射频消融治疗三发性甲状旁腺功能亢进病例分析  

Case analysis of radiofrequency ablation for tertiary hyperparathyroidism

作　　者：刘硕 岳雯雯 何洪峰[3] 张正贤[4] 彭成忠 Liu Shuo;Yue Wenwen;He Hongfeng;Zhang Zhengxian;Peng Chengzhong(Bengbu Medical College,School of Medical Imaging,Bengbu 233000,China;Department of Medical Ultrasound,Shanghai Tenth People′s Hospital,School of Medicine,Tongji University,Shanghai 200072,China;Zhejiang Provincial People′s Hospital,Zhejiang 310014,China;Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China)

机构地区：[1]蚌埠医学院医学影像学院,蚌埠233000 [2]同济大学附属第十人民医院,上海200072 [3]浙江省人民医院,杭州310014 [4]杭州市中医院,杭州310007

出　　处：《国际内分泌代谢杂志》2024年第2期88-92,共5页International Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金项目(82272005)。

摘　　要：目的探讨射频消融(radiofrequency ablation, RFA)治疗三发性甲状旁腺功能亢进(THPT)的中长期疗效和安全性。方法回顾性分析行RFA治疗的30例THPT患者, 观察患者术前, 术后1 d, 术后1周及术后1、3、6、12、24、36个月的血清甲状旁腺激素(PTH)、钙、磷水平以及相关临床症状的变化, 并记录消融过程及术后的并发症。结果患者消融术后1 d, 术后1周及术后1、3、6、12、24、36个月的血清PTH、钙、磷水平与术前相比均明显下降(P均<0.05), 临床症状明显改善。随访终点有22(73.33%)例患者PTH在合理范围内, 分别有4(13.33%)例和3(10%)例患者出现复发性和持续性THPT, 1(3.3%)例患者为持续性甲状旁腺功能低下。消融后20(66.66%)例患者出现低钙血症;术后有2(6.66%)例患者发生声音嘶哑, 1(3.33%)例患者发生甲状旁腺功能低下。结论 RFA治疗THPT有一定的价值, 可作为THPT一个可选择的治疗方案。Objective To investigate the medium-long term efficacy and safety of radiofrequency ablation in the treatment of tertiary hyperparathyroidism(THPT).Methods A retrospective analysis was performed for 30 patients with THPT who underwent radiofrequency ablation,and the changes in serum parathyroid hormone,calcium,phosphorus levels,and related clinical symptoms were observed before surgery,1 day,1 week,1 month,3 months,6 months,12 months,24 months,and 36 months after surgery,and the ablation process and postoperative complications were recorded.Results The levels of serum PTH,calcium,and phosphorus at 1 day,1 week,1 month,3 months,6 months,12 months,24 months,and 36 months after ablation significantly decreased compared with those before ablation(all P<0.05),and the clinical symptoms were significantly improved.At the follow-up endpoint,22(73.33%)patients had PTH levels within a reasonable range,and 4(13.33%)and 3(10%)patients had recurrent and persistent THPT,respectively.And 1(3.33%)patient had persistent hypoparathyroidism.After ablation,20(66.66%)patients developed hypocalcemia,2(6.66%)patients developed hoarseness,and 1(3.33%)patient developed hypoparathyroidism.Conclusions Radiofrequency ablation has some value in the treatment of THPT,and can be regarded as an alternative treatment for THPT.

关 键 词：射频消融 甲状旁腺 三发性甲状旁腺功能亢进 

分 类 号：R653[医药卫生—外科学]