| 霍胜男,魏莹,彭丽丽,李妍,赵朕龙,于明安.超声引导下微波消融治疗异位继发性甲状旁腺功能亢进症[J].中国介入影像与治疗学,2021,18(10):592-595 |
| 超声引导下微波消融治疗异位继发性甲状旁腺功能亢进症 |
| Ultrasound-guided microwave ablation for ectopic secondary hyperparathyroidism |
| 投稿时间：2021-05-20 修订日期：2021-07-26 |
| DOI：10.13929/j.issn.1672-8475.2021.10.004 |
| 中文关键词: 甲状旁腺功能亢进症,继发性 超声检查 微波消融 |
| 英文关键词:hyperparathyroidism, secondary ultrasonography microwave ablation |
| 基金项目:首都临床特色应用研究项目（Z181100001718135）。 |
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| 中文摘要: |
| 目的 观察超声引导下微波消融（MWA）治疗异位继发性甲状旁腺功能亢进症（SHPT）的安全性及有效性。方法 对36例异位SHPT患者行超声引导下MWA治疗。术后定期随访，观察症状改善情况，记录不良反应。检测术前、术后第1天及末次随访时血清全段甲状旁腺激素（iPTH）、钙、磷及碱性磷酸酶（ALP）水平。结果 36例共40枚异位SHPT结节均完全消融。术后第1天血清iPTH、钙、磷均低于术前（P均<0.05）；末次随访时iPTH、磷、ALP均较术前降低（P均<0.01）。术中4例出现短暂轻至中度疼痛，均自行缓解；1例发生血肿，经静脉注射血凝素后出血得到控制。术后1~3天10例出现低钙血症，经补钙治疗后8例血钙恢复正常，2例至随访结束时仍为轻度低钙血症；2例术后声音嘶哑，1~3个月内恢复；1例出现轻度霍纳综合征，未予特殊处理，随访期间症状逐渐改善后消失。结论 超声引导下MWA治疗异位SHPT结节安全、有效。 |
| 英文摘要: |
| Objective To observe the safety and efficacy of ultrasound-guided microwave ablation (MWA) in treatment of ectopic secondary hyperparathyroidism (SHPT). Methods Totally 36 patients with ectopic SHPT underwent ultrasound-guided MWA. Regular follow-up was performed to observe the improvement of symptoms, and the adverse reactions were recorded. The levels of intact parathyroid hormone (iPTH), calcium, phosphorus and alkaline phosphatase (ALP) were detected before treatment, on the first day after treatment and at the last follow-up. Results All 40 ectopic SHPT nodules in 36 SHPT patients were completely ablated. The levels of serum iPTH, calcium and phosphorus on the first day after treatment were lower than those before treatment (all P<0.05). At the last follow-up, iPTH, phosphorus and ALP were all lower than those before treatment (all P<0.01). During MWA, 4 cases experienced transient mild to moderate pain, which relieved spontaneously, while hematoma occurred in 1 case, and the bleeding was controlled after intravenous injection of hemagglutinin. Ten patients developed hypocalcemia 1-3 days after treatment and were treated with calcium supplement, then blood calcium in 8 patients returned to normal, whereas 2 patients still had mild hypocalcemia at the end of follow-up. Two cases had hoarseness and recovered within 1-3 months. One patient developed mild Horner syndrome, and the symptoms improved and disappeared during follow-up without special management. Conclusion Ultrasound-guided MWA was safe and effective in treatment of ectopic SHPT nodules. |
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