微创医学

【摘要】目的比较微波消融(MWA)和甲状旁腺切除术（PTX）治疗继发性甲状旁腺功能亢进(SHPT)的临床疗效。方法76例SHPT患者，根据不同治疗方式分为MWA组(40例)和PTX组(36例)。对两组患者围术期及术后1个月、3个月、6个月的相关数据进行比较。结果两组患者手术均顺利，无术中及围术期死亡病例。与术前比较，两组术后PTH、血钙及血磷值均明显下降，差异有统计学意义（P＜0.05）；术后1个月、3个月、6个月，两组PTH、血钙及血磷值比较，差异无统计学意义(P＞0.05)。MWA组术中出血量明显少于PTX组，差异有统计学意义（P＜0.05)。MWA组术后下床时间、住院时间均明显短于PTX组，两组比较，差异有统计学意义(P＜0.05)。两组患者术后并发症发生率、复发率比较，差异无统计学意义（P＞0.05）。结论微波消融治疗继发性甲状旁腺功能亢进可以达到甲状旁腺切除术相似的疗效，并且创伤小，恢复快，是一种安全有效的微创治疗方法。

【Abstract】 ObjectiveTo compare the clinical efficacy between microwave ablation(MWA) and parathyroidectomy(PTX) for treating secondary hyperparathyroidism (SHPT). MethodsSeventysix patients with SHPT were divided into MWA group(n=40) and PTX group(n=36) according to the therapeutic method. Clinical data were compared between the two groups during perioperation, at 1, 3 and 6 months after operation. ResultsThe operations of both groups were completed successfully. No introperative and perioperative death occurred. In both groups, the postoperative levels of PTH, blood calcium and phosphorus significantly decreased compared with the preoperative levels（P＜0.05）. At 1, 3 and 6 months after operation,there were no significant differences in the levels of PTH, blood calcium and phosphorus between the two groups (P＞0.05). The intraoperative blood loss in the MWA group was less than that in the PTX group（P＜0.05).The time of ambulation and hospital stay in the MWA group were shorter than those in the PTX group（P＜0.05).There were no significant differences in the incident rate of postoperative complication and recurrence rate between the two groups（P＞0.05）. ConclusionFor the treatment of SHPT, MWA can obtain a similar efficacy as PTX, has less trauma and faster recovery. And it is a safe, effective and minimally invasive therapeutic method.