Adámek S, Libánský P, Nanka O, Sedý J, Pafko P
III. chirurgická klinika l. LF UK, Praha.
Zentralbl Chir. 2005 Apr;130(2):109-13. doi: 10.1055/s-2005-836365.
453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done. Struma nodosa was concommitantly present in 48 % of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6 % of treated patients had postoperative decrease of blood calcium to normal level. 5.4 % of cases were reoperations for primary hyperparathyroidism. In 12 % of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3 % intrathyroid, in 7 % mediastinal and in 2 % of all 453 cases in other localization. In 4 % of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient. Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2 % of patients. Recurrent hypercalcemia was present in 0.2 % of cases. In three cases (0.7 %), unilateral injury of recurrent laryngeal nerve was observed.
1994年至2003年间，453例患者接受了原发性甲状旁腺功能亢进症手术。对所有患者进行了生化指标监测，并对颈部进行了X线和超声检查。48%接受原发性甲状旁腺功能亢进症治疗的患者同时存在结节性甲状腺肿。在这种情况下，磁共振成像（MRI）对软组织的分辨率更高。98.6%接受治疗的患者术后血钙降至正常水平。5.4%的病例因原发性甲状旁腺功能亢进症进行了再次手术。12%的病例发现异位定位的甲状旁腺发生病理改变。在这些异位定位中，发现了病理性甲状旁腺：3%位于甲状腺内，7%位于纵隔，在全部453例病例中有2%位于其他部位。4%的患者需要进行胸骨切开术。所有患者均未出现持续性低钙血症。3.5%的患者观察到需要进行输液治疗的短暂性低钙血症。1.2%的患者术后高钙血症持续存在。0.2%的病例出现复发性高钙血症。3例（0.7%）观察到单侧喉返神经损伤。
