两种术式治疗继发性甲状旁腺亢进的近期随访比较  

Comparison of two surgical procedures for secondary hyperparathyroidism

作　　者：赵蕾 Zhao Lei(Shengjing Hospital Affiliated to China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院,110000

出　　处：《中华普外科手术学杂志（电子版）》2021年第6期683-685,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的比较超声引导下微波消融术与甲状旁腺切除术治疗继发性甲状旁腺亢进(SHPT)的近期疗效。方法回顾性分析2015年1月至2018年12月120例SHPT患者资料,60例以超声引导下微波消融术(消融组),60例以传统的甲状旁腺切除术(手术组)。采用SPSS 23.0分析软件进行分析,围术期各项指标、术后疼痛评分、术后1周、1个月、1年的血清PTH、血钙、血磷等计量资料采用(x±s)表示,独立样本t检验;两组患者复发率及相关并发症发生率采用χ^(2)检验;治疗效果采用秩和检验。P<0.05为差异有统计学意义。结果消融组患者手术时间、术中出血量、术后疼痛评分及住院时间均少于手术组(P<0.05),患者治疗后1周声音嘶哑、术后出血、气管损伤、低钙血症等并发症发生率均低于手术组(P<0.05),治疗后1周和1年的有效率均明显高于手术组(P<0.05)。消融组患者治疗后1年复发率、血清PTH和磷水平均低于手术组(P<0.05)。结论微波消融术治疗SHPT的近期效果均优于传统甲状旁腺切除术治疗,且具有更低的复发率。Objective Objective to compare the short-term efficacy of ultrasound-guided microwave ablation and parathyroidectomy in the treatment of secondary hyperparathyroidism.Methods The data of 120 patients with secondary hyperparathyroidism from January 2015 to December 2018 were retrospectively analyzed.Among them,60 patients were treated with ultrasound-guided microwave ablation(ablation group)and 60 patients were treated with traditional parathyroidectomy(operation group).SPSS 23.0 analysis software was used to compare the perioperative indicators,postoperative pain score,serum PTH,blood calcium,blood phosphorus and other measurement data at 1 week,1 month,1year after operation(x±s),independent sample t test;the treatment effect,recurrence rate and related complications of the two groups were analyzed byχ^(2) test;The treatment effect was tested by rank sum test.The difference was statistically significant(P<0.05).Results The operation time,intraoperative blood loss,postoperative pain score and hospitalization time in the microwave ablation group were less than those in the operation group(P<0.05).The incidence of hoarseness,postoperative bleeding,tracheal injury,hypocalcemia and other complications in the microwave ablation group were lower than those in the operation group 1 week and 1 year after treatment(P<0.05).1 year after treatment,the recurrence rate,serum PTH and phosphate water in the ablation group were lower than those in the operation group(P<0.05).Conclusion The short-term effects of microwave ablation in the treatment of secondary hyperparathyroidism are better than those of traditional parathyroidectomy,with lower recurrence rate.

关 键 词：甲状旁腺功能亢进症 继发性 甲状腺切除术 超声检查 微波消融术 

分 类 号：R73[医药卫生—肿瘤]