Comparison of two surgical procedures for secondary hyperparathyroidism

doi:10.3877/cma.j.issn.1674-3946.2021.06.027

Abstract

Abstract:

Objective

Objective to compare the short-term efficacy of ultrasound-guided microwave ablation and parathyroidectomy in the treatment of secondary hyperparathyroidism.

Methods

The data of 120 patients with secondary hyperparathyroidism from January 2015 to December 2018 were retrospectively analyzed. Among them, 60 patients were treated with ultrasound-guided microwave ablation (ablation group) and 60 patients were treated with traditional parathyroidectomy (operation group). SPSS 23.0 analysis software was used to compare the perioperative indicators, postoperative pain score, serum PTH, blood calcium, blood phosphorus and other measurement data at 1 week, 1 month, 1year after operation (±s), independent sample t test; the treatment effect, recurrence rate and related complications of the two groups were analyzed by χ² test; The treatment effect was tested by rank sum test.The difference was statistically significant (P<0.05).

Results

The operation time, intraoperative blood loss, postoperative pain score and hospitalization time in the microwave ablation group were less than those in the operation group (P<0.05). The incidence of hoarseness, postoperative bleeding, tracheal injury, hypocalcemia and other complications in the microwave ablation group were lower than those in the operation group 1 week and 1 year after treatment (P<0.05). 1 year after treatment, the recurrence rate, serum PTH and phosphate water in the ablation group were lower than those in the operation group (P<0.05).

Conclusion

The short-term effects of microwave ablation in the treatment of secondary hyperparathyroidism are better than those of traditional parathyroidectomy, with lower recurrence rate.

Key words: Hyperparathyroidism, secondary, Thyroidectomy, Ultrasonography, Microwave ablation

Lei Zhao. Comparison of two surgical procedures for secondary hyperparathyroidism[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(06): 683-685.

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References 20

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组别	例	年龄(岁)	男/女	BMI(kg/m²)	原发病因
组别	例	年龄(岁)	男/女	BMI(kg/m²)	a/b/c
消融组	60	52.3±8.6	33/27	24.8±5.9	45/12/3
手术组	60	51.8±8.8	31/29	24.3±5.7	41/15/4
t/χ²值		0.378	0.134	0.889	0.828
P值		0.228	0.288	0.316	0.765

组别	例	年龄(岁)	男/女	BMI(kg/m²)	原发病因
组别	例	年龄(岁)	男/女	BMI(kg/m²)	a/b/c
消融组	60	52.3±8.6	33/27	24.8±5.9	45/12/3
手术组	60	51.8±8.8	31/29	24.3±5.7	41/15/4
t/χ²值		0.378	0.134	0.889	0.828
P值		0.228	0.288	0.316	0.765

组别	例	手术时间(min)	术中出血量(ml)	疼痛评分	住院时间(d)
消融组	60	45.2±8.9	5.9±1.7	1.6±0.9	2.7±0.9
手术组	60	78.8±12.5	38.6±5.2	5.2±3.8	5.3±1.6
t值		-13.298	-26.213	-19.512	25.278
P值		<0.001	<0.001	<0.001	<0.001

组别	例	手术时间(min)	术中出血量(ml)	疼痛评分	住院时间(d)
消融组	60	45.2±8.9	5.9±1.7	1.6±0.9	2.7±0.9
手术组	60	78.8±12.5	38.6±5.2	5.2±3.8	5.3±1.6
t值		-13.298	-26.213	-19.512	25.278
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	声音嘶哑	术后出血	气管损伤	低钙血症	其它
消融组	60	1(1.7)	1(1.7)	0	2(3.3)	2(3.3)
手术组	60	4(6.67)	6(10.0)	3(5.0)	8(13.3)	7(11.7)
χ²值		1.879	3.793	3.076	3.927	3.003
P值		0.049	0.023	0.028	0.026	0.041

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