摘要
目的探讨应用^99mTc—MIBI术中定位的甲状旁腺切除术在治疗肾性继发性甲状旁腺功能亢进的临床疗效。方法2005年8月至2011年2月，对上海交通大学医学院附属仁济医院耳鼻咽喉头颈外科肾性继发性甲状旁腺功能亢进25例行手术治疗。病例分为2组，组I行经典的双侧颈部探查术15例，组Ⅱ行^99mTc-MIBI引导的甲状旁腺切除术10例。比较2组术后临床表现、血甲状旁腺激素（PTH）、血钙、病理结果及并发症等。结果2组术后临床症状均较术前改善；组Ⅱ血PTH、血钙下降较组Ⅰ明显，差异有统计学意义（P〈0．001）；组Ⅱ切除组织经病理证实为甲状旁腺组织的准确率比组Ⅰ更高，差异有统计学意义（P=0．038）；2组出现低血钙各10例；持续性高血PTH组I4例，组Ⅱ11例；2组均无喉返神经损伤。结论^99mTc—MIBI引导的甲状旁腺切除术为术中寻找甲状旁腺提供了便利，有助于发现变异甚至异位甲状旁腺。
Objective To discuss the clinical effects of intraoperative 99mTc-MIBI radioguided parathyroidectomy for patients with secondary hyperparathyroidism. Methods From Aug. 2005 to Feb. 2011,25 patients underwent parathyroidectomy for hyperparathyroidism secondary to chronic renal failure. Among them, 15 cases underwent classic exploration （group I） and 10 cases underwent intraoperative 99mTc-MIBI radioguided parathyroidectomy （ group II）. The 2 groups were compared in terms of clinical manifestation, parathyroid hormone （ PTH）, serum calcium, pathology and complications. Results The symptoms of all patients improved after the operation. The de- crease of postoperatiw~ serum PTH and calcium was greater in group II than in group I（P 〈0.001 ）. Pathology con- firmed that parathyroid glands were more accurately identified in group II than in group I（P = 0.038）. 10 cases in each group had hypocalcemia. Persistent high serum PTH occurred in 4 cases of group I and 11 cases of group II. No recurrent laryneal nerve injury happended. Conclusion In patients with secordary hyperparathyroidisim, 99mTc- MIBI radioguided parathyroidectomy is helpful for intraoperative localization of parathyroid glands.
出处
《中华内分泌外科杂志》
CAS
2012年第1期39-41,45,共4页
Chinese Journal of Endocrine Surgery
基金
上海市科委项目（0852nm04000）
