Abstract:

Surgical treatment for secondary hyperparathyroidism: An analysis of 25 cases        LI Peng*，LIANG Wei，JIANG Lei，et al. *Department of Thyroid Surgery，Peking University Shenzhen Hospital，Shenzhen 518036，China
Corresponding author：WEI Wei，E-mail：rxwei1123@163.com
Abstract    Objective    To explore the indications and perioperative management of surgical treatment for secondary hyperparathyroidism (SPHT). Methods    The clinical data of 25 cases of SHPT underwent parathyroidectomy between July 2013 and January 2014 in Department of Thyroid Surgery，Peking University Shenzhen Hospital were analyzed retrospectively. The indications，operation time，postoperative complications and surgery effects were summarized and analyzed retrospectively. Results    The operation for 25 cases of SHPT were successful. Among them, each of 22 cases was resected 4 parathyroids, 1 case was resected 5 parathyroids, and 2 cases each  were resected 3 parathyroids. The average operation time was 115.5（56-182）min. The postoperative complications included subcutaneous hematoma for 1 case，hoarseness for 1 cases，low voice for 1 case and numbness of limbs for 12 cases. The 6 months follow-up: Blood PTH，blood calcium and phosphorus levels were all in the normal range; Various preoperative symptoms were improved in varying degrees; No new case of cardiac valvular calcification occurred. Conclusion    It can achieve the goal of control calcium and phosphorus and improve quality of life by surgical operation for patients with SPHT.

Key words: secondary hyperparathyroidism（SPHT）, operation, perioperative management

摘要：

目的    探讨手术治疗继发性甲状旁腺功能亢进的适应证及临床疗效。方法    回顾性分析2013年7月至2014年1月北京大学深圳医院甲状腺外科收治的25例继发性甲状旁腺功能亢进病人的临床资料，均行甲状腺全切除+自体移植术，分析手术适应证、手术时间、术后并发症和手术疗效。结果    手术均顺利完成，其中22例病人各切除4枚甲状旁腺，1例切除5枚甲状旁腺，2例各切除3枚甲状旁腺。平均手术时间为115.5（56～182）min。术后1例发生颈部血肿，1例发生前臂移植处皮下血肿，1例病人出现声音嘶哑，1例病人出现了声音低沉，12例病人手术后第2天发生了手足麻木，均给予对症治疗后好转或恢复。随访6个月，血PTH、血钙和血磷均处于正常参考值范围，术前的各种不适症状均有不同程度好转。结论    对于继发性甲状旁腺功能亢进病人，外科手术治疗可达到控制钙磷水平和改善生活质量的目的。

关键词: 继发性甲状旁腺功能亢进, 手术, 围手术期处理