本文選題：甲狀旁腺次全切除術(shù) + 腎性甲狀旁腺功能亢進(jìn)癥��； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的:探索甲狀旁腺次全切除術(shù)(Subtotal parathyroidectomy,SPTX)治療腎性甲狀旁腺功能亢進(jìn)(renal hyperparathyroidism,r HPT)的臨床療效。方法:回顧分析自2012年2月至2014年9月在本院行甲狀旁腺次全切術(shù)的腎性甲旁亢患者共22例,收集患者手術(shù)前、后甲狀旁腺激素(Parathyroid-hormone,PTH)、血鈣、血磷、堿性磷酸酶(Alkaline phosphatase,ALP)等實驗室檢查數(shù)據(jù),患者術(shù)后癥狀緩解情況以及有無甲狀旁腺功能亢進(jìn)復(fù)發(fā)的情況,并進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:本組22例患者中手術(shù)成功21例(成功率為95.4%);術(shù)后隨訪6個月至2年內(nèi)各時段PTH、血鈣、血磷較術(shù)前比較皆明顯下降(P0.05);術(shù)后1月內(nèi)ALP呈上升趨勢,隨后下降至正常水平,差異有統(tǒng)計學(xué)意義(P0.05);患者術(shù)后皆出現(xiàn)低鈣血癥,其中2例患者出院后1月余再次入院行靜脈補(bǔ)鈣治療一周;術(shù)后19例患者骨關(guān)節(jié)酸痛均有不同程度好轉(zhuǎn),3例患者術(shù)后骨關(guān)節(jié)酸痛較術(shù)前嚴(yán)重;術(shù)后所有患者皮膚瘙癢均有不同程度好轉(zhuǎn);術(shù)后6個月至2年暫未發(fā)現(xiàn)有患者復(fù)發(fā)。結(jié)論:1.術(shù)中PTH監(jiān)測條件下甲狀旁腺次全切除術(shù)是治療RHPT安全有效的手術(shù)方式,可有效改善患者癥狀及相關(guān)實驗室指標(biāo)。2.患者年齡是術(shù)后低鈣血癥嚴(yán)重程度的一項預(yù)測指標(biāo)。3.術(shù)中PTH下降率直接影響術(shù)后各階段PTH值。
[Abstract]:Objective: to investigate the clinical effect of subtotal parathyroidectomyne (SPTX) in the treatment of renal hyperparathyroidismr (HPTT).Methods: from February 2012 to September 2014, 22 patients with renal parathyroid hyperthyroidism underwent subtotal parathyroid thyroidectomy in our hospital.Alkaline phosphatase (ALP) and other laboratory data, symptom relief and recurrence of hyperparathyroidism were analyzed statistically.Results: among the 22 patients, 21 cases were successfully operated (the success rate was 95.4%), and the levels of PTH, serum calcium and phosphorus were significantly decreased in each period from 6 months to 2 years after operation compared with those before operation, and the ALP increased in one month after operation, and then decreased to normal level.The difference was statistically significant (P 0.05), hypocalcemia was found in all the patients after operation, 2 of them were re-admitted for one week after being discharged from hospital.19 cases of postoperative osteoarticular soreness were improved in varying degrees. 3 cases of postoperative osteoarticular soreness were more serious than those before operation, all postoperative skin pruritus were improved in varying degrees, and no recurrence was found from 6 months to 2 years after operation.Conclusion 1.Subtotal parathyroidectomy under the condition of intraoperative PTH monitoring is a safe and effective method for the treatment of RHPT.Age is a predictor of the severity of hypocalcemia.The decrease rate of PTH during operation directly affected the PTH value in all stages after operation.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R653

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本文編號：1733713