甲状旁腺全切加前臂皮下移植术治疗肾性继发性甲状旁腺功能亢进的研究

继发性甲状旁腺功能亢进是终末性肾脏疾病常见的严重并发症。严重肾衰患者合并存在的低钙血症、高磷血症、稀释性低钠血症、代谢性酸中毒等内稳态失衡，是正常及异位的甲状旁腺组织强烈的生长刺激信号，可引起甲状旁腺组织的弥漫性增生。同时，SHPT又可使患者发生代谢性骨病，动脉粥样硬化等，两种疾病互为因果，又相互促进，严重影响患者的生存质量。2003年，美国肾脏疾病基金会颁布了肾性SHPT的治疗指南，但由于对此疾病的认识，在不同的研究中心还存在不同的观点，SHPT的最佳手术适应症、手术方式等还存在一定的争议，本文就甲状旁腺全切加前臂皮下移植术治疗肾性继发性甲状旁腺功能亢进的研究进展作一综述。

Study of Total Parathyroidectomy with Forearm Subcutaneous Transplantation in the Treatment of Secondary Hyperparathyroidism

Abstract:Secondary hyperparathyroidism is a common serious complication of end-end renal disease.The homeostasis of patients with severe renal failure of hypocalcemia,hyperphosphatemia,hyponatremia,metabolic acidosis,growth stimulating signal of normal and ectopic parathyroid tissue strongly,can cause diffuse hyperplasia of parathyroid tissue.At the same time,SHPT can cause metabolic bone disease,atherosclerosis and so on.The two diseases are mutual cause and effect,and promote each other,which seriously affect the quality of life of patients.In 2003,the American Kidney Disease Foundation issued guidelines for the treatment of renal SHPT. However,due to the recognition of this disease,there are still different views in different research centers.The best surgical indications and surgical methods for SHPT are still present controversy,this article reviews the research progress of parathyroidectomy plus forearm subcutaneous transplantation for the treatment of renal secondary hyperparathyroidism.