Rohl P G, Wilkinson M, Clifton-Bligh P, Posen S
Med J Aust. 1981 May 16;1(10):519-21.
During a seven-year period, after the introduction of parathyroid hormone assays, 113 patients with primary hyperparathyroidism were seen at an Australian teaching hospital. In 68, parathyroidectomy was followed by normalization of serum calcium levels. Fifteen patients (six referred from other units) remained hypercalcaemic after their initial neck exploration. Thirty patients with biochemical changes indicative of primary hyperparathyroidism were not referred for surgery, mainly because of old age or lack of symptoms. Those patients who were not submitted to surgery, and those who had undergone unsuccessful neck explorations, were observed (while hypercalcaemic) for a mean period of three years. During the period of observation, no deterioration occurred in the clinical or biochemical status of these patients. It is proposed that patients with non-symptomatic primary hyperparathyroidism may be managed by clinical observation, rather than by immediate parathyroidectomy.
在引入甲状旁腺激素检测方法后的七年时间里，一家澳大利亚教学医院共接诊了113例原发性甲状旁腺功能亢进患者。其中68例患者在接受甲状旁腺切除术后，血清钙水平恢复正常。15例患者（6例由其他科室转诊而来）在初次颈部探查后仍存在高钙血症。30例有原发性甲状旁腺功能亢进生化改变迹象的患者未被转诊接受手术，主要原因是年龄较大或无症状。那些未接受手术的患者，以及颈部探查未成功的患者，在高钙血症状态下平均观察了三年。在观察期间，这些患者的临床和生化状况均未恶化。建议对无症状的原发性甲状旁腺功能亢进患者进行临床观察，而非立即进行甲状旁腺切除术。
