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目的探讨原发性甲状旁腺功能亢进症(PHPT)的临床诊治方法。方法回顾分析43例PHPT患者临床资料。结果 PHPT临床表现多样,43例患者中首发症状以骨关节痛16例、病理性骨折9例、泌尿系结石8例、骨质疏松伴泌尿系结石8例、乏力2例,误诊率93.02%。43例患者血钙值至少升高一次,40例患者甲状旁腺素(PTH)增高。彩超、CT和99mTc-MIBI联合检查的准确率为100%,均行手术并病理证实。术后患者血钙、PTH值明显下降,症状改善。结论早期行血PTH、B超、99mTc-MIBI检查对提高PHPT诊断率及患者生存质量具有重要意义。
Objective To investigate the clinical diagnosis and treatment of primary hyperparathyroidism (PHPT). Methods The clinical data of 43 patients with PHPT were retrospectively analyzed. Results The clinical manifestations of PHPT were diverse. Among the 43 patients, the first symptom was osteoarthritis in 16 cases, pathological fracture in 9 cases, urolithiasis in 8 cases, osteoporosis with urolithiasis in 8 cases and weakness in 2 cases, the rate of misdiagnosis was 93.02%. Forty-three patients had at least one increase in serum calcium, and 40 patients had an increase in parathyroid hormone (PTH). Color Doppler ultrasound, CT and 99mTc-MIBI joint examination of the accuracy rate of 100%, both underwent surgery and pathology confirmed. Postoperative patients with serum calcium, PTH decreased significantly, the symptoms improved. Conclusion Early detection of blood PTH, B ultrasound and 99mTc-MIBI is of great significance in improving the diagnostic rate of PHPT and the quality of life of patients.