术后甲状旁腺功能减退症的治疗进展  

Progress of Treatment for Postoperative Hypoparathyroidism

作　　者：柯逸凡 胡昆鹏[1] KE Yifan;HU Kunpeng(Department of General Surgery,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院普通外科,广州510630

出　　处：《医学综述》2022年第23期4671-4677,共7页Medical Recapitulate

基　　金：广东省自然科学基金(2021A1515012493);东莞市滨海湾中心医院科研项目(2021001)。

摘　　要：近年来,手术技术的改进降低了术后甲状旁腺功能减退症(HP)的发生率,但甲状腺疾病的高发使术后HP患病总人数增加。控制血钙是HP治疗的关键。口服钙剂和骨化三醇适用于暂时性HP,其用于永久性HP患者易导致多种远期并发症。甲状旁腺激素可同时控制血钙、尿钙和血磷水平,避免远期并发症发生,但其应用受到性价比和安全隐患的限制。甲状旁腺同种移植近年迅速发展,但其具体步骤仍有待进一步规范和完善。目前尚无治疗术后HP的公认最佳方案。因此,外科医师应重视优化颈部手术的术中操作,尽可能地降低术后HP的发生率。In recent years,the improvement of surgical techniques has reduced the incidence of postoperative hypoparathyroidism(HP),but the high incidence of thyroid diseases has increased the total number of postoperative HP patients.Controlling blood calcium is the key to HP treatment.Oral calcium and calcitriol are suitable for temporary HP,and their use in permanent HP patients may easily lead to a variety of long-term complications.Parathyroid hormone can control blood calcium,urine calcium and blood phosphorus levels at the same time,to avoid long-term complications,but its application is limited by cost-effectiveness and safety risks.Parathyroid allotransplantation has developed rapidly in recent years,but its specific steps still need to be further standardized and improved.At present,there is no recognized best scheme for the treatment of postoperative HP.Therefore,the surgeons should pay attention to optimizing the intraoperative operation of neck surgery to reduce the incidence of postoperative HP as much as possible.

关 键 词：甲状旁腺功能减退症 甲状旁腺激素 特立帕肽 Natpara 甲状旁腺移植 

分 类 号：R582.2[医药卫生—内分泌]