摘要
总结了 30例原发性甲状旁腺机能亢进患者的手术治疗经验。颈丛或全身麻醉下低领位切口 ,术中快速病理结果证实 2 8例为甲状旁腺腺瘤 ,均单发性 ,其中 2例异位于甲状腺内 ,1例异位于前上纵隔 ,单纯切除 ;增生 1例 ,但仅 1个旁腺受累 ,全切除 ;腺癌 1例 ,侵及食管、气管 ,肿瘤及受累部分食管气管切除并气管切开。无手术并发症。 2 5例随访 8个月至 19年 ,包括增生 1例 ,症状改善无复发。腺癌患者带气管套管生存已 4年。提示手术治疗原发性甲状旁腺机能亢进疗效确实 ,应首选 ;明确为腺瘤者可行单侧探查 ,即使腺癌也不要轻易放弃。
To study the surgical management of primary hyperparathyroidism, we analysed 30 patients with primary hyperparathyroidism operated in our hospital from 1981 to 1990. A low collar transverse incision was done in all patients. A single parathyroid adenoma was found in 28 patients,and in 3 cases there were ectopic glands (1 in the mediastinum 2 intrathyroid). The adenoma was removed in all patients.In 1 case there was parathyroid hyperplasia, but only one gland was involved and it was excised. 1 case was diagnosed as parathyroid carcinoma which was located in the tracheo esophageal groove and had invaded the trachea and esophagus. An en bloc resection and tracheostomy were performed. 25 cases were followed up(including 1 case with parathyroid hyperplasia and 1 case with carcinoma) from 8 months to 19 years, there was no recurrence.These results suggest surgical management is the most effective treatment for primary hyperparathyroidism. Removal of the parathyroidoma and unilateral cervical exploration are adequate for the patients with parathyroid adenoma. Bilateral exploration is necessary when parathyroid hyperplasia is found. An en bloc resection is necessary for parathyroid carcinoma.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2002年第2期179-180,共2页
Medical Journal of Chinese People's Liberation Army
