Obara T
Department of Endocrine Surgery, Tokyo Women's Medical College.
Nihon Rinsho. 1995 Apr;53(4):930-4.
Retrospective analysis has been performed in 404 patients, undergoing initial operation for primary hyperparathyroidism for differences in clinical presentation, laboratory data, pathological findings and outcome of surgery. In elderly patients (> = 60 years of age, n = 116), neuromuscular and psychic symptoms, hypertension, cholelithiasis and pseudogout were significantly more common, while renal stones were less common than in younger patients. There were no significant difference in preoperative laboratory findings, parathyroid pathology and surgical cure rate. Parathyroidectomy could be safely performed under local anesthesia, particularly in elderly patients in whom general anesthesia was involved with an increased operative risk. An attack of pseudogout was the most common postoperative complication. Hence, immediate calcium supplementation after operation is recommended in patients with a radiologic finding of chondrocalcinosis.
对404例因原发性甲状旁腺功能亢进接受初次手术的患者进行了回顾性分析，以探讨临床表现、实验室数据、病理结果及手术结局的差异。在老年患者（≥60岁，n = 116）中，神经肌肉和精神症状、高血压、胆石症和假性痛风明显更为常见，而肾结石则比年轻患者少见。术前实验室检查结果、甲状旁腺病理及手术治愈率无显著差异。甲状旁腺切除术可在局部麻醉下安全进行，尤其是在全身麻醉手术风险增加的老年患者中。假性痛风发作是最常见的术后并发症。因此，对于有软骨钙质沉着症影像学表现的患者，建议术后立即补充钙剂。
