甲状旁腺切除及无水酒精注射治疗继发性甲状旁腺功能亢进

目的：探讨甲状旁腺切除及腺体内无水酒精注射两种方式治疗继发性甲状旁腺功能亢进（SHPT）的疗效及安全性。方法：17例SHPT患者分为甲状旁腺切除组7例及甲状旁腺无水酒精注射组10例,术后腺体送检病理,观察药物注射前后腺体超声信号变化及术后并发症,记录血清学指标并随访1年。结果：腺体长径大于1.0cm病理改变呈结节样增生,无水酒精注射后腺体血流信号减少。两组术后钙、磷、碱性磷酸酶及甲状旁腺激素水平变化差异存在统计学意义（P〈0.01）,两组术后患者症状均有改善,并发症少,但手术组疗效优于注射组。结论：甲状旁腺切除治疗严重继发性甲状旁腺功能亢进效果确切,临床作为首选,甲状旁腺无水酒精注射治疗可作为单一腺体增生或甲状旁腺切除后的补充治疗。

Parathyroidectomy and Percutaneous Ethanol Injection Treating for Secondary Hyperparathyroidism

Objective：To investigate effect and recurrence of parathyroidectomy（PTX）and percutaneous ethanol injection（PEIT）treating for secondary hyperparathyroidism（SHPT）.Methods：17 SHPT patients were divided into PTX group（n=7）and PEIT group（n=10）.The glands pathology been done after operation.The glands function were observed before and after treatment.Serum markers were recordered and followed up for one year.Results：Diameter more than 1.0cm of glands were nodular hyperplasia.Blood flow signals of the gland、serum calcium、phosphorus、alkaline phosphatase and parathyroid hormone（PTH）were reduced after treatment,There are significant differences during two groups（P0.01）,Symptoms were improved during two groups after the treatment.Fewer complications were observed.The effect of PTX was better than PEIT.Conclusion：PTX for severe SHPT was exact effect and recommended.PEIT was refered for a single parathyroid gland hyperplasia or a replacement therapy after PTX.