术中检测甲状旁腺素治疗肿瘤性甲状旁腺功能亢进的临床观察

刘善廷; 吴俊福; 冯露; 陈德峰; 赵铭; 齐金星; 李文亮

doi:10.13201/j.issn.1001-1781.2013.24.009

术中检测甲状旁腺素治疗肿瘤性甲状旁腺功能亢进的临床观察

- 1 河南省肿瘤医院(郑州大学附属肿瘤医院)头颈科(郑州, 450008);
- 2 河南省肿瘤医院(郑州大学附属肿瘤医院)核医学科

详细信息

通讯作者: 刘善廷,E-mail:liushanting@163.com

中图分类号: R736.2

收稿日期: 2013-02-06

Clinical observation of intra-operative PTH assay in hyperparathyroidism due to parathyroid tumors

- 1 Department of Head and Neck, Henan Tumor Hospital, Zhengzhou University, Zhengzhou, 450008, China;
- 2 Department of Nuclear Medicine, Henan Tumor Hospital, Zhengzhou University

More Information

Corresponding author: LIU Shanting, E-mail: liushanting@163.com

Received Date: 06 February 2013

摘要

摘要: 目的:探讨肿瘤性甲状旁腺功能亢进的临床表现、诊断方法以及术中检测甲状旁腺素在手术治疗中的作用。方法:回顾性分析2003-01-2012-10收治的37例功能性甲状旁腺肿瘤的临床资料,总结其临床表现、检查手段及手术方式,观察手术前后及术中甲状旁腺素的变化。结果:全部患者术前能够明确诊断,颈部彩超的敏感性及阳性预测值为86.5%和97.6%,Tc-99m-MIBI的敏感性及阳性预测值为97.2%和100.0%。肿瘤切除术后10 min较手术切皮前甲状旁腺素下降84.9%。术后血钙下降,症状缓解。结论:肿瘤性甲状旁腺功能亢进的常见症状有反复发作骨病、长期泌尿系结石、不明原因消化道症状等。颈部彩超和Tc-99m-MIBI适于甲状旁腺肿瘤定位。手术切除甲状旁腺肿瘤疗效确切,术中检测甲状旁腺素能够保证功能性甲状旁腺肿瘤手术的彻底性和安全性。
- 甲状旁腺功能亢进 /
- 甲状旁腺肿瘤 /
- 甲状旁腺素
Abstract: Objective: To investigate the clinical manifestations and diagnostic method of hyperparathyroidism due to parathyroid tumors and to evaluate the intra-operative detection of parathyroid hormone in surgical treatment.Method: Thirty-seven cases with functional parathyroid tumors from January 2003 to October 2012 were retrospectively analyzed. The clinical manifestation, examination and operation method, changes of parathyroid hormone before and after operation were collected.Result: All cases were definitely diagnosed before operation. The sensitivity and the positively predictive values of neck ultrasonography were 86.5% and 97.6% respectively, and the same data of Tc-99m-MIBI was 97.2% and 100.0%. The PTH levels declined by 84.9% ten minutes after tumor resecting compared with the level before operation. The serum calcium and PTH returned to normal levels and symptomatic relief occured after operation.Conclusion: Recurrent bone disease, long-term urinary calculus and obscure gastrointestinal symptoms were common symptoms of hyperparathyroidism due to parathyroid tumors. The neck ultrasonography and Tc-99m-MIBI were suitable for location of parathyroid tumors. Surgical operation was an effective treatment for parathyroid tumor. Intra-operative PTH assay would be able to ensure the radical excision and the operative safety for functional parathyroid tumors.
- hyperparathyroidism /
- parathyroid neoplasms /
- parathyroid hormone

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参考文献(14)

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