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经皮超声引导下乙醇消融假定功能性甲状旁腺结节治疗原发性甲状旁腺功能亢进犬的结局:27例(2008 - 2011年)

Outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules: 27 cases (2008-2011).

作者信息

Guttin Talia, Knox Van W, Diroff Jeremy S

出版信息

J Am Vet Med Assoc. 2015 Oct 1;247(7):771-7. doi: 10.2460/javma.247.7.771.

Abstract

OBJECTIVE

To describe outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules.

DESIGN

Retrospective case series.

ANIMALS

24 dogs with primary hyperparathyroidism that underwent 27 ultrasound-guided ethanol ablation procedures of presumed functional parathyroid nodules identified by cervical ultrasonography.

PROCEDURES

Dogs were anesthetized for each procedure. For each nodule, 95% ethanol was injected into the center with ultrasound guidance (volume injected calculated on the basis of ultrasonographic measurements). The interval from treatment to resolution of hypercalcemia, complications, and follow-up clinicopathologic data were recorded.

RESULTS

5 procedures involved simultaneous treatment of 2 nodules. Three dogs underwent a second treatment because of initial treatment failure or development of another nodule. Hypercalcemia resolved after 23 of 27 (85%) procedures. In those 23 treatments, 22 (96%) had resolution of hypercalcemia within 72 hours after treatment. Hypocalcemia was detected in 6 different dogs at 2 (1 dog), 7 (3 dogs), 14 (1 dog), and 21 (1 dog) days after treatment; 5 of these dogs had mild transient hypocalcemia and 1 developed clinical signs requiring calcium supplementation. Although there were no periprocedural adverse effects, 2 dogs had delayed adverse effects; the overall rate of complications (including delayed adverse events and clinical hypocalcemia) was 11.1%. Long-term follow-up data indicated sustained normocalcemia in 17 of 19 dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that percutaneous ultrasound-guided ethanol ablation of functional parathyroid nodules may be an effective treatment for primary hyperparathyroidism of dogs, with short duration of anesthesia, minimal complications, and low risk for hypocalcemia.

摘要

目的

描述经皮超声引导下乙醇消融假定的功能性甲状旁腺结节治疗原发性甲状旁腺功能亢进犬的治疗结果。

设计

回顾性病例系列。

动物

24只患有原发性甲状旁腺功能亢进的犬,对通过颈部超声检查确定的假定功能性甲状旁腺结节进行了27次超声引导下乙醇消融手术。

手术过程

每次手术时对犬进行麻醉。对于每个结节,在超声引导下将95%乙醇注入结节中心(注入量根据超声测量计算)。记录从治疗到高钙血症消退的时间间隔、并发症以及随访临床病理数据。

结果

5次手术涉及同时治疗2个结节。3只犬因初次治疗失败或出现另一个结节而接受了第二次治疗。27次手术中的23次(85%)后高钙血症得到缓解。在这23次治疗中,22次(96%)在治疗后72小时内高钙血症得到缓解。6只不同的犬在治疗后2天(1只犬)、7天(3只犬)、14天(1只犬)和21天(1只犬)检测到低钙血症;其中5只犬有轻度短暂性低钙血症,1只出现需要补充钙的临床症状。虽然围手术期没有不良反应,但有2只犬出现延迟不良反应;并发症总发生率(包括延迟不良事件和临床低钙血症)为11.1%。长期随访数据表明,19只犬中有17只维持正常血钙水平。

结论及临床意义

结果表明,经皮超声引导下乙醇消融功能性甲状旁腺结节可能是治疗犬原发性甲状旁腺功能亢进的有效方法,麻醉时间短,并发症少,低钙血症风险低。

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