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甲状旁腺腺瘤的射频消融:10例患者研究中的安全性与有效性

Radiofrequency Ablation of Parathyroid Adenomas: Safety and Efficacy in a Study of 10 Patients.

作者信息

Khandelwal Anubhav Harish, Batra Smarth, Jajodia Surabhi, Gupta Saurabh, Khandelwal Rohit, Kapoor Abhay Kumar, Mishra Sunil Kumar, Baijal S S

机构信息

Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India.

Department of Endocrinology and Metabolism, Medanta-The Medicity, Gurugram, Haryana, India.

出版信息

Indian J Endocrinol Metab. 2020 Nov-Dec;24(6):543-550. doi: 10.4103/ijem.IJEM_671_20. Epub 2021 Jan 12.

Abstract

PURPOSE

To evaluate safety and effectiveness of ultrasound-guided percutaneous radiofrequency ablation of parathyroid adenoma in surgically unfit patients with hypercalcemia because of hyperparathyroidism.

MATERIALS AND METHODS

A retrospective review of hospital records from Jan 2012 to Dec 2018 revealed 10 patients, who had undergone ablation for solitary parathyroid adenoma. All 10 patients suffered from hyperparathyroidism because of parathyroid adenoma, resulting in hypercalcemia. These patients were surgically unfit because of comorbidities. Pre-ablation serum calcium and serum parathormone levels were measured and compared with the levels after the ablation.

RESULTS

Mean serum calcium level decreased significantly from 2.81 ± 0.17 mmol/L pre-ablation to 2.42 ± 0.17 mmol/L 72 h after ablation and parathyroid hormone levels became normal in all patients within 7 days. Seven patients remained normo-calcaemic at 6 months follow-up with no signs and symptoms of hyperparathyroidism. One patient with pancreatitis died after 15 days because of pre-existing multi-organ failure. Two patients were lost to follow-up before 6 months.

CONCLUSION

Radiofrequency ablation of parathyroid adenoma is a safe and effective alternate treatment method for symptomatic hypercalcemia in surgically unfit patients suffering from primary hyperparathyroidism because of parathyroid adenoma.

摘要

目的

评估超声引导下经皮射频消融甲状旁腺腺瘤治疗因甲状旁腺功能亢进导致高钙血症且不宜手术的患者的安全性和有效性。

材料与方法

回顾性分析2012年1月至2018年12月的医院记录,发现10例接受了孤立性甲状旁腺腺瘤消融治疗的患者。所有10例患者均因甲状旁腺腺瘤患有甲状旁腺功能亢进,导致高钙血症。这些患者因合并症不宜手术。测量消融前的血清钙和血清甲状旁腺激素水平,并与消融后的水平进行比较。

结果

血清钙平均水平从消融前的2.81±0.17mmol/L显著降至消融后72小时的2.42±0.17mmol/L,所有患者的甲状旁腺激素水平在7天内恢复正常。7例患者在6个月随访时血钙正常,无甲状旁腺功能亢进的体征和症状。1例胰腺炎患者因既往多器官功能衰竭在15天后死亡。2例患者在6个月前失访。

结论

对于因甲状旁腺腺瘤导致原发性甲状旁腺功能亢进且不宜手术的有症状高钙血症患者,射频消融甲状旁腺腺瘤是一种安全有效的替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed11/7906106/364aa8d2a047/IJEM-24-543-g001.jpg

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