Diagnosis and treatment of primary hyperparathyroidism
10.3760/cma.j.issn.1007-631X.2010.04.005
- VernacularTitle:原发性甲状旁腺功能亢进症的诊断和外科治疗
- Author:
Nan BAI
;
Aimin CU
;
Ziqin ZHANG
;
Jingming ZHAO
;
Xihou LIN
- Publication Type:Journal Article
- Keywords:
Hyperparathyroidism,primary;
Parathyroid neoplasms;
Diagnosis;
surgical procedures,operative
- From:
Chinese Journal of General Surgery
2010;25(4):281-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience on diagnosis and treatment of primary hyperparathyroidism(PHPT).Methods Clinical data of 91 PHPT patients treated in Beijing Jishuitan Hospital from November 1992 to December 2008 were analyzed retrospectively.Results Among 91 PHPT cases,88 were diagnosed as parathyroid adenoma(96.7%),3 were diagnosed as parathyroid carcinoma (3.3%).Serum calcium and PTH levels increased in all cases.Main clinical manifestations were osteodynia and kidney stones.The accuracy rate of preoperative B-ultrasound.CT and ECT~(99m)Tc-MIBI on location was 83.5%(76/91),60.9%(14/23)and 98.6%(69/70)respectively.Parathyroidectomy was performed in all but one cases,in which parathyroid carcinoma was managed by ipsilateral hemithyroidectomy and modified neck dissection.The cure rate of primary operation was 97.8%(89/91).Ninety cases were followed-up from 8 months to 14 years postoperatively,87 cases with parathyroid adenoma achieved complete remission,2 with parathyroid carcinoma suffered from tumor recurrence and 1 died.Conclusion Patients with chronic bone diseases,repeatedly recurrent nephrolithiasis,peptic ulcer disease should be a suspect of PHPT.The routine examinations of serum calcium and phosphorus are to be conducted.UItrasonography and ECT~(99m)Tc-MIBI should be considered as the methods of first choice for preoperative localization.
