甲状旁腺腺瘤的诊断与外科治疗研究

目的:探讨甲状旁腺腺瘤伴甲状旁腺功能亢进的诊断与外科治疗。方法:回顾性分析收治的6例甲状旁腺腺瘤患者,对其临床表现、诊断、外科治疗进行总结。结果:6例患者以消化道症状为主的3例,表现为肾型的1例,以全身性骨痛和(或)病理性骨折为首发症状的3例,胆总管结石1例,发现颈部肿块的1例。术前检测血钙高、血磷低,甲状旁腺素(PTH)升高,行骨扫描和(或)X线片示骨质疏松和普遍脱钙,彩色多普勒超声检查、CT检查或99mTc-MIBI扫描,考虑甲状旁腺肿瘤,予手术切除,术中冰冻切片示甲状旁腺腺瘤,血钙、血磷、PTH恢复正常,术前症状好转或消失,随访至今无复发。结论:甲状旁腺腺瘤伴甲状旁腺功能亢进的临床表现复杂,结合实验室检查血钙、血磷、PTH等,以及多普勒超声、CT、99mTc-MIBI显像,可明确诊断。手术疗效确切。

Diagnosis and surgical treatment of Parathyroid Adenoma(report of 6 cases)

Objective To explore the diagnosis and surgical treatment of Parathyroid adenoma（PA） with primary hyperparathyroidism（PHPT）.Methods The clinical data of 6 patients with PA were retrospectively analyzed.To summarize their clinical manifestations,diagnosis and surgical treatment.Results Of all patients,3 cases showed digestive tract symptoms,one suffered kidney diseases,3 cases’early symptoms were general ostalgia and（or） pathological fracture,one had common bile duct calculus,one patient found a neck lump.Before the operation,we found that Serum calcium was high,serum phosphorus was low and parathyroid hormone（PTH） was high.Bone scanning and（or） X-ray showed osteoporosis and general decalcification.Color Doppler Ultrasound,computed tomography or 99mTc-MIBI scanning regarded them as Pas.All the patients underwent operations.Frozen slices confirmed the nature of the lesion.Serum calcium,serum phosphorus and parathyroid hormone（PTH） returned to normal after operations.The preoperation’s symptoms got better or disappeared.There was no recurrence following up to now.Conclusion The clinical manifestations of PA concomitant PHPT are complicated.But ombined Serum calcium、serum phosphorus and PTH,and Color Doppler Ultrasound,computed tomography or 99mTc-MIBI scanning,the diagnosis is definited.The surgical outcome is satisfactory.