山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (3): 114-119.doi: 10.6040/j.issn.1673-3770.1.2020.041

• 临床研究 • 上一篇    下一篇

继发性甲旁亢甲状旁腺切除不同移植方案疗效研究

汪茂林,李菊兰,鲜昆仑   

  1. 武警四川省总队医院 耳鼻咽喉头颈外科, 四川 乐山 614000
  • 发布日期:2020-06-29
  • 通讯作者: 汪茂林. E-mail:59975642@qq.com

Efficacy of different transplantation schemes for parathyroid gland resection in patients with secondary hyperparathyroidism

WANG Maolin, LI Julan, XIAN Kunlun   

  1. Department of Otolaryngology Head and Neck Surgery, Armed Police Sichuan General Corps Hospital, Leshan 614000, Sichuan, China
  • Published:2020-06-29

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摘要： 目的 回顾性总结继发性甲状旁腺功能亢进症患者行甲状旁腺切除移植术不同移植方案的疗效。 方法 2013年3月至2018年3月共86例甲状旁腺全切移植术患者,按先后不同3种移植方案分为3组,收集患者术前、术后以及随访PTH结果、住院天数、术后补钙天数、术后并发症和复发情况等判断疗效。 结果 3组短期(术后1 d~1个月)治疗效果有差别,而长期治疗效果差异不大,其中A组短期疗效最差,B组、C组短期治疗效果较为接近,但总体而言C组好于B组。 结论 移植甲状旁腺颗粒大小、移植床血供对移植的甲状旁腺存活和生长有着密切关系。从手术角度处理难治性继发性甲状旁腺功能亢进,将甲状旁腺组织小颗粒的方式移植于胸锁乳突肌肉囊,是一种简便、易行、高效的方式。

关键词: 继发性, 甲状旁腺功能亢进, 甲状旁腺切除, 甲状旁腺移植

Abstract: Objective Retrospectively summarize the efficacy of different transplantation schemes for parathyroid gland resection in patients with secondary hyperparathyroidism. Methods A total of 86 patients who had undergone total parathyroid gland transplantation in our hospital between March 2013 to March 2018 were divided into three groups according to the three different transplantation schemes. The preoperative, postoperative, and follow-up PTH results, hospital stay, postoperative calcium supplementation days, postoperative complications, and recurrence were collected to determine the efficacy. Results The short-term treatment efficacy(1 day after surgery-1 month after surgery)was different among the three groups, while the long-term treatment effect was not different. The short-term treatment effect of group A was the worst. The short-term treatment effect of group B and group C were similar, but overall, group C was better than group B. Conclusion The particle size of the transplanted parathyroid and the blood supply of the transplanted bed are closely related to the survival and growth of the transplanted parathyroid. Refractory secondary hyperparathyroidism can be efficaciously treated by the transplantation of small particles of parathyroid tissue into the sternocleidomastoid muscle sac.

Key words: Secondary, Hyperparathyroidism, Parathyroid resection, Parathyroid gland transplantation

中图分类号: 

  • R739.91
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