【摘要】 目的研究微波消融持续/复发性继发甲旁亢(SHPT)的安全性与有效性。方法 19例入组患者24个SHPT结节行微波消融,消融后超声造影评估疗效。对比消融前后患者全段甲状旁腺激素(iPTH)及血钙、血磷、碱性磷酸酶(ALP)测值变化,记录并发症发生情况。结果所有24个持续/复发性SHPT结节消融后超声造影为无增强。术后iPTH由术前(1 376±1 359)pg/ml降为术后1d(254±235)pg/ml(P<0.01)和随访终点(345±362)pg/ml(P<0.01);血钙由术前(2.48±0.21)mmol/L降为(2.15±0.25)mmol/L(P<0.01)和(2.32±0.22)mmol/L(P<0.05);血磷由术前(2.09±0.70)mmol/L降为(1.78±0.60)mmol/L(P<0.01)和(1.44±0.38)mmol/L(P<0.01);消融前后ALP测值无统计学差异(P>0.05)。1例患者(5.3%)发生一侧喉返神经损伤,随访期内[3~24个月,平均(14.2±7.3)d]无其他并发症发生。结论微波消融作为一种微创技术治疗持续/复发性SHPT是安全和有效的。更多还原

【Abstract】 Objective To study the safety and efficiency of microwave ablation(MWA)of persistent/recurrent secondary hyperparathyroidism(PRSHPT).Methods 24 RPSHPT nodules in 19 enrolled cases were treated by MWA.The curative effect was evaluated by contrast-enhanced ultrasound(CEUS).The values of iPTH,serum calcium,phosphorus and ALP before MWA were compared to the values after MWA.The complications were recorded.Results All 24 PRSHPT nodules were completely ablated and had no enhancement on CEVS.The value of iPTH was decreased from(1376±1359)pg/ml before MWA to(254±235)pg/ml after MWA 1 day(P<0.01)and(345±362)pg/ml at the end of follow-up(P<0.01).The value of serum calcium was decreased from(2.48±0.21)mmol/L to(2.15±0.25)mmol/L after MWA 1 day(P<0.01)and(2.32±0.22)mmol/L at the end of follow-up(P<0.05).The value of phosphorus was decreased from(2.09±0.70)mmol/L to(1.78±0.60)mmol/L(P<0.01)and(1.44±0.38)mmol/L(P<0.01).The difference of values of ALP before and after ablation was not statistically significant(P>0.05).The damage of unilateral recurrent laryngeal nerve was encountered in 1 cases during ablation(5.3%),and no other complication was reported at the follow-up period.Conclusions It is safe and efficient for applying MWA to manage PRSHPT as minimally invasive technique.更多还原