉科,江西赣州341000

出　　处：《中国现代医生》2021年第29期84-87,共4页China Modern Doctor

基　　金：江西省卫生健康委员会科技计划项目(20194051)。

摘　　要：目的探讨超声引导下甲状旁腺微波消融(MWA)治疗继发性甲状旁腺功能亢进的疗效。方法选取我院2019年1—8月收治的继发性甲状旁腺功能亢进患者110例,用随机数字法等分为对照组和研究组。对照组患者应用甲状旁腺全切除联合自体前臂移植术治疗。研究组患者应用超声引导下甲状旁腺MWA治疗。对比两组术后甲状旁腺激素(PTH)、血钙、血磷值,对比两组临床指标、并发症情况及复发情况。结果研究组手术后24 h、1周、1个月、3个月、6个月、1年的PTH、血钙、血磷值低于对照组,两组比较,差异有统计学意义(P<0.05);研究组手术时间(35.22±8.31)min、术后下床时间(7.62±1.41)h短于对照组(90.12±10.14)min、(36.45±7.54)h,研究组术中出血量(3.43±2.82)ml小于对照组(58.62±21.94)ml且研究组并发症发生率5.45%、复发率1.82%低于对照组25.45%、20.00%,两组比较,差异有统计学意义(P<0.05)。结论继发性甲状旁腺功能亢进患者,应用超声引导下甲状旁腺MWA治疗疗效肯定、手术时间短、术后康复快、并发症发生率低、复发率低、安全性高,值得在临床上推广应用。Objective To investigate the efficacy of ultrasound-guided microwave ablation(MWA)of parathyroid glands in the treatment of the secondary hyperparathyroidism(SHPT).Methods A total of 110 SHPT patients admitted to our hospital from January 2019 to August 2019 were selected.They were divided into the control group and the study group by random number method.Patients in the control group were treated with total parathyroidectomy combined with autologous forearm transplantation.Patients in the study group were treated with ultrasound-guided MWA of parathyroid glands.The parathyroid hormone(PTH),blood calcium and blood phosphorus were compared between the two groups after operation,and the clinical indexes,complications and recurrence of the two groups were compared.Results PTH,blood calcium and blood phosphorus were lower in the study group than those in the control group at 24 hours,1 week,1 month,3 months,6 months and 1 year after operation,with statistically significant differences(P<0.05).The operation time of the study group was(35.22±8.31)min,and the time of getting out of bed after operation was(7.62±1.41)h,which were shorter than those of the control group[(90.12±10.14)min,(36.45±7.54)h].The amount of intraoperative blood loss in the study group was(3.43±2.82)ml,which was less than that in the control group[(58.62±21.94)ml].The incidence of complications in the study group was 5.45%,and the recurrence rate was 1.82%,which were lower than that in the control group(25.45%,20.00%),with statistically significant differences(P<0.05).Conclusion Ultrasound-guided MWA of parathyroid glands is effective for patients with SHPT,with shorter operation time,faster postoperative recovery,lower complication rate,lower recurrence rate,and higher safety.It is worthy of clinical application.

关 键 词：甲状旁腺微波消融 甲状旁腺全切除 自体前臂移植术 继发性甲状旁腺功能亢进 

分 类 号：R692.5[医药卫生—泌尿科学]