Diagnosis and treatment of primary hyperparathyroidism: 115 cases / 中华内分泌外科杂志

ABSTRACT

Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.