中国实用外科杂志

中国实用外科杂志

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原发性甲状旁腺功能亢进60例外科治疗体会

王    松，代文杰，姜洪池，宋春芳   

  1. 哈尔滨医科大学附属第一医院甲状腺乳腺外科，黑龙江哈尔滨 150001
  • 发布日期:2013-11-28

  • Published:2013-11-28

摘要：

目的    总结原发性甲状旁腺功能亢进的诊断、手术治疗经验。方法 对1992年1月至2012年12月哈尔滨医科大学附属第一医院甲状腺乳腺外科收治的60例原发性甲状旁腺功能亢进病人的资料进行回顾性分析。结果    60例均行手术治疗，男性14例，女性46例。切除病变甲状旁腺74枚。术后病理证实：61枚（82.4%）为甲状旁腺腺瘤，13枚（17.6%）为甲状旁腺增生 ，无甲状旁腺癌结果回报。60例行病变甲状旁腺切除术后甲状旁腺激素（PTH）均降至正常，血钙下降。其中11例术后出现低血钙症状，经补充维生素D和葡萄糖酸钙，血钙恢复正常。无其他并发症。结论    完善的术前评估、围手术期正确的处理、术中精细操作、个体化治疗，能降低手术并发症的发生率，提高病人的生活质量。

关键词: 原发性甲状旁腺功能亢进, 病变甲状旁腺切除术, 甲状旁腺激素

Abstract:

Primary hyperparathyroidism：A surgical treatment summary of 60 cases        WANG Song，DAI Wen-jie, JIANG Hong-chi, et al. Department of Thyroid and Breast Surgery，the First Affiliated Hospital of Harbin Medical University，Harbin 150001, China
Corresponding author：DAI Wen-jie，E-mail：davidhmu@163.com
Abstract    Objective    To summary the primary hyperparathyroidism surgery and perioperative treatment experience. Methods    The clinical data of 60 cases of primary hyperparathyroidism performed parathyroidectomy between January 1992 and December 2012 in Department of Thyroid and Breast Surgery, First Affiliated Hospital of Harbin Medicaid University were analyzed retrospectively. Results    Sixty cases were performed parathyroidectomy. There were 14 men and 46 women. A total of 74 pathological parathyroid bodies were resected. Postoperative pathological results indentified that there were 61（82.4%）parathyroid adenoma, 13（17.6%） parathyroid hyperplasia and no parathyroid carcinoma. After parathyroidectomy  PTH was all down to normal and  the blood calcium was declined too. The symptoms of low calcium appeared in 11 cases. After the vitamin D and calcium gluconate were used, the blood calcium was back to normal. There was no other complication. Conclusion    Perfect preoperative evaluation, correctly perioperative handle, experienced operative skills and individualized treatment can reduce the incidence of surgical complications and improve the patient's quality of life.

Key words: primary hyperparathyroidism, parathyroidectomy, parathyroid hormone