甲状旁腺全消融与部分消融对继发甲状旁腺功能亢进疗效的观察.pdf

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1、-——498—-——介入放射学杂志2015年6月第24卷第6期JInterventRadiol2015，Vo1．24，No．6·非血管介人Non．vascularintervention·甲状旁腺全消融与部分消融对继发甲状旁腺功能亢进疗效的观察余力，勾常龙，李芳，冯芝娅【摘要】目的比较甲状旁腺全消融和甲状旁腺部分消融的2种消融方式对超声引导下经皮微波消融(MWA)或射频消融(RFA)治疗继发性甲状旁腺功能亢进(SHirr)疗效的影响方法回顾分析2012年l0月至2013年9月尿毒症SHfrr患者行MWA或RFA治疗且随访9个月以上26例患者，比较2种消融方式的疗效及对血

2、钙水平的影响。结果从甲状旁腺激素(PTH)水平分析：全消融组术后H水平较术前逐渐下降并保持正常水平，且无复发；部分消融组术后PTH水平先下降并于术后9个月出现反弹，并高于全消融组和正常水平(P<0．05)，15例中有5例复发。从血钙水平分析：2种消融术后较术前血钙水平均下降，但部分消融组术后3、9个月血钙水平高于全消融组(P<0．05)，l1例全消融组中4例发生低钙血症。结论全消融方式术后不易复发但有发生低钙血症风险，部分消融方式术后易复发但血钙控制良好，从控制血钙水平考虑部分消融可能更适合临床需要。【关键词】继发性甲状旁腺功能亢进；消融技术；低钙血症；疗效中图分类号：

3、R582．1文献标志码：A文章编号：1008—794X(2015)．06—0498．04Thetherapeuticeffectoffullablationandpartialablationofparathyroidforsecondaryhyperparathyroidism：acomparisonstudyYULi，GOUChang—long，L1fang，FENGZhi-)，DepartmentofUltrasound，TaizhouHospital，Taizhou，ZhejiaugProvince317000，ChinaCorrespondingauthor：

4、YULi，E—mail：zjyuli@126．com【Abstract】0bjectiveToinvestigatethecurativeeffectofcompleteablationandpartialablationofparathyroidforsecondaryhyperparathyroidism(SHFF)byusingultrasound—guidedradiofrequencyablation(RFA)ormicrowaveablation(MWA)．MethodsAtotalof26patientswithhyperparathyroidismsec

5、ondarytouremia，whowereadmittedtoauthors’hospitalduringtheperiodfromOctober2012toSeptember2013toreceivefullablation(n=l1)orpartialablation(n=15)ofparathyroidwithMWAorRFAandwerefollowedupforatleast9monthsafterthetreatment，wereincludedinthisstudy．Theclinicaldatawereretrospectivelyanalyzed．T

6、hetherapeuticeffectandtheinfluenceofMWAandRFAontheserumcalciumlevelswerecomparedbetweenthetwoablationmethods．ResultsAnalysisofparathyroidhormone(PTH)levelsindicatedthatinfullablationgroupthepostoperativePTHlevelwasgraduallydecreased．whencomparedwiththepreoperativelevel，untilitbecamestabl

7、eandmaintainedthenormallevel，andnorecu~encewasobserved；inpartialablationgroupthepostoperativePTHlevelwasdecreasedfirstwithasubsequentreboundaboutninemonthsafterthetreatment，andthisFFHlevelwashigherthanthePTHleveloffullablationgroupaswellashigherthanthenormallevel(P<0．05)．