摘要
目的本文就国内七所甲状旁腺功能亢进症病例较集中的医院的诊治状况进行分析。方法回顾分析自1965年至2005年间国内七所医院手术治疗甲状旁腺功能亢进症730例，就其临床特征以及诊治资料进行分析。结果730例甲状旁腺功能亢进症患者中有临床症状者652例（89．3％），无症状者78例（10．7％），^99mTc—MIBI扫描阳性442例；双侧甲状旁腺探查术377例，常规颈横部切口单侧甲状旁腺探查204例，小切口单个腺体探查甲状旁腺瘤切除术143例，腔镜辅助颈部小切口单个腺体探查6例。腺瘤632例（86．6％），甲状旁腺增生58例（8．3％），甲状旁腺癌40例（5．5％）。手术后无严重并发症，20例患者持续甲状旁腺功能亢进，其余患者血钙降低或恢复正常。结论手术前定位检查很有帮助；单侧甲状旁腺探查对甲状旁腺瘤是合适的手术方法；颈部小切口甲状旁腺瘤切除适用于术前有明确定位诊断的病例。
Objective In China primary hyperparathyroidism is not a kind of common disease as in the western countries. This article reports the current status in the diagnosis and treatment of primary hyperparathyroidism in the mainland of China. Methods We collected 730 cases of primary hyperparathyroidism diagnosed and treated in 7 top hospitals for endocrine surgery from 1965 to 2005. Results In this study, 652 （89. 3% ） cases were clinically symptomatic while 78 （10. 7% ） cases were asymptomatic; 442 cases were positive on ^99mTc-MIBI scanning. Bilateral explorations were undertaken in 377 patients and unilateral or uni-gland exploration through the conventional incision in 204 cases. Minimally invasive parathyroidectomy in 143 cases. Endoscopically assisted 2 cm incision was taken in 6 cases for unilateral gland exploration. Pathologically 632 （ 86. 6% ） cases were identified as adenoma, 58 （ 8.3% ） cases were of hyperplasia and 40 （ 5.5% ） cases were of carcinoma. There were no major postoperative complications. While 20 patients suffering from recurrence or persistent postoperative hyperparathyroidism, the others are of normal or depressed serum level of calcium. Conclusions Preoperative localization is very helpful; Unilateral exploration for parathyroid adenoma is feasible ; minimally invasive parathyroidectomy through minimal incision is a kind of improving procedure for the localized parathyroid adenoma.
出处
《中华普通外科杂志》
CSCD
北大核心
2008年第9期689-691,共3页
Chinese Journal of General Surgery
关键词
甲状旁腺功能亢进症
诊断
外科手术
Primary hyperparathyroidism
Diagnosis
Surgical procedures, operative
