| 引用本文: | 李宗魁,刘天奇,陈元元,李梦阳,唐耘天,姚思扬,梁斌.自体移植5颗1×1×1mm3甲状旁腺组织颗粒的甲状旁腺全切术[J].中国临床新医学,0,():-. |
| Li ZongKui,Liu TianQi,Chen YuanYuan,Li MengYang,Tang YunTian,Yao SiYang,Liang Bin.自体移植5颗1×1×1mm3甲状旁腺组织颗粒的甲状旁腺全切术[J].中国临床新医学,0,():-. |
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| 摘要: |
| 目的 探讨甲状旁腺全切术+自体前臂移植5颗1×1×1mm3甲状旁腺组织颗粒（称为“甲状旁腺全切术加改进甲状旁腺自体移植术”：total parathyroidectomy with improved autotransplantation ,TPTX+IAT）治疗尿毒症继发甲状旁腺功能亢进症（secondary hyperparathyroidism ,SHPT）的可行性。方法 行甲状旁腺全切后，自体前臂移植5颗1×1×1mm3甲状旁腺组织颗粒，观察患者手术后血清全段甲状旁腺激素水平（intact parathyroid hormone，iPTH）、血钙、血磷等生化指标变化情况及术后症状缓解情况，及术后住院时间、术后并发症、术后复发率。结果 2017年3月至2018年3月共13例患者进行了TPTX+IAT的手术治疗。全组无术中喉返神经损伤，全部患者术后第1天iPTH均降至正常水平以内，骨痛、皮肤瘙痒等症状1周内缓解或消失，术后骨骼变形、身高缩短等症状改善或未继续进展，口服钙剂和骨化三醇均无低钙血症症状维持两天以上予以出院，患者术后平均住院时间10天，无术后复发。结论 TPTX+IAT安全有效可行，但其甲状旁腺自体移植量减少了一半以上，可能是治疗SHPT的更优术式。 |
| 关键词: 尿毒症，继发性甲状旁腺功能亢进症，改良甲状旁腺自体移植术 ,甲状旁腺组织移植量 |
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| 基金项目:广西医疗卫生适宜技术研究与开发项目 |
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| EFFECT OF TOTAL PARATHYROIDECTOMY WITH IMPROVED AUTOTRANSPLANTATION FOR SECONDARY HYPERPARATHYROIDISM |
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Li ZongKui1,2,3, Liu TianQi, Chen YuanYuan, Li MengYang, Tang YunTian, Yao SiYang, Liang Bin
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1.The People'2.'3.s Hosptial of Guangxi Zhuang Autonomous Region
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| Abstract: |
| ABSTRACT
Objective To investigate the effect of total parathyroidectomy with improved autotransplantation (TPTX+IAT) for Hyperthyroidism secondary (SHPT) to uremia. Methods 5 autologous parathyroid tissue granules (each one 1 × 1 × 1mm3) were transplanted into patient’s healthy forearm after total parathyroid thyroidectomy. The serum levels of total parathyroid hormone (iPTH), serum calcium and phosphorus, relief of symptoms of SHPT, operative complications, postoperative hospitalization time and postoperative recurrence rate were observed. Results From March 2017 to March 2018, 13 patients underwent this procedure. On the first day after operation, iPTH was reduced to normal level in all patients. The symptoms of bone pain and pruritus were relieved or disappeared within one week, and the symptoms of bone deformation and height shortening were improved or did not progress. The average hospitalization time was 10 days after operation. At 1 week, 3 months, 6 months and 12 months after operation, the serum iPTHs, serum calcium, serum phosphorus, calcium were significantly decreased. There was no intraoperative recurrent laryngeal nerve injury or HPT recurrence in all cases. Conclusion TPTX+IAT is safe, effective and feasible. Because of the volume of autografts of parathyroid gland is reduced by more than half, TPTX+IAT may be a better method for the treatment of SHPT secondary to Uremia compared with the former TPTX+AT. |
| Key words: Uremia, secondary hyperparathyroidism, improved autotransplantation,Parathyroid tissue transplant volume |
