Diagnosis And Treatment Of Primary Hyperparathyroidism In49Cases

Objective:To explore the diagnosis, clinical manifestations and surgical treatment of primary hyperparathyroidism(PHPT).Methods:The clinical data of31patients with PHPT treated in our hospital in10years were reviewed and analyzed. Diagnosis relied on serology,imaging,99mTc-MIBI and clinical manifestations. Patients were given surgical(10cases) and non-surgical(21cases) treatment according to the different conditions.Results:1. Among31patients,25suffered kidney diseases,one kidney diseases and the other5bone and kidney disease.2. Their parathyroid hormone and calcium were increased to various degrees. The accuracyrates of level diagnosis of Color Doppler ultrasound, CT or MRI, and99mTc-MIBI were80.77%,83.33%, and93.75%respectively.3.10out of31patients got surgical treatment, of whom9got parathyroid adenoma resection (unilateral neck exploration), the other one got parathyroid tumor exploratory surgery (bilateral exploration). All of10were cured without recurrence.4. On the other hand, the other21patients got non-surgical treatment, of whom14were alleviated,5deteriorated, and2died.Conclusion:1. The main clinical manifestations Of PHPT are pains in joint, spontaneous fractures and renal colic. Moreover they can also involve the gastrointestinal, cardiovascular and nervous system.2. The rise in serum calcium and PTH may serve as the basis of qualitative diagnosis of PHPT.3. High-resolution ultrasonography and99mTc-MIBI should be used as the optimal methods of PHPT diagnosis. The combined examination can significantly improve the diagnostic accuracy rates.4. The surgery is effective measures for the treatment of PHPT. If the symptomatic patients of PHPT are confirmed without contraindications, they should be treated surgically. Those who can not undergo surgery, should be regularly reviewed for serum calcium and PTH.5. For the targeted PHPT patients, the line of parathyroid adenoma resection is a safe, simple,effective surgery. For those whose position of tumor are not clear, the patients should take the parathyroidexploratory surgery.6. For Patients with calcium calcium>3.8mmol/L, diagnosis of parathyroid crisis should be considered, so that it may cause enough attention to do the rescue measures and early surgery.