一种用于6例继发性甲状旁腺功能亢进患者的甲状旁腺自体移植新装置——病例系列
A novel device in parathyroid autotransplantation for 6 patients with secondary hyperparathyroidism - Case series.
作者信息
Zhang Xi Wei, Liu Gang, Tang Xue Feng, Zhang Hao, Huang Jian Ping, Du Lei
机构信息
Department of General Surgery, Shanghai Shu Guang Hospital, China.
出版信息
Ann Med Surg (Lond). 2018 Sep 19;35:51-54. doi: 10.1016/j.amsu.2018.09.012. eCollection 2018 Nov.
BACKGROUND
Secondary hyperparathyroidism(sHPT) is one of the most serious complications in long-term hemodialysis patients. Patients may suffer from metabolic bone diseases, severe atherosclerosis and undesirable cardiovascular events. Endoscopic parathyroidectomy with autotransplantation is a treatment option for those who do not respond to clinical management.
METHODS
6 patients with secondary hyperparathyroidism were treated with endoscopic parathyroidectomy and autotransplantation. Pieces of parathyroid tissue were squeezed in our novel self-made device and injected into brachioradialis.
RESULTS
Preoperative symptoms were alleviated, and the serum PTH and alkaline phosphatase levels, hyperphosphatemia, and hypercalcemia were improved or normalized in all 6 patients. The preparation time of parathyroid fragments for autotransplantation was less than 10 min in all 6 patients.Pathological examinations revealed parathyroid cells remains active.
CONCLUSION
Application of the novel squeezing device is an economic, effective and safe way in endoscopic parathyroidectomy and autotransplantation for patients with secondary hyperparathyroidism.
背景
继发性甲状旁腺功能亢进（sHPT）是长期血液透析患者最严重的并发症之一。患者可能患有代谢性骨病、严重动脉粥样硬化和不良心血管事件。内镜下甲状旁腺切除术联合自体移植是治疗那些对临床治疗无反应患者的一种选择。
方法
6例继发性甲状旁腺功能亢进患者接受了内镜下甲状旁腺切除术及自体移植。将甲状旁腺组织块在我们自制的新型装置中挤压后注入肱桡肌。
结果
所有6例患者术前症状均得到缓解，血清甲状旁腺激素（PTH）和碱性磷酸酶水平、高磷血症和高钙血症均得到改善或恢复正常。所有6例患者甲状旁腺碎片用于自体移植的制备时间均少于10分钟。病理检查显示甲状旁腺细胞仍保持活性。
结论
新型挤压装置的应用是继发性甲状旁腺功能亢进患者内镜下甲状旁腺切除术及自体移植的一种经济、有效且安全的方法。
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