摘要
随着慢性肾衰竭患者寿命的延长,60%以上的患者会出现继发性甲状旁腺功能亢进症(SHPT),主要表现为高甲状旁腺激素水平(PTH)、钙磷代谢紊乱、骨折及心血管事件等。随着医学进展,虽然口服药物及透析方案的改善可缓解SHPT的进展,但部分患者最终需行甲状旁腺切除术(PTX)。PTX是SHPT重要的治疗措施,但部分患者术后仍然存在持续性或复发性甲状旁腺功能亢进,给患者生理及心理造成极大损害。术后复发主要原因是初次手术不充分遗漏多余腺体,或者自体移植腺体过度增生,最终导致甲状旁腺功能亢进复发,成为目前PTX术后治疗重点与难点。本文进行了对有关如何减少初次手术后SHPT复发相关文献的检索和复习,旨在提高SHPT术后复发的防治。
As the life expectancy of patients with chronic renal failure increases,more than 60%of them develop secondary hyperparathyroidism(SHPT),which is mainly manifested as high parathyroid hormone(PTH),calcium and phosphorus metabolism disorders,fractures,and cardiovascular events.With the advancement of medicine,the improvements in oral medications and dialysis protocols can alleviate the progression of SHPT,but some patients eventually still need to undergo parathyroidectomy(PTX).Although PTX is an important treatment measure for SHPT,some patients still suffer from persistent or recurrent hyperparathyroidism after surgery,which can cause devastating physical and psychological effects on the patients.The most common cause of postoperative recurrence of SHPT is the incomplete removal of the excess glands in the initial operation,or the excessive proliferation of the autologous transplanted gland,eventually leading to the recurrence of SHPT,which has become the current focus and difficulty of treatment after PTX.This article conducted a search and review of relevant literature on how to reduce the recurrence of SHPT after the initial operation,with an aim to improve the prevention and treatment of recurrence of SHPT after PTX.
作者
李丹
谢坤
陈倩倩
刘昌华
Li Dan;Xie Kun;Chen Qianqian;Liu Changhua(Dalian Medical University Graduate School of Medicine,Dalian 116000,Liaoning Province;Central South University Xiangya School of Medicine,Changsha 410013,Hunan Province;Yangzhou University School of Clinical Medicine,Yangzhou 225000,Jiangsu Province;Department of Nephrology,Jiangsu Provincial Subei People's Hospital,Yangzhou 225001,Jiangsu Province,China)
出处
《中华肾病研究电子杂志》
2021年第3期166-169,共4页
Chinese Journal of Kidney Disease Investigation（Electronic Edition）
