甲状旁腺增生的解剖学

The anatomy of parathyroid hyperplasia.

作者信息

Liechty R D, Weil R

出版信息

Surgery. 1984 Dec;96(6):1099-102.

Abstract

Parathyroid hyperplasia aids the surgeon in studying parathyroid anatomy for several reasons: (a) Nature magnifies the glands in hyperplasia; (b) there is a strong clinical imperative to find all glands; (c) histologic controls help guide the dissections; and (d) postoperative clinical and laboratory responses help determine the presence of supernumerary glands. In this study of parathyroid hyperplasia we found four glands in each of 34 patients (136 glands total--37 operations). Six patients (18%) had parathyroid glands totally covered by thyroid tissue, five patients (15%) had mediastinal glands, one patient (3%) had a retroesophageal gland, and one (3%) had a "kissing pair." In addition, after four-gland parathyroidectomy, three patients gave evidence of functioning supernumerary glands (9%). Abnormalities in parathyroid anatomy occurred in almost half (47%) of these patients with parathyroid hyperplasia.

摘要

甲状旁腺增生有助于外科医生研究甲状旁腺解剖结构，原因如下：(a) 甲状旁腺增生时腺体自然增大；(b) 临床上迫切需要找到所有腺体；(c) 组织学对照有助于指导解剖；(d) 术后临床和实验室反应有助于确定是否存在额外的腺体。在这项甲状旁腺增生的研究中，我们发现34例患者中每例都有4个腺体（总共136个腺体——37例手术）。6例患者（18%）的甲状旁腺完全被甲状腺组织覆盖，5例患者（15%）有纵隔内甲状旁腺，1例患者（3%）有食管后甲状旁腺，1例（3%）有“相邻对”甲状旁腺。此外，在进行4个腺体的甲状旁腺切除术后，3例患者显示有功能的额外腺体（9%）。这些甲状旁腺增生患者中近一半（47%）存在甲状旁腺解剖结构异常。