目的:加深对甲状旁腺腺瘤并急性胰腺炎并双肾结石的认识,从而减少漏诊率,防止不良并发症。方法:回顾性分析患者基本资料、临床表现、生化指标、影像学资料及治疗转归,结合国内外相关文献讨论甲状旁腺腺瘤的诊治经验。结果:患者住院期间...目的:加深对甲状旁腺腺瘤并急性胰腺炎并双肾结石的认识,从而减少漏诊率,防止不良并发症。方法:回顾性分析患者基本资料、临床表现、生化指标、影像学资料及治疗转归,结合国内外相关文献讨论甲状旁腺腺瘤的诊治经验。结果:患者住院期间发现高钙血症和低磷血症,最终通过甲状旁腺超声和核素显像诊断为甲状旁腺腺瘤所致的原发性甲状旁腺功能亢进。手术治疗后症状好转,术后病理确诊为甲状旁腺腺瘤。结论:原发性甲状旁腺功能亢进临床表现多样,以腹痛(如胰腺炎、肾结石)为首发症状时易漏诊。对于急性胰腺炎合并高钙血症患者,即使甲状旁腺素早期正常,仍需动态监测,避免漏诊原发性甲状旁腺功能亢进。Objective: This case report aims to enhance the understanding of parathyroid adenoma associated with acute pancreatitis and bilateral renal stones, in order to reduce the misdiagnosis rate and prevent the occurrence of adverse complications. Methods: A retrospective analysis was conducted on the patient’s demographic information, clinical presentation, biochemical markers, imaging findings, and therapeutic outcomes. Relevant literature, both domestic and international, was reviewed to discuss the diagnostic approaches and treatment strategies for parathyroid adenoma. Results: During the patient’s hospitalization, hypercalcemia and hypophosphatemia were detected, ultimately leading to a diagnosis of primary hyperparathyroidism caused by parathyroid adenoma, confirmed through parathyroid ultrasound and scintigraphy. Following surgical intervention, the patient’s symptoms improved, and postoperative pathology confirmed the diagnosis of parathyroid adenoma. Conclusion: Primary hyperparathyroidism (PHPT) presents with a wide range of clinical manifestations, and when abdominal pain (such as that seen in pancreatitis or renal stones) is the initial symptom, it is often misdiagnosed. In patients with acute pancreatitis complicated by hypercalcemia, even if parathyroid hormone (PTH) levels are initially normal, dynamic monitoring of PTH is necessary to avoid missing the diagnosis of primary hyperparathyroidism.展开更多
目的:研究彩色多普勒超声征象联合血清甲状腺球蛋白(Tg)、促甲状腺激素(TSH)对甲状腺微小乳头状癌(PTMC)发生颈部淋巴结转移的预测价值。方法:以回顾性分析法纳入研究人员共102例,均为中南大学湘雅医学院附属海口医院从2017年1月~2022年...目的:研究彩色多普勒超声征象联合血清甲状腺球蛋白(Tg)、促甲状腺激素(TSH)对甲状腺微小乳头状癌(PTMC)发生颈部淋巴结转移的预测价值。方法:以回顾性分析法纳入研究人员共102例,均为中南大学湘雅医学院附属海口医院从2017年1月~2022年6月收治的PTMC患者。将其按照是否发生颈部淋巴结转移分成转移组35例及无转移组67例。对比两组彩色多普勒超声征象、血清Tg、TSH水平。以多因素Logistic回归分析明确PTMC发生颈部淋巴结转移的影响因素。通过受试者工作特征(ROC)曲线分析彩色多普勒超声征象以及血清Tg、TSH水平预测PTMC发生颈部淋巴结转移的效能。结果:转移组病灶形状不规则、病灶有微钙化、肿瘤大小≥0.5 cm、紧贴包膜人数占比分别为91.43%、60.00%、40.00%、48.57%,相较于无转移组的74.63%、32.84%、17.91%、23.88%均较高(均P<0.05);两组回声、边界、血流征象、FT3、FT4对比差异均不明显(均P>0.05);转移组血清Tg、TSH水平相较于无转移组更高(均P<0.05)。经多因素Logistic回归分析可得:病灶形状不规则、病灶有微钙化以及血清Tg>2 ng/mL、TSH>0.5 m IU/L、肿瘤大小≥0.5 cm、紧贴包膜均是PTMC发生颈部淋巴结转移的危险因素(P<0.05)。经ROC曲线分析发现:彩色多普勒超声征象联合血清Tg、TSH预测PTMC发生颈部淋巴结转移的曲线下面积、灵敏度以及特异度均高于上述指标单独预测。结论:彩色多普勒超声征象联合血清Tg、TSH预测PTMC发生颈部淋巴结转移的价值较高。此外,病灶形状不规则、病灶有微钙化以及血清Tg>2 ng/mL、TSH>0.5 m IU/L、肿瘤大小≥0.5 cm、紧贴包膜均是PTMC发生颈部淋巴结转移的危险因素。展开更多
文摘目的:加深对甲状旁腺腺瘤并急性胰腺炎并双肾结石的认识,从而减少漏诊率,防止不良并发症。方法:回顾性分析患者基本资料、临床表现、生化指标、影像学资料及治疗转归,结合国内外相关文献讨论甲状旁腺腺瘤的诊治经验。结果:患者住院期间发现高钙血症和低磷血症,最终通过甲状旁腺超声和核素显像诊断为甲状旁腺腺瘤所致的原发性甲状旁腺功能亢进。手术治疗后症状好转,术后病理确诊为甲状旁腺腺瘤。结论:原发性甲状旁腺功能亢进临床表现多样,以腹痛(如胰腺炎、肾结石)为首发症状时易漏诊。对于急性胰腺炎合并高钙血症患者,即使甲状旁腺素早期正常,仍需动态监测,避免漏诊原发性甲状旁腺功能亢进。Objective: This case report aims to enhance the understanding of parathyroid adenoma associated with acute pancreatitis and bilateral renal stones, in order to reduce the misdiagnosis rate and prevent the occurrence of adverse complications. Methods: A retrospective analysis was conducted on the patient’s demographic information, clinical presentation, biochemical markers, imaging findings, and therapeutic outcomes. Relevant literature, both domestic and international, was reviewed to discuss the diagnostic approaches and treatment strategies for parathyroid adenoma. Results: During the patient’s hospitalization, hypercalcemia and hypophosphatemia were detected, ultimately leading to a diagnosis of primary hyperparathyroidism caused by parathyroid adenoma, confirmed through parathyroid ultrasound and scintigraphy. Following surgical intervention, the patient’s symptoms improved, and postoperative pathology confirmed the diagnosis of parathyroid adenoma. Conclusion: Primary hyperparathyroidism (PHPT) presents with a wide range of clinical manifestations, and when abdominal pain (such as that seen in pancreatitis or renal stones) is the initial symptom, it is often misdiagnosed. In patients with acute pancreatitis complicated by hypercalcemia, even if parathyroid hormone (PTH) levels are initially normal, dynamic monitoring of PTH is necessary to avoid missing the diagnosis of primary hyperparathyroidism.
文摘目的:研究彩色多普勒超声征象联合血清甲状腺球蛋白(Tg)、促甲状腺激素(TSH)对甲状腺微小乳头状癌(PTMC)发生颈部淋巴结转移的预测价值。方法:以回顾性分析法纳入研究人员共102例,均为中南大学湘雅医学院附属海口医院从2017年1月~2022年6月收治的PTMC患者。将其按照是否发生颈部淋巴结转移分成转移组35例及无转移组67例。对比两组彩色多普勒超声征象、血清Tg、TSH水平。以多因素Logistic回归分析明确PTMC发生颈部淋巴结转移的影响因素。通过受试者工作特征(ROC)曲线分析彩色多普勒超声征象以及血清Tg、TSH水平预测PTMC发生颈部淋巴结转移的效能。结果:转移组病灶形状不规则、病灶有微钙化、肿瘤大小≥0.5 cm、紧贴包膜人数占比分别为91.43%、60.00%、40.00%、48.57%,相较于无转移组的74.63%、32.84%、17.91%、23.88%均较高(均P<0.05);两组回声、边界、血流征象、FT3、FT4对比差异均不明显(均P>0.05);转移组血清Tg、TSH水平相较于无转移组更高(均P<0.05)。经多因素Logistic回归分析可得:病灶形状不规则、病灶有微钙化以及血清Tg>2 ng/mL、TSH>0.5 m IU/L、肿瘤大小≥0.5 cm、紧贴包膜均是PTMC发生颈部淋巴结转移的危险因素(P<0.05)。经ROC曲线分析发现:彩色多普勒超声征象联合血清Tg、TSH预测PTMC发生颈部淋巴结转移的曲线下面积、灵敏度以及特异度均高于上述指标单独预测。结论:彩色多普勒超声征象联合血清Tg、TSH预测PTMC发生颈部淋巴结转移的价值较高。此外,病灶形状不规则、病灶有微钙化以及血清Tg>2 ng/mL、TSH>0.5 m IU/L、肿瘤大小≥0.5 cm、紧贴包膜均是PTMC发生颈部淋巴结转移的危险因素。
