中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (03): 256-258.

• 论著 • 上一篇    下一篇

甲状旁腺危象的诊断和治疗（附4例报告）

白艳霞a，马清涌b，闫利英a，施秉银c，李随勤a，张少强a，邵 渊a，姚小宝a   

  1. 西安交通大学医学院第一附属医院a.耳鼻咽喉头颈外科，b.肝胆外科，c.内分泌科，陕西西安710061
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-03-13 发布日期:2009-03-13

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-03-13 Published:2009-03-13

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摘要：

目的 探讨甲状旁腺危象病人的定性、定位诊断及抢救治疗方法。方法 报告2005年1月至2007年5月西安交通大学医学院第一附属医院收治的4例原发性甲状旁腺功能亢进症并发甲状旁腺危象病人的临床资料以及手术方法、治疗效果并复习相关文献。结果 其中首诊内分泌科2例、肝胆外科1例、耳鼻咽喉头颈外科1例。 4例病人中有3例经及时甲状旁腺探查切除手术加内科治疗后痊愈，1例并发多脏器功能衰竭而死亡。结论 经过短暂的内科治疗后及时行甲状旁腺探查切除术是抢救原发性甲状旁腺功能亢进症并发甲状旁腺危象病人的有效方法；术前明确诊断及准确定位、术中进行冰冻切片和快速甲状旁腺激素测定是手术成功的有力保障。

关键词: 甲状旁腺功能亢进症, 原发性；甲状旁腺危象；甲状旁腺探查切除术；甲状旁腺激素

Abstract:

Diagnosis and treatment of hyperparathyroid crisis：a report of 4 cases BAI Yan-xia*, MA Qing-yong, YAN Li-ying, et al . *Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital, Medical College of Xi’an Jiaotong University，Xi’an 710061，China Corresponding Author： MA Qing-yong, E-mail: qyma56@xjtu.edu.cn Abstract Objective To explore the diagnostic and therapeutic method of hyperparathyroid crisis. Methods The clinical data, the operative technique, the therapeutic effect of 4 cases which were treated in First Affiliated Hospital of Xi’an Jiaotong University from January 2005 to May 2007 were presented. Through reviewing pertinent literature, we discuss the qualitative diagnosis、level diagnosis and operative juncture of primary hyperparathyroidism complicating hyperparathyroid crisis. Results The three patients were healed by promptly exploratory parathyroidectomy and medical treatment. One patient died for complicating of multiple organ dysfunction. Conclusions Promptly exploratory parathyroidectomy after temporal medical treatment is an effective method to rescue the patient of primary hyperparathyroidism complicating hyperparathyroid crisis；The exploratory parathyroidectomy can be successed on preoperative definite diagnosis and accurate localization、frozen section and quickly PTH determination in the operation.

Key words: primary；hyperparathyroid crisis；exploratory parathyroidectomy；parathyroid hormone, hyperparathyroidism