【摘要】：目的 研討原發(fā)性甲狀旁腺功能亢進(jìn)癥的臨床特點(diǎn)、診斷方案、相關(guān)治療策略及延誤原因。方法回顧性分析在我院2009年1月至2014年10月收治的36例原發(fā)性甲狀旁腺功能亢進(jìn)癥的患者資料。結(jié)果原發(fā)性甲狀旁腺功能亢進(jìn)癥的臨床表現(xiàn)具有顯著多樣性,誤診率高,占25.0%(9/36)。36例患者中男：女比例為1：1。36例患者首發(fā)癥狀中,骨關(guān)節(jié)疼痛9例、消化道(惡心,嘔吐)癥狀7例、頸部包塊6例(其中3例為B超檢查時(shí)發(fā)現(xiàn))、泌尿系結(jié)石5例、乏力4例、骨質(zhì)疏松及泌尿系結(jié)石2例、骨折1例,無癥狀者2例。36例患者實(shí)驗(yàn)室檢查,血清鈣(至少有一次)、甲狀旁腺激素值均升高。所有患者行頸部彩超檢查,部分聯(lián)合CT/99mTc-MIBI檢查,聯(lián)合后檢查的準(zhǔn)確率分別提高到85.2%、93.1%。其中,術(shù)后患者的癥狀有一定程度的改善,血清鈣、甲狀旁腺素水平明顯降低。另外8例未采取手術(shù)治療,其中7例緩解,1例因難以糾正的高鈣危象而死亡。結(jié)論在臨床工作中,應(yīng)提高對(duì)原發(fā)性甲狀旁腺功能亢進(jìn)癥的識(shí)別,更加重視血鈣檢查,對(duì)疑似病例應(yīng)早期行頸部彩超、甲狀旁腺素等檢查,爭(zhēng)取早期手術(shù)治療,改善預(yù)后及提高生存質(zhì)量。
[Abstract]:Objective to investigate the clinical features, diagnostic scheme, treatment strategies and causes of delay in primary hyperparathyroidism. Methods 36 patients with primary hyperparathyroidism admitted in our hospital from January 2009 to October 2014 were retrospectively analyzed. Results the clinical manifestations of primary hyperparathyroidism were significantly diverse, with a high misdiagnosis rate of 25.0% (9 / 36). There were 7 cases of vomiting, 6 cases of neck mass (3 cases found by B-ultrasound), 5 cases of urinary tract stones, 4 cases of fatigue, 2 cases of osteoporosis and urinary calculi, 1 case of fracture, 2 cases of asymptomatic cases, 36 cases of laboratory examination. Serum calcium (at least once), parathyroid hormone levels increased. All patients were examined by color Doppler ultrasonography, some of them were examined with CT/99mTc-MIBI, and the accuracy of the combined examination was increased to 85.2 and 93.1, respectively. The symptoms were improved and serum calcium and parathyroid hormone levels were significantly decreased. The other 8 cases were not treated surgically, 7 cases were relieved and 1 case died because of the difficult to correct high calcium crisis. Conclusion in clinical work, we should improve the recognition of primary hyperparathyroidism and pay more attention to the examination of blood calcium. Improve prognosis and quality of life.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R582.1

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