Secondary hyperparathyroidism (SHPT) caused by Chronic kidney disease, CKD) is treated with Parathyroidectomy, PTX) after conservative treatment fails. This method is the final and most effective treatment for severe ...Secondary hyperparathyroidism (SHPT) caused by Chronic kidney disease, CKD) is treated with Parathyroidectomy, PTX) after conservative treatment fails. This method is the final and most effective treatment for severe SHPT patients. However, complications also follow: the continuation or recurrence of SHPT, hypoparathyroidism, non-dynamic osteopathy, starvation osteopathy, etc. These may all be related to whole-segment parathyroid hormone, PTH). The purpose of this article is to make a review on the influence of postoperative parathyroid function;Secondly, we know very little about how to maintain calcium balance after PTX and how to adjust drugs to avoid calcium ion load to prevent calcification. This paper summarizes the existing research results and puts forward problems to be solved, and reminds clinical workers to pay attention to the control of CKD patients after PTX.展开更多
Parathyrin (PTH) and calcitonin were measured with radioimmunoassay in 39 cases of pregnancy-induced hypertension (PIH) in late pregnancy, 76 cases in normal early pregnancy and 278 cases in late pregnancy without PIH...Parathyrin (PTH) and calcitonin were measured with radioimmunoassay in 39 cases of pregnancy-induced hypertension (PIH) in late pregnancy, 76 cases in normal early pregnancy and 278 cases in late pregnancy without PIH. Markedly increased PTH was noted in the women in late pregnancy, indicating the state of secondary hyperparathyroidism. PTH values in the women in late pregnancy with PIH were higher than those in the normal early pregnancy group, but lower than those in the women in late pregnancy without PIH. The difference between PTH values in the PIH group and late pregnancy without PIH group was of statistical significance (P<0.05), while no significant difference was seen between calcitonin values of the two groups (P > 0.05). The results suggest that the pathogenesis of PIH may be related to the function of parathyroid.展开更多
The prevalence of osteoporosis and decline in renal function increases with age. Therefore, the coexistence rate of both these conditions rises in the elderly population. Abnormalities in mineral bone metabolism are m...The prevalence of osteoporosis and decline in renal function increases with age. Therefore, the coexistence rate of both these conditions rises in the elderly population. Abnormalities in mineral bone metabolism are major complications in chronic kidney disease (CKD). However, in elderly osteoporotic patients without a history of CKD, there are few reports on the relationship between calcium (Ca), phosphorus (P), and parathyroid hormone (PTH), and renal function. The purpose of this study was to investigate the relationship between Ca, P, and PTH, and renal function in elderly osteoporosis patients with no history of CKD. We evaluated 169 patients who had been treated for osteoporosis. The eGFR decreased with age resulting in a negative correlation (r = -0.514, p p p p p < 0.01, respectively). Even if Ca and P are in the normal range, in case of a poor effect of an osteoporotic therapeutic drug, it is necessary to consider the measurement of intact PTH in elderly osteoporosis patients with no history of CKD.展开更多
目的探讨微创甲状腺手术对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者术后甲状旁腺功能恢复的影响,明确恢复时间及其相关影响因素。方法采用队列研究,选取2023年1月至2024年1月在新乡医学院第一附属医院接受手术治疗的110例...目的探讨微创甲状腺手术对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者术后甲状旁腺功能恢复的影响,明确恢复时间及其相关影响因素。方法采用队列研究,选取2023年1月至2024年1月在新乡医学院第一附属医院接受手术治疗的110例PTC患者,分为微创手术组(55例)和传统开放手术组(55例)。收集术前甲状腺及甲状旁腺功能指标、术中甲状旁腺保护情况、手术时间、术后血清钙和甲状旁腺激素(parathyroid hormone,PTH)水平、术后恢复时间、低钙血症发生率、住院时间和术后疼痛评分。通过Cox回归模型分析影响恢复的因素,并对两组术后指标进行比较。结果微创手术组的甲状旁腺功能恢复时间显著短于传统组[10(8~12)d vs 17(15~21)d,P<0.001]。术后24和72 h,微创组的血清钙及PTH水平均显著高于传统组(P<0.001),低钙血症发生率明显低于传统组(15.8%vs 32.5%,P=0.005)。Cox回归分析显示,手术方式(HR=0.55,95%CI:0.33~0.91,P=0.021)、甲状旁腺保护(HR=0.58,95%CI:0.35~0.95,P=0.037)、术后早期血清钙(HR=1.32,95%CI:1.10~1.60,P=0.002)及手术时间(HR=1.12,95%CI:1.05~1.20,P=0.001)为独立影响因素。此外,微创组的住院时间(5.2 d vs 7.8 d,P<0.001)和术后疼痛评分(第1 d:2.3 vs 3.7,P<0.001;第3 d:1.5 vs 2.8,P<0.001)均显著低于传统组。结论微创甲状腺手术在甲状腺乳头状癌患者的甲状旁腺功能恢复中具有显著优势,能够缩短恢复时间,减少低钙血症发生率,降低住院时间和术后疼痛。手术方式及甲状旁腺保护是恢复时间的关键因素。展开更多
目的:对比单侧甲状腺癌根治术使用无充气经腋窝入路与胸乳入路腔镜手术的效果。方法:选取2023年4月—2024年7月苏州市立医院收治的90例单侧甲状腺癌患者,以治疗方式不同分为对照组与观察组,各45例。对照组行经胸乳入路腔镜手术,观察组...目的:对比单侧甲状腺癌根治术使用无充气经腋窝入路与胸乳入路腔镜手术的效果。方法:选取2023年4月—2024年7月苏州市立医院收治的90例单侧甲状腺癌患者,以治疗方式不同分为对照组与观察组,各45例。对照组行经胸乳入路腔镜手术,观察组行无充气经腋窝入路腔镜手术。比较两组围手术期指标、术后并发症发生情况、术后美容效果,并比较术前和术后3 d甲状旁腺功能[甲状旁腺素(PTH)、血钙]与应激反应[肾上腺素(Adr)、皮质醇(Cor)]情况。结果:相比对照组,观察组出血量、术后引流量、术后1个月视觉模拟评分法(VAS)评分均更低,差异有统计学意义(P<0.05);两组手术时间、淋巴结清扫数量比较,差异无统计学意义(P>0.05)。相比对照组,观察组术后并发症发生率更低,而术后美容效果总满意度更高,差异有统计学意义(P<0.05)。两组术前、术后3 d甲状旁腺功能和应激反应比较,差异无统计学意义(P>0.05);但两组术后3 d PTH、血钙、Adr较术前升高,Cor较术前降低,差异有统计学意义(P<0.05)。结论:无充气经腋窝入路腔镜手术和胸乳入路腔镜手术的手术时间及对淋巴结的清除效果基本一致,对甲状旁腺和应激反应影响均较小,但无充气腋窝入路腔镜手术出血量和术后引流量更少,且可减轻术后疼痛,降低术后并发症发生率,同时具有较高的美学效果满意度。展开更多
文摘Secondary hyperparathyroidism (SHPT) caused by Chronic kidney disease, CKD) is treated with Parathyroidectomy, PTX) after conservative treatment fails. This method is the final and most effective treatment for severe SHPT patients. However, complications also follow: the continuation or recurrence of SHPT, hypoparathyroidism, non-dynamic osteopathy, starvation osteopathy, etc. These may all be related to whole-segment parathyroid hormone, PTH). The purpose of this article is to make a review on the influence of postoperative parathyroid function;Secondly, we know very little about how to maintain calcium balance after PTX and how to adjust drugs to avoid calcium ion load to prevent calcification. This paper summarizes the existing research results and puts forward problems to be solved, and reminds clinical workers to pay attention to the control of CKD patients after PTX.
文摘Parathyrin (PTH) and calcitonin were measured with radioimmunoassay in 39 cases of pregnancy-induced hypertension (PIH) in late pregnancy, 76 cases in normal early pregnancy and 278 cases in late pregnancy without PIH. Markedly increased PTH was noted in the women in late pregnancy, indicating the state of secondary hyperparathyroidism. PTH values in the women in late pregnancy with PIH were higher than those in the normal early pregnancy group, but lower than those in the women in late pregnancy without PIH. The difference between PTH values in the PIH group and late pregnancy without PIH group was of statistical significance (P<0.05), while no significant difference was seen between calcitonin values of the two groups (P > 0.05). The results suggest that the pathogenesis of PIH may be related to the function of parathyroid.
文摘The prevalence of osteoporosis and decline in renal function increases with age. Therefore, the coexistence rate of both these conditions rises in the elderly population. Abnormalities in mineral bone metabolism are major complications in chronic kidney disease (CKD). However, in elderly osteoporotic patients without a history of CKD, there are few reports on the relationship between calcium (Ca), phosphorus (P), and parathyroid hormone (PTH), and renal function. The purpose of this study was to investigate the relationship between Ca, P, and PTH, and renal function in elderly osteoporosis patients with no history of CKD. We evaluated 169 patients who had been treated for osteoporosis. The eGFR decreased with age resulting in a negative correlation (r = -0.514, p p p p p < 0.01, respectively). Even if Ca and P are in the normal range, in case of a poor effect of an osteoporotic therapeutic drug, it is necessary to consider the measurement of intact PTH in elderly osteoporosis patients with no history of CKD.
文摘目的探讨微创甲状腺手术对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者术后甲状旁腺功能恢复的影响,明确恢复时间及其相关影响因素。方法采用队列研究,选取2023年1月至2024年1月在新乡医学院第一附属医院接受手术治疗的110例PTC患者,分为微创手术组(55例)和传统开放手术组(55例)。收集术前甲状腺及甲状旁腺功能指标、术中甲状旁腺保护情况、手术时间、术后血清钙和甲状旁腺激素(parathyroid hormone,PTH)水平、术后恢复时间、低钙血症发生率、住院时间和术后疼痛评分。通过Cox回归模型分析影响恢复的因素,并对两组术后指标进行比较。结果微创手术组的甲状旁腺功能恢复时间显著短于传统组[10(8~12)d vs 17(15~21)d,P<0.001]。术后24和72 h,微创组的血清钙及PTH水平均显著高于传统组(P<0.001),低钙血症发生率明显低于传统组(15.8%vs 32.5%,P=0.005)。Cox回归分析显示,手术方式(HR=0.55,95%CI:0.33~0.91,P=0.021)、甲状旁腺保护(HR=0.58,95%CI:0.35~0.95,P=0.037)、术后早期血清钙(HR=1.32,95%CI:1.10~1.60,P=0.002)及手术时间(HR=1.12,95%CI:1.05~1.20,P=0.001)为独立影响因素。此外,微创组的住院时间(5.2 d vs 7.8 d,P<0.001)和术后疼痛评分(第1 d:2.3 vs 3.7,P<0.001;第3 d:1.5 vs 2.8,P<0.001)均显著低于传统组。结论微创甲状腺手术在甲状腺乳头状癌患者的甲状旁腺功能恢复中具有显著优势,能够缩短恢复时间,减少低钙血症发生率,降低住院时间和术后疼痛。手术方式及甲状旁腺保护是恢复时间的关键因素。
文摘目的:对比单侧甲状腺癌根治术使用无充气经腋窝入路与胸乳入路腔镜手术的效果。方法:选取2023年4月—2024年7月苏州市立医院收治的90例单侧甲状腺癌患者,以治疗方式不同分为对照组与观察组,各45例。对照组行经胸乳入路腔镜手术,观察组行无充气经腋窝入路腔镜手术。比较两组围手术期指标、术后并发症发生情况、术后美容效果,并比较术前和术后3 d甲状旁腺功能[甲状旁腺素(PTH)、血钙]与应激反应[肾上腺素(Adr)、皮质醇(Cor)]情况。结果:相比对照组,观察组出血量、术后引流量、术后1个月视觉模拟评分法(VAS)评分均更低,差异有统计学意义(P<0.05);两组手术时间、淋巴结清扫数量比较,差异无统计学意义(P>0.05)。相比对照组,观察组术后并发症发生率更低,而术后美容效果总满意度更高,差异有统计学意义(P<0.05)。两组术前、术后3 d甲状旁腺功能和应激反应比较,差异无统计学意义(P>0.05);但两组术后3 d PTH、血钙、Adr较术前升高,Cor较术前降低,差异有统计学意义(P<0.05)。结论:无充气经腋窝入路腔镜手术和胸乳入路腔镜手术的手术时间及对淋巴结的清除效果基本一致,对甲状旁腺和应激反应影响均较小,但无充气腋窝入路腔镜手术出血量和术后引流量更少,且可减轻术后疼痛,降低术后并发症发生率,同时具有较高的美学效果满意度。
