Meta Analysis And Follow-up Study On The Prognosis Of Surgical Treatment Of Secondary Hyperparathyroidism

Objective: To evaluate the effectiveness of surgical treatment for ESRD patients with SHPT to provide clinical basis.Therefore,Meta analysis was used to compare the safety and efficacy of TPTX and TPTX + AT in the treatment of SHPT.Through the follow-up study of PTX patients in our hospital,we compared the curative effect of PTX patients with different surgical methods.Methods :Through searching databases such as PubMed,Web of Science,CNKI,Wanfang,VIP,Superstar and other databases,the search time was from the database to October 2016,at the same time,the related literatures were retrieved and included in the randomized controlled study and cohort study of PTX in the treatment of SHPT patients.The quality of the literature was evaluated and Meta-analysis of the data was performed using RevMan 5.3 software.ethod.52 patients with PTX of SHPT in our hospital were followed up,and the blood calcium,phosphorus,PTH and postoperative symptoms,complications,recurrence,death and cardiovascular events were collected before and after the operation.Results:A total of 402 articles were retrieved in Meta-analysis and eventually 9 were included in the study,including 223 in the TPTX group and 690 in the TPTX + AT group.Comparisons were made between the two groups in terms of symptom improvement,persistent hyperparathyroidism,and all-cause mortality There was no significant difference between the two groups.The recurrence rates of the two groups were respectively: TPTX + AT: 11.81%,TPTX: 2.24%,the difference between the two groups was statistically significant(P <0.00001)The recurrence rate was lower after surgery.There was statistically significant difference in the need for reoperation between the two surgical procedures.The rate of reoperation required by TPTX + AT was higher(3.73%).Conclusion:Meta analysis and clinical follow-up studies show that PTX is an effective means of treatment of SHPT,postoperative patients significantly improved clinical symptoms.TPTX treatment of SHPT recurrence andreoperation than the incidence of TPTX + AT low in the end point of cardiovascular death compared to the two surgical methods there was no significant difference.