摘要
目的分析甲状旁腺功能亢进(hyperathyroidism,HPT)的临床特点、诊断与手术治疗策略。方法回顾性分析2010年1月至2015年6月复旦大学附属中山医院普外科同一组手术医师治疗44例HPT类型、临床特点及手术疗效评估。结果手术治疗HPT患者共44例,原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)26例(59.1%),继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)17例(38.6%),三发性甲状旁腺功能亢进(tertiary hyperparathyroidism,THPT)1例(2.3%)。PHPT组病灶大小,术前血甲状旁腺激素(parathyroidhormone,PTH)、血钙水平、血磷水平及碱性磷酸酶(alkaline phosphatase,ALP)与SHPT组患者比较,差异均有统计学意义(P<0.05),而年龄比较,差异无统计学意义(P>0.05);两组术前与术后血钙水平比较,差异有统计学意义(P<0.05)。术后血PTH下降率PHPT组为79%;SHPT组为87%。结论HPT患者以PHPT多见,且病灶大小及相关血清生化指标与SHPT差异有统计学意义;手术治疗对PHPT及药物治疗无效的SHPT患者能取得良好疗效。
Objective To investigate the clinical symptoms,diagnosis,and strategy of surgery for hyperparathyroidism(HPT).Methods A retrospective study was made in patients with HPT who received operation by the same surgeron group from Jan.2010 to Jun.2015 in Zhongshan Hospital of Fudan University.Results 44 patients with HPT underwent surgery.There were 26(59.1%)primary hyperparathyroidism(PHPT)patients,17(38.6%)secondary hyperparathyroidism(SHPT)patients and 1(2.3%)tertiary hyperparathyroidism(THPT)patient.There were statistical difference between patients with PHPT and patients with SHPT in terms of lesion size,preoperative parathyroid hormone,calcium,phosphate and alkaline phosphatase(P<0.05),while no statistical difference was found in age between the two groups(P<0.05).The postoperative decline rate of parathyroid hormone was 79% in PHPT group and 87% in SHPT group.Conclusions Hyperparathyroidism is more common in patients with PHPT,and the difference in lesion size and related serum biochemical values has statistical significance.Surgical treatment of primary hyperparathyroidism and patients with secondary hyperparathyroidism who are ineffective to drug therapy can achieve good results.
作者
周秀娟
张宏伟
Zhou Xiujuan;Zhang Hongwei(Deparment of General Surgery,Yaan People’s Hospital,Ya’an 625000,China;Deparment of General Surgery,Zhongshan Hospital of Fudan University,Shanghai 200032,China)
出处
《中华内分泌外科杂志》
CAS
2019年第1期40-43,共4页
Chinese Journal of Endocrine Surgery
