Diagnosis and treatment of 27 cases of primary hyperparathyroidism
10.16066/j.1672-7002.2024.10.002
- VernacularTitle:27例原发性甲状旁腺功能亢进症的诊治分析
- Author:
Yinjuan DU
1
;
Zhichun HUANG
;
Lifen WANG
;
Xu FENG
Author Information
1. 东南大学附属中大医院耳鼻咽喉头颈外科,江苏 南京 210009
- Keywords:
Hyperparathyroidism,Primary;
Surgical Procedures,Operative;
preoperative localization
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2024;31(10):620-625
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the clinical characteristics,diagnosis and treatment of primary hyperparathyroidism(PHPT),and to improve the diagnosis and treatment ability of this disease.METHODS The clinical data of 27 patients with PHPT admitted to Southeast University Affiliated Zhongda Hospital from January 2016 to June 2023 were retrospectively analyzed,and the clinical characteristics,preoperative diagnosis,surgical treatment and postoperative follow-up were summarized.RESULTS All patients had elevated serum calcium and parathyroid hormone before operation,and were diagnosed before operation.All patients underwent parathyroidectomy with low neck incision,19 underwent unilateral parathyroidectomy and 8 underwent bilateral parathyroidectomy.PTH was rapidly detected 10 min after resection of the diseased gland,all 27 cases terminated surgery after PTH decreased by more than 50%.All patients experienced no postoperative complications such as hoarseness and coughing due to diet.There were 20 cases diagnosed pathologically as parathyroid adenoma and 7 cases diagnosed as parathyroid hyperplasia after operation.After operation,15 patients had short-term hypocalcemia,the hypocalcemia patients were treated with calcitriol and calcium for 2-4 weeks and their blood calcium returned to normal.and one patient was slightly higher than normal value,the hypercalcemia returned to normal about one week after operation.The remaining patients had normal serum calcium after operation.The parathyroid hormone returned to normal in 27 patients within 6 months.All patients were followed up for 6 months to 6 years,and no one recurred.CONCLUSION Parathyroidectomy is the best treatment for PHPT.Preoperative imaging location and intraoperative PTH measurement are helpful to narrow the exploration range,shorten the operation time and reduce the complications.
