Coffey R J, Lee T C, Canary J J
Ann Surg. 1977 May;185(5):518-23. doi: 10.1097/00000658-197705000-00003.
Analysis of a series of 200 surgically treated cases of primary hyperparathyroidism was carried out in an effort to identify not only the changing clinical patterns and improved diagnostic methods but also to assess the long term results of our conventional operative methods in light of recent reports of a high incidence of diffuse hyperplasia and a high recurrence rate when surgery is restricted to removal of the adenoma. As reported by others the "chemical diagnosis" of primary hyperparathyroidism, the clinical setting in which unsuspected hypercalcemia is demonstrated on routine blood analysis, accounts for the majority of diagnoses today. Impending or actual "parathyroid crisis" has been observed with alarming frequency. The use of the thiazide challenge test provides a useful diagnostic aid in many instances. The incidence of diffuse hyperplasia was 6% in this series while an adenoma was present in 88%. No instance of recurrence was observed in either the cases of adenomas or diffuse hyperplasia.
对200例接受手术治疗的原发性甲状旁腺功能亢进病例进行了分析，目的不仅是确定不断变化的临床模式和改进的诊断方法，而且根据最近有关弥漫性增生发病率高以及手术仅限于切除腺瘤时复发率高的报告，评估我们传统手术方法的长期效果。正如其他人所报告的，原发性甲状旁腺功能亢进的“化学诊断”，即在常规血液分析中发现意外高钙血症的临床情况，占当今大多数诊断病例。已观察到即将发生或实际发生的“甲状旁腺危象”的频率令人担忧。在许多情况下，使用噻嗪类激发试验有助于诊断。本系列中弥漫性增生的发生率为6%，而腺瘤的发生率为88%。腺瘤或弥漫性增生病例均未观察到复发情况。
