甲状旁腺全切除+自体移植术在尿毒症继发性甲状旁腺功能亢进患者中的应用价值  

Application Value of Total Parathyroidectomy and Autologous Transplantation in Patients with Secondary Hyperparathyroidism of Uremia

作　　者：罗文斌 黄晖 饶根辉 LUO Wenbin;HUANG Hui;RAO Genhui(Gao’an Traditional Chinese Medicine Hospital,Jiangxi Province,Gao’an 330800,China;不详)

机构地区：[1]江西省高安市中医院,江西高安330800 [2]江西省高安市妇幼保健院

出　　处：《中国医学创新》2022年第34期5-9,共5页Medical Innovation of China

基　　金：江西省宜春市科技计划项目(JXYC2021KSA143)。

摘　　要：目的:探究及观察甲状旁腺全切除+自体移植术在尿毒症继发性甲状旁腺功能亢进患者中的应用价值。方法:选取2021年1-12月高安市中医院的80例尿毒症继发性甲状旁腺功能亢进患者为研究对象,根据随机数字表法将其分为对照组和观察组,每组40例。对照组进行甲状旁腺次全切除术治疗,观察组则采用甲状旁腺全切除+自体移植术治疗。比较两组手术前后的症状体征积分、甲状腺体积、血清全段甲状旁腺激素(iPTH)、血钙、血磷、钙磷乘积及血清骨代谢指标[骨钙素(BGP)、碱性磷酸酶(ALP)及β-Ⅰ型胶原羧基末端肽(β-CTX)]。结果:术前两组的症状体征积分、甲状腺体积、血清iPTH、血钙、血磷、钙磷乘积及血清骨代谢指标比较,差异均无统计学意义(P>0.05),术后7 d及3个月观察组的症状体征积分、血清iPTH及血清骨代谢指标均低于对照组,差异均有统计学意义(P<0.05),术后7 d及3个月两组的甲状腺体积、血钙、血磷及钙磷乘积比较,差异均无统计学意义(P>0.05),但均显著低于本组术前(P<0.05)。结论:甲状旁腺全切除+自体移植术在尿毒症继发性甲状旁腺功能亢进患者中的应用效果较好,在控制症状体征及改善骨代谢方面具有更好的效果,因此应用价值较高。Objective:To investigate and observe the application value of total parathyroidectomy and autologous transplantation in patients with secondary hyperparathyroidism of uremia.Method:A total of 80 patients with secondary hyperparathyroidism of uremia in Gao’an Traditional Chinese Medicine Hospital from January to December 2021 were chosen as the study object,and they were divided into control group and observation group with 40 cases in each group by the method of random random number.The control group were treated with subtotal parathyroidectomy,the observation group were treated with total parathyroidectomy and autologous transplantation.Then the symptom and sign scores,thyroid volume,serum intact parathyroid hormone(iPTH),blood calcium,blood phosphorus,calcium phosphorus product and serum bone metabolism indexes[bone glaprotein(BGP),alkaline phosphatase(ALP)andβ-isomerized carboxy-terminal cross-linking telopeptide of typeⅠcollagen(β-CTX)]of two groups before and after the operation were compared.Result:The symptom and sign scores,thyroid volume,serum iPTH,blood calcium,blood phosphorus,calcium phosphorus product and serum bone metabolism indexes of two groups were compared,the differences were not statistically significant(P>0.05),the symptom and sign scores,serum iPTH and serum bone metabolism indexes of observation group at 7th day and 3rd month after the operation were all lower than those of control group,the differences were all statistically significant(P<0.05),the thyroid volume,blood calcium,blood phosphorus and calcium phosphorus product of two groups at 7th day and 3rd month after the operation were compared,the differences were not statistically significant(P>0.05),while the results were all significantly lower than those before the operation(P<0.05).Conclusion:The application effect of total parathyroidectomy and autologous transplantation in patients with secondary hyperparathyroidism of uremia is better,and it can effectively control the symptom and sign and improve the bone metabolism,so it

关 键 词：甲状旁腺全切除 自体移植术 尿毒症继发性甲状旁腺功能亢进 

分 类 号：R692.5[医药卫生—泌尿科学] R653[医药卫生—外科学]