Kasiliauskiene Almina, Priluckiene Janina, Slepavicius Algis
Seamen's Hospital of Klaipeda, Liepojos 45, 92329 Klaipeda, Lithuania.
Medicina (Kaunas). 2005;41 Suppl 1:50-4.
The aim of the study was to analyze criteria for selection of patients for parathyroidectomy, results of surgery and the need for such surgeries in patients undergoing dialysis in Klaipeda region.
201 chronic patients were hemodialyzed in Klaipeda region in January 2005. 4 of them underwent parathyroidectomy. Before surgery parathyroid hormone of all patients was greater than 1000 pg/ml; during sonoscopy enlarged parathyroid glands were identified; increased levels of alkaline phosphatase and bone lesions, hyperphosphatemia hardly corrected with drugs were detected; one patient had tissue calcification. After surgery clinical state of all the patients improved noticeably and amounts of parathyroid hormone, calcium and phosphorus in blood decreased. No postoperative complications were observed. After review of medical records of 201 chronic patients undergoing hemodialysis, it was discovered that 9.4 % of patients had secondary hyperparathyroidism resistant to treatment.
The first parathyroidectomies in Klaipeda region were successful; previous disorders of metabolism of calcium, parathyroid hormone and phosphorus were corrected. On average 9.4% of patients on hemodialysis in Klaipeda region were recommended to undergo parathyroidectomy.
本研究的目的是分析克莱佩达地区接受透析患者的甲状旁腺切除术患者选择标准、手术结果以及此类手术的必要性。
2005年1月，克莱佩达地区有201名慢性病患者接受血液透析。其中4人接受了甲状旁腺切除术。术前所有患者的甲状旁腺激素均大于1000 pg/ml；超声检查时发现甲状旁腺增大；检测到碱性磷酸酶水平升高、骨病变以及药物难以纠正的高磷血症；1例患者有组织钙化。术后所有患者的临床状况明显改善，血液中甲状旁腺激素、钙和磷的含量降低。未观察到术后并发症。在查阅201名接受血液透析的慢性病患者的病历后发现，9.4%的患者患有对治疗耐药的继发性甲状旁腺功能亢进。
克莱佩达地区的首例甲状旁腺切除术取得成功；先前钙、甲状旁腺激素和磷的代谢紊乱得到纠正。克莱佩达地区平均有9.4%的血液透析患者被建议接受甲状旁腺切除术。
