论文部分内容阅读
目的分析总结甲状旁腺肿瘤合并甲状旁腺功能亢进症的诊治经验与体会。方法回顾性分析我院2007年2月至2012年2月收治的4例甲状旁腺肿瘤合并甲状旁腺功能亢进症的临床特征、诊断过程、治疗情况与治疗效果。结果以多发性骨折及颈前肿块为首发症状者各2例,入院时3例被误诊,3例并存泌尿系结石及甲状腺疾病;受检者全部存在高血钙、低血磷、高尿钙及甲状旁腺激素升高;术前B超、CT检查与术中及术后病理诊断符合率分别为75%及100%;术中见2例位于甲状腺右叶下极后下方,1例位于甲状腺左叶下极后下方,另1例位于左叶甲状腺腺体内;3例良性者(甲状旁腺腺瘤)行局部切除,1例恶性者(甲状旁腺癌)行左甲状腺全切除;术后早期均出现一过性低钙低钾低镁血症,2周内电解质、尿钙、甲状旁腺激素水平均恢复正常。结论此病极易误诊,术前必须注重定性及定位诊断,外科手术切除是首选的治疗方法。
Objective To analyze the experience and experience of diagnosis and treatment of parathyroid tumor with hyperparathyroidism. Methods We retrospectively analyzed the clinical features, diagnosis process, treatment status and therapeutic effect of 4 parathyroid tumors with hyperparathyroidism treated in our hospital from February 2007 to February 2012. Results There were 2 cases with multiple fractures and anterior cervical masses as the first symptoms. Three cases were misdiagnosed on admission. Three cases were complicated with urinary calculi and thyroid diseases. All the subjects were found to have hypercalcemia, hypophosphatemia, and high urinary calcium. And parathyroid hormone increased; preoperative B-ultrasound, CT examination and intraoperative and postoperative pathological diagnostic coincidence rate was 75% and 100%; intraoperative see 2 cases in the lower right lower lobe of the thyroid gland, 1 case is located The lower part of the left lower lobe of the thyroid gland was located posterior to the lower part of the left thyroid gland. The other case was located in the left thyroid gland gland; 3 cases of benign (parathyroid adenoma) were locally resected; 1 case of malignant (parathyroid carcinoma) was treated with total left thyroidectomy; In the early postoperative period, transient hypocalcemia, hypokalemia, hypomagnesemia occurred, and electrolytes, urinary calcium, and parathyroid hormone levels returned to normal within 2 weeks. Conclusion The disease is easy to be misdiagnosed. Preoperative diagnosis and positioning diagnosis must be emphasized. Surgical resection is the preferred treatment.