【摘要】 目的：探讨甲状旁腺全切除加前臂自体移植术治疗继发性甲状旁腺功能亢进的疗效。方法：1999年11 月～2005年4月，对15例继发性甲状旁腺功能亢进病人施行了上述治疗。结果：15例患者共切除增生性甲状旁腺52 枚。B 超对甲状旁腺的检出率为96． 2%。术后临床症状改善，血钙控制在正常范围内，术后第1天、1周、2周、3周和 3个月血全段甲状旁腺素(intact parathyroid hormone，iPTH)平均值分别为14． 0、 17． 8、 113． 7、 145． 0和148． 2ng/L。1例 术后4年移植物增生复发，切除后临床症状改善，无并发症。结论：甲状旁腺全切除加前臂自体移植术治疗继发性 甲状旁腺功能亢进是可行的，手术安全，近期疗效满意，其远期疗效有待进一步随访加以肯定。更多还原

【Abstract】 Objective To evaluate the effect of total parathyroidectomy with forearm autotransplantation of the parathyroid tissue in patients with secondary hyperparathyroidism.Methods Such treatment was performed in 15 eases of chronic renal failure with secondary hyperparathyroidism.Results Fifty-two parathyroid glands were resected in the 15 patients.The accuracy rate of parathyroid localization was 96． 2% in cases undergoing B uhrasonography.The operation was successfully accomplished in all the cases without serious complication.The clinical symptoms were improved and the level of serum calcium was controlled within normal range after the operation.The average value of serum intact parathyroid hormone(iPTH)was 14． 0,17． 8,113． 7,145． 0 and 148． 2 ng/L respectively in day 1,week 1,week 2,week 3 and month 3 after operation.Recurrent secondary hyperparathyroidism occurred in 1 case after 4 years of operation because of the development of autograft hyperplasia,and the clinical symptoms were improved again after the secondary operation.Conclusions Total parathyroidectomy with forearm autotransplantation is a safe and effective measure for patients with secondary hyperparathyroidism,but its long-term effect needs to be confirmed by longer observation.更多还原