原发性甲状旁腺功能亢进外科诊治分析(附24例报告)

目的 讨论原发性甲状旁腺功能亢进(PHPT) 的临床表现、诊断、治疗与预后.方法 回顾性分析我院10年间收治的24例PHPT患者的临床资料.结果 女性发病多于男性;B超检查是首选,诊断的准确率为79.2%;CT联合99mTc-MIBI检查可以提高异位甲状旁腺腺瘤诊断的准确率;手术在定位明确的甲状旁腺腺瘤可行单侧探查.定位不明确或异位者可在CT与放射性核素指导下行手术探查;手术后均发生不同程度的低血钙症,应用钙剂后症状缓解,大部分患者骨痛缓解或泌尿系多发结石消失;未发现喉返神经损伤、永久性甲状旁腺功能减退等并发症.结论 PHPT早期手术治疗,效果良好,能明显减轻患者的症状,并且并发症较少.

Surgical diagnosis and treatment of primary hyperparathyroidism (report of 24 cases)

Objective To discuss the clinical symptoms,diagnosis,treatment and prognosis of primary hyperparathyroidism (PHPT).Methods Clinical data of 24 cases of PHPT were retrospectively analyzed in the past 10 years in Changhai hospital.Results Nineteen out of 24 cases (79.2%) undergoing preoperative ultrasonography with a positive result were verified by intraoperative findings.CT in combination with 99m Tc-MIBI could find the parathyroidoma without accurate localization and increase accurate rate.Unilateral neck exploration (UNE) was performed on the parathyroidoma in the unambiguous location.All cases developed hypocalcemia to varying degrees after surgery,but the symptoms were relieved with the use of calcium gluconate.And bone pain and urine stone disappeared.There was no permanent hypoparathyroidism or recurrent recurrent laryngeal nerve injury or other complications.Conclusion Early surgery is good for PHPT,it can relieve its symptons obviously and its complications are rare.