继发性甲状旁腺功能亢进症甲状旁腺切除术后并发症分析

doi:10.3969/j.issn.1006-298X.2019.01.004

肾脏病与透析肾移植杂志 ›› 2019, Vol. 28 ›› Issue (1): 19-23.DOI: 10.3969/j.issn.1006-298X.2019.01.004

继发性甲状旁腺功能亢进症甲状旁腺切除术后并发症分析

出版日期:2019-02-28 发布日期:2019-03-04

Complications after parathyroidectomy for secondary hyperparathyroidism

Online:2019-02-28 Published:2019-03-04

摘要/Abstract

摘要：

目的：分析尿毒症患者难治性继发性甲状旁腺功能亢进症(SHPT)行甲状旁腺切除术(PTX)后并发症及预后。
方法：选取2008年9月至2017年09月在南京医科大学第二附属医院行PTX的1 000例维持性血液透析患者，其中甲状旁腺全切术(tPTX)926例(926%)、甲状旁腺全切加前臂自体移植术(tPTX+AT)49例(49%)，其他术式25例（25%），回顾性分析术后的出血、感染、喉返神经损伤、心律失常等的发生率及其预后。
结果：1 000例次手术患者平均年龄470±112岁，平均透析龄920±434月，其中围手术期死亡2例，术后出血28例、切口感染49例、喉返神经损伤24例、新发心律失常16例、急性左心衰竭3例、动静脉内瘘闭塞8例、低钙血症776例、高钾血症247例。
结论：PTX治疗SHPT术后低钙血症发生率高，死亡率较低，是治疗难治性SHPT的一种安全方式。

关键词: 继发性甲状旁腺功能亢进, 甲状旁腺切除术, 并发症

Abstract:

Ｏｂｊｅｃｔｉｖｅ：Parathyroidectomy (PTX) is the main method to treat refractory secondary hyperparathyroidism (SHPT).However,the safety of treating SHPT with PTX in patients with uremia remains controversial.The purpose of this study was to evaluate the safety of the operation in uremia patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 1 000 maintenance hemodialysis patients who underwent PTX in our hospital from September 2008 to September 2017 were selected,of which total parathyroidectomy without autotransplantation (tPTX) was performed in 926 cases (926%),total parathyroidectomy with autotransplantation (tPTX+AT) was performed in 49 cases (49%)，other operations were performed in 25 cases（25%）.The incidence of complications and their recovery during PTX were retrospectively analyzed,and the perioperative safety of the patients was analyzed and summarized.
Ｒｅｓｕｌｔｓ：They were an average age of 470±112 years and an average age of dialysis was 920±434 months.Among them,perioperative death was in 2 cases,intraoperative bleeding in 28 cases,postoperative incision infection in 49 cases,laryngeal recurrent nerve injury in 24 cases,new oneself arrhythmia in 16 cases,acute left heart failure in 3 cases,arteriovenous fistula occlusion in 8 cases,hypocalcemia in 776 cases and hyperkalemia in 247 cases.
Ｃｏｎｃｌｕｓｉｏｎ：
PTX is a safe method for the treatment of refractory uremia SHPT.

Key words: secondary hyperparathyroidismp, arathyroidectomy, complication

赵沙沙，闻萍，甘巍，等. 继发性甲状旁腺功能亢进症甲状旁腺切除术后并发症分析[J]. 肾脏病与透析肾移植杂志, 2019, 28(1): 19-23.

ZHAO Shasha,WEN Ping,GAN Wei,et al. Complications after parathyroidectomy for secondary hyperparathyroidism[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2019, 28(1): 19-23.

[1]	朱妍, 秦卫松. 糖尿病斑马鱼模型研究进展[J]. 肾脏病与透析肾移植杂志, 2021, 30(1): 59-63.
[2]	徐金梅,林晶晶,陈思瑜,雷欣,蒋华,陈江华,张萍. 术中甲状旁腺激素测定对继发性甲状旁腺功能亢进患者手术疗效的预测价值[J]. 肾脏病与透析肾移植杂志, 2020, 29(6): 514-519.
[3]	陈雪芹,李博厚,张凤霞,连智雯,蒋楠,温似春,吴琼,夏郁彬,柯贵宝,张鸿,邝素娟,邓春玉,刘双信. COMM域蛋白5参与血液透析患者甲状旁腺切除术后血压下降的机制[J]. 肾脏病与透析肾移植杂志, 2020, 29(6): 520-525.
[4]	成水芹,陈赟敏,周婷婷,张志宏,王芳,吕桂兰,王金泉,俞雨生. 体外徒手腹膜透析导管拔除术的临床应用[J]. 肾脏病与透析肾移植杂志, 2020, 29(6): 531-535.
[5]	ACTIVE研究工作组. 西那卡塞治疗中国维持性血液透析继发性甲状旁腺功能亢进的多中心临床研究（ACTIVE）方案[J]. 肾脏病与透析肾移植杂志, 2020, 29(5): 478-483.
[6]	马妍,谢红浪. 非蛋白尿型糖尿病肾病[J]. 肾脏病与透析肾移植杂志, 2020, 29(4): 369-374.
[7]	赵景宏. 再谈拟钙剂的临床应用[J]. 肾脏病与透析肾移植杂志, 2020, 29(3): 247-248.
[8]	梁馨苓,徐丽霞. 拟钙剂在维持性血液透析患者的应用体会[J]. 肾脏病与透析肾移植杂志, 2020, 29(3): 249-250.
[9]	朱钰钰,陶舒曼,王德光. 慢性肾脏病患者锌缺乏的研究进展[J]. 肾脏病与透析肾移植杂志, 2020, 29(3): 265-269.
[10]	阳晓. 紧急腹膜透析在终末期肾病中的应用[J]. 肾脏病与透析肾移植杂志, 2020, 29(2): 144-145.
[11]	张凌. 维持性透析患者甲状旁腺切除术式选择和并发症管理[J]. 肾脏病与透析肾移植杂志, 2020, 29(1): 44-45.
[12]	高佩娟,崔娟,陶冶. 肠道菌群与肾移植[J]. 肾脏病与透析肾移植杂志, 2020, 29(1): 83-87.
[13]	司丽,张森,桂凌,等. 甲状旁腺全切加自体移植在继发性甲状旁腺功能亢进患者中的疗效观察[J]. 肾脏病与透析肾移植杂志, 2017, 26(5): 426-431.
[14]	张蕊,张念荣,席秋萍,等. 维持性血液透析合并难治性继发性甲状旁腺功能亢进患者腹主动脉钙化相关因素分析[J]. 肾脏病与透析肾移植杂志, 2017, 26(5): 432-437.
[15]	王萍,俞雨生. 腹膜透析导管相关并发症防治进展[J]. 肾脏病与透析肾移植杂志, 2017, 26(5): 481-485.

ISSN 1006-298X CN 32-1425/R

继发性甲状旁腺功能亢进症甲状旁腺切除术后并发症分析

Complications after parathyroidectomy for secondary hyperparathyroidism

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价