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目的探讨原发性甲状旁腺机能亢进症(primary hyperparathyroidism,PHPT)的早期诊断与合理治疗。方法对近10年来两院收治的23例PHPT患者的临床资料进行回顾性分析。结果女15例,男8例;年龄16～64岁,患者临床表现多样,病程迁延,术前均采用颈部彩超+颈部增强CT或MRI检查+血钙+血PTH检查的综合分析诊断模式。21例行单侧甲状旁腺探查术,2例行双侧甲状旁腺探查术,22例术后确诊为PHPT并治愈,1例永久性甲状旁腺机能减退。结论对可疑PHPT患者可采用颈部彩超+颈部增强CT或MRI检查+血钙+血PTH检查的综合分析诊断模式可帮助早期诊断。单侧甲状旁腺探查术是PHPT有效的治疗方法。
Objective To investigate the early diagnosis and rational treatment of primary hyperparathyroidism (PHPT). Methods The clinical data of 23 patients with PHPT admitted in two hospitals in the recent 10 years were retrospectively analyzed. Results There were 15 females and 8 males, aged from 16 to 64 years old. The clinical manifestations were varied and the course of disease was prolonged. Preoperative diagnosis was performed by using color Doppler ultrasound, neck enhanced CT or MRI examination, blood calcium and blood PTH examination . 21 cases of unilateral parathyroid exploration, 2 cases of bilateral parathyroid exploration, 22 cases were diagnosed as PHPT and cured, 1 case of permanent parathyroid dysfunction. Conclusions The comprehensive diagnostic model for suspected PHPT in patients with cervical ultrasonography, neck enhanced CT or MRI and calcium + blood PTH may be helpful for early diagnosis. Unilateral parathyroidectomy is an effective treatment for PHPT.