Application of total parathyroidectomy with autotransplantation in secondary hyperparathyroidism
10.3760/cma.j.issn.1674-6090.2018.01.009
- VernacularTitle:甲状旁腺全切加微量甲状旁腺自体移植术在肾性甲状旁腺功能亢进中的临床应用
- Author:
Peng ZHOU
1
;
Qingqing HE
;
Dayong ZHUANG
;
Luming ZHENG
;
Ziyi FAN
;
Jian ZHU
;
Tao YUE
;
Fang YU
;
Lei HOU
Author Information
1. 250031,济南军区总医院甲状腺乳腺外科
- Keywords:
Secondary hyperparathyroidism;
Chronic renal failure;
Intact parathyroid hormone;
Total parathyroidectomy;
Parathyroid autograft
- From:
Chinese Journal of Endocrine Surgery
2018;12(1):34-38,50
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical safety and effectiveness of total parathyroidectomy with autotransplantation on the chronic renal failure (CRF) patients who are suffering from severe secondary hyperparathyroidism (SHPT).Methods A retrospective analysis was performed on 149 patients with secondary hyperparathyroidism who were given total parathyroidectomy with autotransplantation from Apr.2010 to Oct.2015.The changes of clinical symptoms,parathyroid hormone,calcium and phosphate blood levels were followed up during 6 months to 6 years.Results 598 parathyroid glands were obtained form 149 patients who underwent surgical resection.Musculoskeletal pain and skin itching relieved or disappeared in 145 cases the 2nd day after operation,while these symptoms gradually relieved one week after operation for 4 cases.Serum intact parathyroid hormone (iPTH)was 89.67±180.61,serum phosphate 1.74±0.52,and serum calcium 2.07±0.32 the 1st day after operation,and they all decreased compared with those before operation(P＜0.001).Serum calcium,phosphorus and iPTH levels were similar at 6,36 and 60 months after operation (P＞0.05).Two patients had pathological fracture after operation.No persistent bone pain or skin itching was found during the follow-up period.Two patients had secondary hyperparathyroidism.Six patients had recurrence,among whom five underwent surgery again,and one patient had clinical follow-up.One patient died of pulmonary infection at 13 months after operation.Conclusion Total parathyroidectomy with autotransplantation were applied to ineffective medical treatment for advanced secondary hyperparathyroidism in patients with chronic renal failure.
