目的:总结原发性甲状旁腺功能亢进的诊治经验。方法:回顾分析中国医科大学附属第一医院普通外科1991-2005年经手术并经病理证实的48例原发性甲状旁腺功能亢进的诊治经验。结果:37例行超声检查的阳性准确率为81.1%（30/37）。35例行ECT检查的阳性准确率为91.4%（32/35）。38例甲状旁腺腺瘤均行单侧探查；6例甲状旁腺增生中4例行单侧探查,2例行双侧探查;3例甲状旁腺癌均参照甲状腺癌行根治性切除和颈部淋巴结功能性清扫术；1例甲状旁腺腺瘤恶变行患侧甲状腺和甲状旁腺全切除。手术后均发生不同程度的低钙血症,应用钙剂后症状缓解。结论:超声和ECT检查可做为诊断甲状旁腺疾病的首选定位诊断方法。定性诊断主要依据血钙和血甲状旁腺素的同步升高，一旦明确诊断即应手术治疗。定位明确的甲状旁腺腺瘤可行单侧探查。

Objective:To summarize the experience in the primary hyperparathyroidism. Methods:The clinical data of 48 cases of the PHPT admitted from 1991 to 2005 in the First Affiliated Hospital of China Medical University were analyzed retrospectively. Results:For ultrasonography,the positive rate was 81.1%(30/37).For ECT,the positive rate was 91.4%(32/35).Unilateral neck explorations (UNE) was performed in 38 cases with parathyroidoma.Four cases of parathyroid hyperplasia were treated by UNE and the other 2 cases by bilateral neck exploration (BNE).The procedure for 3 cases of parathyroid carcinoma was the same as that for papillary thyroid carcinoma.Unilateral resection of thyroid and parathyroid was done in a case of parathyroidoma with malignant change.All cases developed hypocalcemia in various degrees after operation,but the symptoms were relieved with the use of calcium gluconate. Conclusion:PHPT could be diagnosed according to coelevated calcemia and PTH.Ultrasonography and ECT should be considered as the methods of first choice for preoperative localization.UNE of parathyroidoma could be feasible if accurate image localizations are available.