甲状旁腺全切除术联合甲状旁腺自体移植术治疗尿毒症SHPT的效果与安全性  

Efficacy and Safety of Total Parathyroidectomy Combined with Parathyroid Auto-transplantation in the Treatment of Uremia with SHPT

作　　者：杨徐雄 王强 顾伟青 欧贵雪 YANG Xuxiong;WANG Qiang;GU Weiqing;OU Guixue(Mindong Hospital Affiliated to Fujian Medical University,Fu’an 355000,China;不详)

机构地区：[1]福建医科大学附属闽东医院(宁德市闽东医院),福建福安355000

出　　处：《中外医学研究》2023年第1期139-143,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨甲状旁腺全切除术(TPTX)联合甲状旁腺自体移植术(TPTX+AT)治疗尿毒症继发性甲状旁腺功能亢进症(SHPT)的效果与安全性。方法:选取2018年12月-2021年5月福建医科大学附属闽东医院就诊的62例尿毒症SHPT患者作为试验对象。根据随机数字表法将其分为联合组(n=31)和对照组(n=31)。对照组给予TPTX治疗。联合组给予TPTX+AT治疗。比较两组围手术期指标,术前及术后1 d、1周、1个月生化指标、临床症状,并发症及术后3个月复发率。结果:联合组手术时长显著长于对照组(P<0.05),两组术中出血量和住院时长比较差异均无统计学意义(P>0.05)。术后1 d,两组甲状旁腺激素(PTH)、血磷及血钙水平均显著降低,两组比较差异均无统计学意义(P>0.05);术后1周、1个月,联合组PTH和血磷水平均显著低于对照组(P<0.05),术后1周,联合组血钙水平显著低于对照组(P<0.05),术后1个月,两组血钙水平比较差异无统计学意义(P>0.05)。术后1周、1个月两组皮肤瘙痒、骨痛、肌无力占比均较术前显著降低,且联合组皮肤瘙痒、骨痛、肌无力占比均显著低于对照组(P<0.05)。两组术后声音嘶哑、伤口感染发生率及术后3个月复发率比较差异均无统计学意义(P>0.05)。结论:TPTX+AT可更快速改善尿毒症SHPT患者临床症状,恢复其生化指标,有助于患者预后。Objective:To explore the efficacy and safety of total parathyroidectomy(TPTX)combined with parathyroid autotransplantation(TPTX+AT)in the treatment of uremia with secondary hyperparathyroidism(SHPT).Method:A total of 62 uremia with SHPT patients admitted to Mindong Hospital Affiliated to Fujian Medical University from December 2018 to May 2021 were selected as test subjects.They were divided into combined group(n=31)and control group(n=31)according to random number table method.The control group was treated with TPTX.The combined group was treated with TPTX+AT.The perioperative indexes,biochemical indexes,clinical symptoms before operation,1 day,1 week,1 month after operation,complications and recurrence rate 3 months after operation were compared between the two groups.Result:The operation time of the combined group was significantly longer than that of the control group(P<0.05),but there were no significant differences in intraoperative blood loss volume and hospitalization time between the two groups(P>0.05).At 1 day after operation,the levels of parathyroid hormone(PTH),serum phosphorus and calcium in the two groups were significantly decreased,and there were no significant differences between the two groups(P>0.05).At 1 week and 1 month after operation,the PTH and blood phosphorus levels in the combined group were significantly lower than those in the control group(P<0.05).At 1 week after operation,the blood calcium level in the combined group was significantly lower than that in the control group(P<0.05).At 1 month after operation,there was no significant difference in the blood calcium level between the two groups(P>0.05).At 1 week and 1 month after operation,the proportions of skin itching,bone pain,and muscle weakness in the two groups decreased significantly,and the proportions of skin itching,bone pain,and muscle weakness in the combined group were significantly lower than those in the control group(P<0.05).There were no significant differences in the incidences of voice hoarseness,wound infection and

关 键 词：尿毒症继发性甲状旁腺功能亢进症 甲状旁腺全切除术 甲状旁腺自体移植术 

分 类 号：R653[医药卫生—外科学]