Delbridge L W, Marshman D, Reeve T S, Crummer P, Posen S
University of Sydney Department of Surgery, Royal North Shore Hospital of Sydney, St Leonards, NSW.
Med J Aust. 1988 Jul 18;149(2):74-6. doi: 10.5694/j.1326-5377.1988.tb120508.x.
In a consecutive series of 100 neck explorations for primary hyperparathyroidism, 42 patients were 60 years of age or older; in this group of elderly patients the surgical cure rate was 100%. These patients were reviewed retrospectively by means of a structure interview. Twenty-one patients had had preoperative neuromuscular symptoms that ranged from coma to subjective muscular weakness. These patients had significantly-higher preoperative serum calcium and parathyroid hormone levels than did 21 patients without neuromuscular symptoms (P = 0.003 and P = 0.046, respectively). Most of the neuromuscular symptoms improved in the postoperative period. In particular, 15 of 17 patients with muscle weakness reported a significant improvement, while 14 of 15 patients who suffered from fatigue and lethargy reported an improvement. An improvement also occurred in the level of day-to-day function in eight patients. While surgery for primary hyperparathyroidism generally is undertaken for a specific indication, such as severe hypercalcaemia or renal stones, it appears from this study that neuromuscular symptoms also may improve, particularly in elderly patients.
在连续进行的100例因原发性甲状旁腺功能亢进症而进行的颈部探查手术中，42例患者年龄在60岁及以上；在这组老年患者中，手术治愈率为100%。通过结构化访谈对这些患者进行了回顾性研究。21例患者术前有神经肌肉症状，范围从昏迷到主观肌肉无力。这些患者术前血清钙和甲状旁腺激素水平显著高于21例无神经肌肉症状的患者（分别为P = 0.003和P = 0.046）。大多数神经肌肉症状在术后有所改善。特别是，17例肌肉无力患者中有15例报告有显著改善，而15例疲劳和嗜睡患者中有14例报告有改善。8例患者的日常功能水平也有所改善。虽然原发性甲状旁腺功能亢进症的手术通常是针对特定指征进行的，如严重高钙血症或肾结石，但从这项研究来看，神经肌肉症状似乎也可能改善，尤其是在老年患者中。
