超声引导下微波消融治疗对MHD患者并发SHPT短期复发率的影响研究  

Effect of Ultrasound-Guided Microwave Ablation on Short-Term Recurrence Rate of SHPT in Patients with MHD

作　　者：程晓雪 徐晓红[1] CHENG Xiaoxue;XU Xiaohong(Guangdong Medical University,Zhanjiang,Guangdong Province,524000 China;Department of Ultrasound,Meizhou People's Hospital,Meizhou,Guangdong Province,514000 China)

机构地区：[1]广东医科大学,广东湛江524000 [2]广东省梅州市人民医院超声科,广东梅州514000

出　　处：《世界复合医学》2022年第3期1-3,16,共4页World Journal of Complex Medicine

摘　　要：目的 探讨基于超声引导下的微波消融治疗血液透析(MHD)继发性甲状旁腺功能亢进(SHPT)患者,对病灶完全消融坏死的影响。方法 选取该院2017年12月—2021年5月收治的38例行微波消融治疗的MHD并发SHPT患者为研究对象,对纳入研究患者采用微波消融术治疗,观察治疗后完全消融坏死率,检测术前、术后患者血清甲状旁腺激素(PTH)、血清钙、血清磷与血清碱性磷酸酶(ALP)水平变化情况;同时评估临床治疗安全性,随访3个月,对患者复发情况进行统计。结果 针对<15 mm的病灶,完全消融坏死率为94.51%;≥15 mm的病灶,完全消融坏死率为95.16%。术后3 d,PTH、血清钙、血清磷、ALP水平较术前明显降低,差异有统计学意义(P<0.05)。并发症发生率为10.53%、复发率为5.26%。结论 微波消融对于SHP并发TMHD患者具有良好的治疗效果,对术后复发预防有较好的效果,但需要注意预防相关并发症。Objective To investigate the effect of ultrasound-guided microwave ablation on the complete ablation and necrosis of lesions in patients with secondary hyperparathyroidism(SHPT) on hemodialysis(MHD). Methods A total of 38 patients with MHD complicated by SHPT who underwent microwave ablation in the hospital from December 2017 to May 2021 were selected as the research subjects, and the included patients were treated with microwave ablation. The complete ablation necrosis rate after treatment was observed, and the changes of serum parathyroid hormone(PTH), serum calcium, serum phosphorus and serum alkaline phosphatase(ALP) levels were detected before and after surgery. At the same time, the safety of clinical treatment was evaluated, and the patients were followed up for 3 months to make statistics on the recurrence of patients. Results For lesions <15 mm, the complete ablation and necrosis rate was 94.51%, and for lesions ≥15 mm, the complete ablation and necrosis rate was 95.16%. Three days after operation, the levels of PTH, serum calcium, serum phosphorus and ALP in the two groups were significantly lower than those before treatment, and the difference was statistically significant(P<0.05). The complication rate was 10.53%, and the recurrence rate was 5.26%. Conclusion Microwave ablation has a good therapeutic effect on SHP patients complicated with TMHD, and has a good effect on postoperative recurrence prevention, but it is necessary to pay attention to the prevention of related complications.

关 键 词：血液透析 继发性甲状旁腺功能亢进 超声引导 微波消融 消融坏死率 

分 类 号：R445[医药卫生—影像医学与核医学]