ABSTRACT
Objective:Comparative analysis of total parathyroidectomy (total parathyroidectomy, TPTX) and total parathyroidectomy with autoransplantation (total parathyroidectomy with autoransplantation, TPTX+ AT) for the treatment of uremia secondary hyperparathyroidism Clinical efficacy.Methods:A total of 82 cases of SHPT treated with TPTX or TPTX + AT in First Affiliated Hospital of Chengdu Medical College from June 2015 to July 2019 were collected According to the operation methods, 82 cases were devided into TPTX group and TPTX+ AT group.There were 34 patients in the TPTX group, 17 males and 17 females, with an average age of (45.97±8.96) years, and 48 patients in the TPTX+ AT group, 21 males and 27 females, with an average age of (49.12±7.30) years. SPSS 20.0 software was used for statistical analysis. The measurement data conforming to normal distribution were represented by ( Mean± SD), and the comparison between groups was performed by t test. The data not conforming to normal distribution were represented by quaternary M( P25, P75), and the comparison between groups was performed by non-parametric test. Enumeration data were expressed as cases (%), and comparison was performed by χ2 test. The postoperative complications, postoperative efficacy and recurrence rate were compared between the two procedures. Results:Both TPTX and TPTX+ AT had a low incidence of complications after SHPT, and both of them could effectively relieve symptoms such as bone pain, skin itching and subcutaneous soft tissue calcification.After 1 year of follow-up, both of the two surgical methods can effectively reduce blood calcium (TPTX group: t= 14.522, P<0.05; TPTX+ AT group: t=13.704, P<0.05), blood phosphorus (TPTX group: t=35.022, P<0.05; TPTX+ AT group: t=42.303, P<0.05) and iPTH(TPTX group: t= 20.166, P<0.05; TPTX+ AT group: t= 23.976, P<0.05), but the reduction of iPTH in TPTX group was more effective than that in TPTX+ AT group ( t=-3.416, P<0.05). Conclusion:Both TPTX and TPTX+ AT can effectively treat SHPT, and have high safety and can be used as an alternative for SHPT treatment.