【摘要】：目的觀察繼發(fā)性甲狀旁腺功能亢進(jìn)癥患者甲狀旁腺全切加腹壁皮下移植術(shù)后的甲狀旁腺功能。方法回顧性分析25例藥物保守治療無效,行甲狀旁腺全切加自體旁腺腹壁皮下移植術(shù)的繼發(fā)性甲狀旁腺功能亢進(jìn)癥患者,移植物為所切除旁腺中無明顯腺體增生的旁腺組織,切成30小塊,移植于左側(cè)腹壁皮下。收集術(shù)中(甲狀旁腺全切術(shù)后10 min)、術(shù)后24 h、1、5、15、30周血全段甲狀旁腺激素(i PTH)數(shù)據(jù)。結(jié)果每一例接受了手術(shù)的患者生活質(zhì)量都得到明顯提高。術(shù)前i PTH平均為(1 832±189.4)pg/mL,術(shù)中為(120.3±67.7)pg/mL;術(shù)后24 h為(17.4±18.7)pg/mL;1周為(17.9±21.7)pg/mL;5周為(36.3±36.4)pg/mL;15周為(76.2±76.9)pg/mL;30周為(102.3±85.5)pg/mL;82.6%患者自體移植物在第5周時(shí)即可具備功能。所有患者均沒有行移植物清除術(shù)。結(jié)論腹壁皮下自體甲狀旁腺移植是一種有效、簡單、快捷的手術(shù)方式,且避免了前臂自體甲狀旁腺移植所導(dǎo)致的潛在的并發(fā)癥。
[Abstract]:Objective To observe the parathyroid function of the secondary hyperparathyroidism in patients with secondary hyperparathyroidism. Methods A retrospective analysis of 25 cases of secondary hyperparathyroidism, which was not effective in conservative treatment of the primary and secondary hyperparathyroidism, was performed in 25 cases of hyperparathyroidism. The graft was a tissue with no obvious glandular hyperplasia and was cut into 30 small pieces. The graft was implanted subcutaneously in the left abdominal wall. The total parathyroid hormone (i-PTH) data were collected at 24 h,1,5,15 and 30 minutes after the operation (10 min after the total hypoparathyroidism). Results The quality of life of every patient was significantly improved. The pre-operative i PTH was (1 832 to 189.4) pg/ mL, and was (120.3 to 67.7) pg/ mL in the operation; (17.4 to 18.7) pg/ mL for 24 h, and (36.3 to 36.4) pg/ mL for the first week; and (76.2 to 76.9) pg/ mL for 15 weeks, and (102.3 to 85.5) pg/ mL for 30 weeks; 82.6% of the patient's autograft was functional at Week 5. No graft removal was performed for all patients. Conclusion Autologous parathyroid transplantation in the abdominal wall is an effective, simple and rapid method of operation, and avoids the potential complications caused by the auto-parathyroid transplantation of the forearm.
【作者單位】： 廣東省中醫(yī)院耳鼻咽喉科;廣州醫(yī)科大學(xué)附屬腫瘤醫(yī)院頭頸腫瘤外科;
【分類號(hào)】：R653;R692.5

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