Vujić D, Majster Z, Lazić N, Radmirović A, Kekić Z
Srp Arh Celok Lek. 1994 Jan-Feb;122(1-2):34-7.
Secondary hyperparathyroidism is one of the main and most consistent clinical manifestations of chronic renal failure. It develops in the early stage of chronic renal failure, and its severity increases with further deterioration of renal function. Renal osteodystrophy is the most frequent form of secondary hyperparathyroidism. The management of secondary hyperparathyroidism leads to improvement of calcium and phosphorus homeostasis and suppression of parathyroid secretion. Such treatment with medicament may be unsuccessful, and certain features of secondary hyperparathyroidism may necessitate parathyroid surgery. The aim of this article is to present our experience in the treatment of secondary hyperparathyroidism with subtotal parathyroidectomy. Twenty two patients on haemodialysis after subtotal parathyroidectomy were followed for about 2 years (x +/- SD: 2.0 +/- 1.5) after the operation. During this time the effect of operation on biochemical and clinical signs, and radiographical features of secondary hyperparathyroidism was evaluated. According to our results the subtotal parathyroidectomy stopped in most cases, the progression of secondary hyperparathyroidism. In two patients the reappearance of overt secondary hyperparathyroidism was observed 2.5 and 3.5 years after the operation.
继发性甲状旁腺功能亢进是慢性肾衰竭主要且最常见的临床表现之一。它在慢性肾衰竭早期就会出现，且其严重程度会随着肾功能的进一步恶化而加重。肾性骨营养不良是继发性甲状旁腺功能亢进最常见的形式。继发性甲状旁腺功能亢进的治疗可改善钙磷稳态并抑制甲状旁腺分泌。药物治疗可能并不成功，继发性甲状旁腺功能亢进的某些特征可能需要进行甲状旁腺手术。本文的目的是介绍我们采用甲状旁腺次全切除术治疗继发性甲状旁腺功能亢进的经验。22例接受甲状旁腺次全切除术后进行血液透析的患者在术后随访了约2年（x±标准差：2.0±1.5）。在此期间，评估了手术对继发性甲状旁腺功能亢进的生化和临床体征以及影像学特征的影响。根据我们的结果，甲状旁腺次全切除术在大多数情况下阻止了继发性甲状旁腺功能亢进的进展。在两名患者中，术后2.5年和3.5年观察到明显的继发性甲状旁腺功能亢进复发。
