关键词: 甲状旁腺全切除术, 干体重, 骨密度

Abstract: Objective: To investigate the changes in bone mineral density (BMD) and dry weight in patients after total parathyroidectomy without autotransplantation (TPTX) and to analyze their correlation. Methods: This retrospective cohort study ultimately included 49 maintenance hemodialysis patients who underwent TPTX in our hospital from September 2013 to September 2018. The changes in postoperative BMD and dry weight were followed up, and their correlation was analyzed. Results: Among the 49 patients, 19 were female (38.8%). At the time of TPTX, the mean age was 45.9±11.2 years, the mean dialysis vintage was 127.2±56.3 months, and the mean follow⁃up duration was 48.5±27.2 months post⁃surgery. During the postoperative follow⁃up, the patients' dry weight increased significantly from 58.00 (51.10-69.00) kg preoperatively to 61.70 (51.95-73.15) kg postoperatively (P<0.001). Additionally, bone mineral content and BMD at various sites of the lumbar spine and hip joint were significantly increased compared to preoperative values. The total lumbar spine BMD increased from 0.87±0.14 g/cm2 preoperatively to 1.00±0.18 g/cm2 postoperatively (P<0.001); the total hip BMD increased from 0.77± 0.16 g/cm2 preoperatively to 0.90± 0.18 g/cm2 postoperatively (P<0.001). Further analysis revealed that the change in dry weight was weakly positively correlated with changes in hip trochanter BMD (r=0.347, P=0.017), hip intertrochanteric BMD (r=0.333, P=0.022), and total hip BMD (r=0.307, P=0.036), but showed no correlation with changes in lumbar spine BMD. Conclusion: Following TPTX, patients experienced a significant increase in dry weight and a significant improvement in BMD. Furthermore, the change in dry weight was correlated with the improvement in hip BMD.