甲状旁腺切除治疗继发性甲状旁腺功能亢进

目的探讨甲状旁腺全切加自体移植及甲状旁腺次全切的2种手术治疗继发性甲状旁腺功能亢进（SHPT）的效果。方法根据19例SHPT患者甲状旁腺增生数目及腺体大小分为甲状旁腺全切加自体移植组及甲状旁腺次全切组，观察术后并发症，记录血清学指标，随访1年。结果腺体长径大于1cm病理改变且呈结节样增生。2组术后1个月钙、磷、碱性磷酸酶及甲状旁腺素水平变化无差异，术后1年碱性磷酸酶及甲状旁腺素变化存在显著统计差异。结论甲状旁腺切除治疗严重的SHPT效果确切，甲状旁腺全切加自体移植比甲状旁腺次全切复发率更小。

Parathyroidectomy for secondary hyperparathyroidism

Objective To investigate the effectiveness of total parathyroidectomy（PTX） plus parathyroid autotransplantation vs. subtotal parathyroidectomy for secondary hyperparathyroidism （SHPT）. Methods Nineteen cases of SHPT were divided into two groups： total PTX plus parathyroid autotransplantation group and subtotal PTX group according to the number and size of hyperplasia glands. Postoperative complications were observed, serum markers were recorded, and all patients were followed up for a year. Results Glands with length diameter more than 1.0 cm presented nodular hyperplasia. The levels of calcium, phosphorus, alkaline phosphatase and parathyroid hormone in the two groups had no significant difference within a month, but alkaline phosphatase and parathyroid hormone （PTH） levels had significant difference within a year. Conclusions PTX for severe SHPI was effective, In comparison to subtotal PTX,total PTX plus parathyroid autotransplantation has lower recurrence rate and is firstly chosen clinically.