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目的探讨超声引导下无水乙醇注射疗法(PEIT)治疗难治性继发性甲状旁腺功能亢进(SHPT)的疗效和安全性。方法对16例SHPT经内科治疗不理想的尿毒症患者进行PEIT治疗,比较术前术后血清甲状旁腺素(PTH)水平和腺体内部血流信号,并统计并发症发生例数和情况。结果 16例患者经PEIT治疗后,血清PTH均明显下降,腺体内部血流信号明显减少;疗效满意56.3%(9/16),明显缓解25.0%(4/16),缓解12.5%(2/16),不理想6.3%(1/16),有效率为81.3%(13/16)。并发症7例,中度以上疼痛7例,其中出血2例,声音嘶哑1例。结论应用合理的PEIT技术治疗难治性SHPT,创伤小,效果佳,安全性高;腺体内血流信号的变化和血清PTH是评价疗效的重要指标。
Objective To investigate the efficacy and safety of ultrasound-guided percutaneous ethanol injection (PEIT) in the treatment of refractory secondary hyperparathyroidism (SHPT). Methods Sixteen cases of SHPT were treated with PEIT. The serum parathyroid hormone (PTH) levels and glandular blood flow were compared before and after operation. The incidence and incidence of complications were analyzed. Results After treatment with PEIT, the serum PTH levels of 16 patients were significantly decreased, and the signal of blood flow inside the gland was significantly reduced. The response rate was 56.3% (9/16), significantly relieved 25.0% (4/16) and 12.5% (2 / 16), unsatisfactory 6.3% (1/16), and effective rate was 81.3% (13/16). Complication in 7 cases, moderate and severe pain in 7 cases, including 2 cases of bleeding, hoarseness in 1 case. Conclusions The rational PEIT technique is used to treat the refractory SHPT. The trauma is small, the effect is good and the safety is high. The changes of the glandular blood flow signal and serum PTH are important indexes to evaluate the curative effect.