Tominaga Y, Uchida K, Yamada N, Kawai M, Kano T, Kawahara K, Takagi H, Morimoto T, Yasue M
Hinyokika Kiyo. 1984 Jul;30(7):989-92.
Forty-three patients with chronic renal failure and secondary hyperparathyroidism underwent parathyroid surgery. The first 20 patients were submitted to subtotal parathyroidectomy, and the last 23 patients underwent total parathyroidectomy and parathyroid autotransplantation in the forearm. Non-invasive image diagnosis, CT, ultrasonography and scintigraphy are valuable for 1) making a definite diagnosis of secondary hyperparathyroidism, 2) locating the tumor 3) determining the effectiveness of treatment, and 4) differentially diagnosing thyroid tumors. For surgical treatment, we recommend total parathyroidectomy and autotransplantation in the forearm because the second operation for recurrence may be done more safely and easily than after subtotal parathyroidectomy.
43例慢性肾衰竭合并继发性甲状旁腺功能亢进患者接受了甲状旁腺手术。前20例患者接受了甲状旁腺次全切除术,后23例患者接受了甲状旁腺全切除术及前臂甲状旁腺自体移植术。非侵入性影像诊断,如CT、超声和闪烁扫描术,对于1)明确诊断继发性甲状旁腺功能亢进,2)定位肿瘤,3)确定治疗效果,以及4)鉴别诊断甲状腺肿瘤很有价值。对于手术治疗,我们推荐甲状旁腺全切除术及前臂自体移植术,因为与甲状旁腺次全切除术后相比,复发时再次手术可能会更安全、更容易进行。