原发性甲状旁腺机能亢进症19例的诊断和治疗

目的：探讨原发性甲状旁腺机能亢进症的诊断和手术处理方法。方法：对我院１９８１～１９９８年１９例原发性甲状旁腺机能亢进症的患者的临床表现、实验室检查和术前、术中定位方法及手术治疗进行了回顾性分析总结。结果：持重部骨关节疼痛、多发骨折为其主要征象，实验室检查有血钙、血甲状旁腺激素、血碱性磷酶及尿钙、尿磷升高和血磷降低。Ｘ线主要表现为骨质疏松、骨质变薄，Ｂ超、ＣＴ及＾９９ｍＴｃ造影三项结合可使术前定位准

Diagnosis and surgical treatment of 19 patients with primary hyperparathyroidism

Objective:To study the diagnosis and surgical treatment of primary hyperparathroidism. Methods:We analysed 19 patients with hyperparathroidism who were treated in our hospital from 1981 to 1998 retrospectively. Results:The main clinical manifestation was symmetrical pain of the supporting bones and joins, hypercalcemia, hypercalnuria, hypophosphatemia and hyperalkaline phosphatasemia, and increase of PTH in peripheral blood. X ray examination showed ostroporosis and ecalcification, accopanied with multiple fracture. The accuracy of parathyroid tumor localization was above 89% by B ultrasound, CT scan and 99m Tc examination preoperation. We used thymo thyroid ligment as guide and injectied methylene blue into the artey during opeation to search parathyroid tumor. Conclusion:The key procedure of the operation was to search for tumor of parathyroid. If one abnormal parathyroid gland and a normal gland are found on the first side of the neck, the second side shoud not be explored.