University of Utah, 50 N Medical Drive, Salt Lake City, UT 84132, USA.
University of Utah, Huntsman Cancer Institute, 50 N Medical Drive, 3C120SOM, Salt Lake City, UT 84132, USA.
Surg Clin North Am. 2022 Apr;102(2):251-265. doi: 10.1016/j.suc.2021.12.009.
Primary hyperparathyroidism can be asymptomatic or symptomatic, as well as classic, normocalcemic, or normohormonal. It is important to rule out other causes of hypercalcemia or hyperparathyroidism. Preoperative localization with imaging is necessary for a minimally invasive approach and can be helpful even if planning 4-gland exploration. There are a variety of intraoperative techniques that can assist with localization as well as confirming success. Standard of care remains surgical resection of affected glands. However, there are less invasive management strategies that can be considered for poor surgical candidates.
原发性甲状旁腺功能亢进可无症状或有症状，也可表现为经典型、血钙正常型或甲状旁腺素正常型。重要的是要排除其他引起高钙血症或甲状旁腺功能亢进的原因。对于微创方法，术前进行影像学定位是必要的，即使计划进行 4 腺探查，也会有所帮助。有多种术中技术可以协助定位并确认手术成功。标准的治疗方法仍然是手术切除受影响的腺体。但是，对于手术条件差的患者，可以考虑采用一些微创的管理策略。
