魏莹,彭丽丽,赵朕龙,曹晓静,伍洁,李妍,于明安.超声引导下微波消融治疗原发性甲状旁腺功能亢进症的效果[J].中国介入影像与治疗学,2021,18(10):587-591
超声引导下微波消融治疗原发性甲状旁腺功能亢进症的效果
Ultrasound-guided microwave ablation for primary hyperparathyroidism
投稿时间:2021-05-20  修订日期:2021-08-20
DOI:10.13929/j.issn.1672-8475.2021.10.003
中文关键词:  甲状旁腺功能亢进症  超声检查  微波消融
英文关键词:hyperparathyroidism  ultrasonography  microwave ablation
基金项目:首都临床特色应用研究项目(Z181100001718135)、中日友好医院院级科研基金(2019-2-HL-4)。
作者单位E-mail
魏莹 中日友好医院介入医学科, 北京 100029  
彭丽丽 中日友好医院介入医学科, 北京 100029  
赵朕龙 中日友好医院介入医学科, 北京 100029  
曹晓静 中日友好医院介入医学科, 北京 100029  
伍洁 中日友好医院介入医学科, 北京 100029  
李妍 中日友好医院介入医学科, 北京 100029  
于明安 中日友好医院介入医学科, 北京 100029 yma301@163.com 
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中文摘要:
      目的 观察超声引导下微波消融(MWA)治疗原发性甲状旁腺功能亢进症(PHPT)的有效性及安全性。方法 回顾性分析96例接受超声引导下MWA及术后规律随访的PHPT患者。术后6个月评价治疗效果,计算病灶体积缩小率。对比术前与术后6个月血清全段甲状旁腺激素(iPTH)、钙及磷,记录不良反应。结果 96例患者共109个PHPT病灶,均获完全消融。术后随访7~43个月,中位随访时间18.5个月。术后6个月85例血清iPTH及钙在正常值范围内,治愈率为88.54%(85/96);9例(9/96,9.38%)持续性PHPT,2例(2/96,2.08%)复发性PHPT。术后6个月血清iPTH、钙较术前降低,磷较术前升高(P均<0.01)。术后6个月病灶体积缩小率为74.20%。1例术中出现局部血肿,经按压局部后止血;5例术后出现声音嘶哑,经对症处理后6个月内均恢复;24例出现一过性甲状旁腺功能减退,13例手部麻木,3例一过性低钙血症,1例头痛,均未经特殊处理后好转。结论 超声引导下MWA治疗PHPT安全、有效。
英文摘要:
      Objective To observe the efficacy and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). Methods Ninety-six PHPT patients who underwent ultrasound-guided MWA and regularly followed-up after treatment were retrospectively analyzed. The therapeutic effect was evaluated 6 months after ablation, and the volume reduction rate (VRR) was calculated. The serum intact parathyroid hormone (iPTH), calcium and phosphorus were compared before and 6 months after MWA. The complications of MWA were recorded. Results A total of 109 lesions in 96 PHPT patients were completely ablated. The follow-up time was 7-43 months, and the median follow-up time was 18.5 months. Six months after MWA, the serum iPTH and calcium levels of 85 patients were within normal ranges, and the cure rate was 88.54% (85/96). There were 9 cases (9/96, 9.38%) of persistent PHPT and 2 cases (2/96, 2.08%) of recurrent PHPT. The serum iPTH, calcium and phosphorus levels were improved 6 months after MWA (all P<0.01). Six months later, the volume reduction rate (VRR) of the ablation zone was 74.20%. Local hematoma occurred in 1 patient during ablation, and bleeding stopped after local compression. Hoarseness occurred in 5 cases after ablation, but recovered within 6 months after symptomatic treatment. There were 24 cases of transient hypoparathyroidism, 13 cases of hand numbness, 3 cases of transient hypocalcemia and 1 case of headache, all recovered spontaneously without special treatments. Conclusion MWA was safe and effective for treatment of PHPT.
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