Sitges-Serra A, Caralps-Riera A
Surg Clin North Am. 1987 Apr;67(2):359-77. doi: 10.1016/s0039-6109(16)44189-7.
Hyperparathyroidism associated with renal failure is due to chronic parathyroid stimulation by hypocalcemia, which, in turn, results from hyperphosphatemia and low circulating 1,25(OH)2D3. If prophylactic measures and medical treatment of hyperparathyroidism fail, parathyroidectomy should be performed to prevent the progression of bone disease. Resolution of renal hyperparathyroidism is often seen after kidney transplantation, but some hypercalcemic patients require prophylactic or therapeutic parathyroidectomy. Hypocalcemia is the most common complication after parathyroidectomy. Our long-term results with subtotal parathyroidectomy are satisfactory. Total parathyroidectomy plus parathyroid autograft should be used in selected cases.
与肾衰竭相关的甲状旁腺功能亢进是由于低钙血症对甲状旁腺的慢性刺激所致，而低钙血症又是由高磷血症和循环中1,25(OH)₂D₃水平降低引起的。如果甲状旁腺功能亢进的预防措施和药物治疗无效，应进行甲状旁腺切除术以防止骨病进展。肾性甲状旁腺功能亢进在肾移植后常可缓解，但一些高钙血症患者需要预防性或治疗性甲状旁腺切除术。低钙血症是甲状旁腺切除术后最常见的并发症。我们行甲状旁腺次全切除术的长期效果令人满意。在特定病例中应采用甲状旁腺全切除术加甲状旁腺自体移植术。
