34 例原发性甲状旁腺功能亢进的临床分析

目的：探讨原发性甲状旁腺功能亢进（PHPT）的诊断和治疗。方法：回顾性分析15年问收治的34例PHPT的临床资料。结果：34例PHPT均经手术治疗、病理证实，全组均表现为：不同程度的骨病变，其中合并泌尿结石患者7例（20．5％）经超声检查的阳性率为85％（22／26），放射性计算机X线断层扫描（EC T）检查的阳性率95．4％（20／21），手术后无永久性甲旁减和喉返神精损伤等并发症，部分患者骨痛缓解和消失。结论：超声和ECT可作为首选的定位诊断方法，定性诊断主要依靠血钙和甲状旁腺素升高。定位明确的甲状旁腺腺瘤可行单侧探查。定位不明确或异位者，可在放射性核素指导下行手术探查。PHPT手术是有效的治疗手段，经手术可大大减少严重骨病的发生。要注意术前高钙危象和术后低钙血症的处理。

The clinical analysis of 34 cases of primary hyperparathyraidism

Objesctive: To explore the diagnosis and treatment of p rimary hyperparathyroidism(PHPT).Methods: Clinical date of 34 cases of PHPT were retrospectively analyzed.Rseults: 34 patient s with PHPT were confirmed by operation and pathology.There were bone pathologi c changes of varying extant in all patients stones in urinary system plus bone p athology in 7 casea.22 out of 26 cases(85%)undergoing preperative ultrasonogra phy with a positive result were verified by intraoperative findings.For ECT the positive rate was 20 out of 21 cases(95.4%) there was no permanent hypoparathy roidism of recurrent nerve injury of other comlications.Conclusions: PHPT could be diagnosed according to co-elevated calcemia and PTH. Ultras onography and ECT Should be considered as the methods of first choice for preope rative Localization UNE of parathyroidoma could be feasible if accurate image lo calizations are available Radionuclear guided parathyroid resection could be per formed in the patients with ectopic parathyroid disease or lesions without accur ate localization effective early treatment by surgical removal of the pathlolgi c lesion can alleviate the occurrence of severe bone changes and deformity.