彩色多普勒超声对继发性甲状旁腺功能亢进超声引导下无水乙醇注射疗效的评价

目的应用彩色多普勒超声对慢性肾功能衰竭继发甲状旁腺功能亢进超声引导下注射无水乙醇治疗的疗效进行观察评价。方法2011年1月至2013年5月南京军区南京总医院53例慢性肾功能衰竭继发甲状旁腺功能亢进患者，对患者增生的甲状旁腺腺体于超声引导下注射无水乙醇治疗。彩色多普勒超声观察治疗前后甲状旁腺腺体回声、体积和血供变化。采用独立样本t检验比较患者治疗前后血清PTH浓度、甲状旁腺体积差异。结果治疗前，53例患者甲状旁腺体积为（5．28±0．84）cm^2，肿大的甲状旁腺均呈均匀低回声，血供丰富，血清PTH浓度为（1041．6±37．1）ngm；治疗后甲状旁腺体积为（3．93±0．67）cm^2，与治疗前比较差异无统计学意义，甲状旁腺回声多增强，血供减少，血清PTH浓度为（509．2±27．6）ng／L，较治疗前降低，且差异有统计学意义（t=3．792，P〈0．05）。结论彩色多普勒超声引导下注射无水乙醇对继发性甲状旁腺功能亢进的治疗效果显著，并能及时观察疗效，具有重要价值。

The role of ultrasound guided percutaneous ethanol injection for secondary hyperparathyroidism

Objective To observe and evaluate the effect of ultrasound guided percutaneous ethanol injection for hyperparathyroidism secondary to chronic renal failure. Methods Fifty-three patients with secondary hyperparathyroidism in Nanjing General Hospital Military Command from January 2011 to May 2013 were treated by percutaneous ethanol injection. The echogenicity, size and blood supply of parathyroid glands were observed by color Doppler ultrasound before and after treatment. Parathyroid hormone （PTH） and volumes of parathyroid glands were analyzed and compared with non-paired t test. Results Before treatment, the parathyroid gland volume was （5.28±0.84） cm3. The enlarged parathyroid glands had homogeneous hypoechogenicity and abundant blood supply, and the PTH was （1041.6 ±37.1） ng/L. After treatment, the size of solitary parathyroid gland was （3.93±0.67） cm3 which did not change significantly compared with that before treatment. The echogenicity of parathyroid glands enhanced and blood supply decreased after injection ethanol into solitary parathyroid. PTH [（509.2 ±27.6） ng/L] decreased obviously （t=3.792, P 〈 0.05）. Conclusion Color Doppler ultrasound guided percutaneous injection of ethanol has an important role in the treating of secondary hyperparathyroidism and the curative effect can be observed timely.