原发性甲状旁腺功能亢进症的临床特点及治疗

目的：探讨我国原发性甲状旁腺功能亢进症（PHPT）的临床特点和手术治疗方法。方法：分析1968－2001年间收治的28例PHPT患者的临床资料并与国内相关文献进行比较分析。结果：手术治疗28例,颈部探查术12例,囊肿切除术1例,癌根治术1例,甲状旁腺腺瘤直接切除术14例。术后病理证实,甲状旁腺腺瘤25例,甲状旁腺腺癌2例,甲状旁腺囊肿1例。28例PHPT患者全部治愈,肿瘤无复发。结论：在我国PHPT临床上比较少见,一般好发于30－40岁的青壮年,有骨病者占90％以上。单个甲状旁腺腺瘤可在颈小切口下直接行甲状旁腺腺瘤切除术,效果优于常规颈探查术。

Clinical research of primary hyperparathyroidism

OBJECTIVE: To investigate the clinical features and therapeutic procedures of primary hyperparathyroidism(PHPT) in China. METHODS: Clinical data of twenty eight consecutive in-patients with PHPT hospitalized in the Second Hospital Affiliated to Zhejiang University Medical School during the period 1968-2001 were analyzed retrospectively and compared with the domestic relevant literature. RESULTS: Twenty-eight patients underwent operative treatment, including exploratory operation of neck in 14 cases, cystectomy in one case, cancer radical operation in one case, and direct parathyroid adenomectomy in 14 cases with solitary adenoma. All cases resulted in normocalcemia after operation. The cure rate of PHPT was 100%. No early and long-term operative complications and recurrence were found. CONCLUSION: PHPT, mostly occurring among people aged 30-40, is rare in China. Osteopathy can be seen in 90% of PHPT patients. For solitary parathyroid adenoma, direct adenomectomy through small neck incision is a safe and effective alternative to conventional neck exploratory operation.