射频消融与甲状旁腺切除治疗继发性甲状旁腺功能亢进的meta分析  

Radiofrequency ablation and parathyroidectomy for treating secondary hyperparathyroidism:a meta analysis

作　　者：肖武[1] 陈薇[1] 杨勇[1] 徐华 XIAO Wu;CHEN Wei;YANG Yong;XU Hua(Department of Thyroid Head and Neck Surgery,Jiangxi Provincial People’s Hospital/First Affiliated Hospital of Nanchang Medical College,Nanchang,Jiangxi 330000,China)

机构地区：[1]江西省人民医院/南昌医学院第一附属医院甲状腺头颈外科,330006

出　　处：《重庆医学》2025年第2期484-488,495,共6页Chongqing Medical Journal

摘　　要：目的 通过meta分析比较射频消融(RFA)与甲状旁腺切除(PTx)治疗继发性甲状旁腺功能亢进(SHPT)的有效性及安全性。方法 检索Pubmed、Embase、Cochrane Library、中国知网(CNKI)、万方、中国生物医学文献服务系统(CBM)、维普数据库中关于RFA与PTx治疗SHPT的研究,检索时间为建库至2023年12月,根据纳入与排除标准筛选文献,提取资料,评价文献质量,应用RevMan5.3软件对纳入资料进行meta分析。结果 最终纳入7篇文献,共415例研究对象,其中RFA组185例,PTx组230例。meta分析结果显示:两组术后声音嘶哑发生率比较差异无统计学意义(RR=0.96,95%CI:0.65~1.42,P=0.83),RFA组术后低钙发生率明显低于PTx组(RR=0.58,95%CI:0.42~0.81,P<0.05),RFA组住院时间短于PTx组(MD=-3.32,95%CI:-5.28~-1.36,P<0.05),两组患者术后1、3、6个月PTH、血钙、血磷比较差异均无统计学意义(P>0.05)。结论 RFA较PTx治疗SHPT能减少术后并发症发生率,缩短住院时间,并可达到PTx相同的治疗效果。Objective To compare the efficacy and safety of radiofrequency ablation(RFA)and parathyroidectomy(PTx)for treating secondary hyperparathyroidism(SHPT)by meta analysis.Methods The studies on the clinical efficacy of RFA and PTx in the treatment of SHPT were retrieved from Pubmed,Embase,Cochrane Library,CNKI,Wanfang,CBM,and VIP databases.The retrieval time was from the establishment of the database to December 2023.The literatures were screened according to the inclusion and exclusion criteria,the data were extracted and the literature quality was evaluated.The meta analysis of the included data was performed by using RevMan5.3.Results Finally,7 articles with 415 patients were finally included,including 185 cases in the RFA group and 230 cases in the PTx group.The results of meta analysis showed:there was no statistically significant difference in the incidence rate of postoperative hoarseness between the two groups(RR=0.96,95%CI:0.65-1.42,P=0.83),the incidence rate of postoperative hypocalcemia in the RFA group was significantly lower than that in the PTx group(RR=0.58,95%CI:0.42-0.81,P<0.05),and the hospital stay duration in the RFA group was shorter than that in the PTx group(MD=-3.32,95%CI:-5.28--1.36,P<0.05),and there was no statistically significant difference in the levels of PTH,blood calcium and blood phosphorus in postoperative 1,3,6 months between the two groups(P>0.05).Conclusion C ompared with PTx,RFA for treating SHPT could reduce the incidence rate of postoperative complications,shorten the length of hospital stay,and achieve the same therapeutic effect.

关 键 词：射频消融 甲状旁腺切除 继发性甲状旁腺功能亢进 META分析 

分 类 号：R582[医药卫生—内分泌]