| Objective: To studying the effect of total parathyroidectomy plus forearm transplantation on bone pain in patients with secondary hyperparathyroidism,and discussing its related factors,the clinical application can be guided.Methods:From October 2015 to October 2020,64 patients with secondary hyperparathyroidism who underwent total parathyroidectomy and forearm transplantation in the Department of Gastrointestinal and Thyroid Surgery of the First Affiliated Hospital of Shihezi University were collected.Strictly collect relevant patient data:(1)General information: basic patient information(height,age,weight,gender,whether drinking alcohol,smoking,hypertension,diabetes,etc.);(2)serum indicators: patients In line with the requirements of total parathyroidectomy plus forearm transplantation,the patient’s serum indicators(serum calcium content,serum phosphorus content,alkaline phosphatase,thyroid gland)were collected before,3 years after taking the drug,and at various time points during the perioperative period.Parathyroid hormone)and the pathological type of postoperative parathyroid glands.(3)Before taking the medicine,3 years after taking the medicine,before the operation,3 days after the operation,8 weeks after the operation,and 12 weeks after the operation,the patient’s pain VAS score.To summarize and explore the effects of total parathyroidectomy plus forearm transplantation on bone pain in patients with secondary hyperparathyroidism.Results:After collecting statistics,the average age of 64 patients was(51±10)years old,including 32 male and female patients.When the patients were treated with drugs,serum phosphorus content,serum calcium content,and parathyroid glands were taken before and 3years after taking the drug.The hormone,alkaline phosphatase,and bone pain scores were statistically analyzed.The results showed that there was no statistically significant difference before and 3 years after taking the medicine(P>0.05);the collected patients were collected before operation,3 days after operation,and 8 days after operation.According to the analysis of the bone pain score scale for the week and 12 weeks after the operation,the bone pain after the operation was significantly lower than that before the operation(P<0.01),and the symptoms of the bone pain after the operation were significantly reduced;compared with the patients before the operation,3 days after the operation and 8 weeks after the operation,12 weeks after surgery,serum phosphorus content,serum calcium content,parathyroid hormone,alkaline phosphatase are all reduced(P<0.05);for parathyroid hormone,alkaline phosphatase,serum calcium content,Serum phosphorus content was analyzed before surgery,3 days after surgery,8 weeks after surgery,and 12 weeks after surgery.The correlation with bone pain was analyzed.Parathyroid hormone,serum calcium content,alkaline phosphatase,serum Phosphorus content and pathological type may affect the curative effect of postoperative bone pain in patients undergoing surgical treatment,while smoking,drinking,gender,weight,etc.have no significance in the curative effect of postoperative bone pain.In this study,62 cases(96.90%)were successful in one-time operation,and 2 cases(3.10%)had 2 operations.There were 4cases(6.2%)of patients with transient recurrent laryngeal nerve injury,of which 2 cases(3.10%)had hoarseness,and the other 2 cases(3.10%)choked on drinking water.The condition of the patients improved spontaneously without special treatment.48 cases(76.20%)of patients had postoperative hypocalcemia,and their condition was controlled after active calcium supplementation.There were 2 cases(3.10%)with persistent hyperparathyroidism after operation.No incision infection,asphyxia,or hypothyroidism occurred in the patients.Conclusion:1)For patients with secondary hyperparathyroidism,total parathyroidectomy plus forearm transplantation can significantly improve the symptoms of bone pain.2)There are differences in the curative effect of bone pain in patients with different pathological types,and the relief of postoperative bone pain in patients with nodular type is better than that of diffuse type.3)Parathyroid hormone,alkaline phosphatase,serum calcium content,and serum phosphorus content may affect the curative effect of postoperative bone pain,while smoking,drinking,gender,etc.have no statistical significance in the curative effect of postoperative bone pain. |
PDF Full Text Request