Curative effect of total parathyroidectomy and autogenous transplantation in patients with secondary hyperparathyroidism of hemodialysis
ZHUANG Yixin
SHEN Weixing
ZHOU Weiqing
CUI Hengguan
Abstract：Objective To observe the effects of total parathyroidectomy (tPTX) and autologous transplantation (AT) in the treatment of secondary hyperparathyroidism (SHPT) of hemodialysis and the effect on the recovery of parathyroid function.Methods The clinical data of 52 patients with SHPT of hemodialysis who were treated with PTX and AT in our hospital from June 2014 to May 2016 were collected,and the relief of symptoms was observed.Changes of laboratory parameters such as intact parathyroid hormone (iPTH),blood calcium,serum phosphorus,calcium phosphorus product and alkaline phosphatase (ALP) were monitored.Complications and recurrence were statistically analyzed,and the improvement of quality of life was determined.Results (1) The success rate of surgery in 52 patients with SHPT was 98.08％ (51/52).6 months after surgery,the proportions of patients with itchy skin,joint pain and restless leg syndrome were significantly lower than those before surgery,but there were statistically significant differences only in itchy skin,bone and joint pain (x2 =13.565,x2 =57.671,P ＜0.01).(2) 1 week,1 month,6 months and 12 months after surgery,iPTH,serum phosphorus and calcium phosphorus product decreased significantly (F =12.141,F =6.471,F =8.458,P ＜0.01).The serum calcium showed a transient decrease at 1 week and 1 month after surgery (P ＜ 0.05),and recovered to the level before surgery at 6 months and 12 months after surgery.1 month,6 months and 12 months after surgery,ALP levels decreased,but there were significant differences only after 6 and 12 months after surgery,compared with those before surgery (F =5.788,P ＜0.05).(3) Among the 52 patients,there were 3 cases (5.77％) with transient hoarseness after surgery and 39 cases (75.00％) with hypocalcemia within 1 month after surgery,and there were 2 cases (3.85％) of recurrence during 12 months of follow-up.(4) 3 months,6 months and 12 months after surgery,KDTA scores increased (t =10.581,t =12.138,t =9.845,P ＜ 0.01).Conclusion PTX combined with AT is safe and effectiw in the treatment of SHPT of hemodialysis.The combined treatment can relieve hyperparathyroidism,and improve the quality of life of patients.
Keywords：Secondary hyperparathyroidismHemodialysisThyroidectomyAutogenous transplantation
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1113-1115,1119 )