| Objective To evaluate the clinical value of color ultrasound combined with 99 mTc-MIBI bitime-phase imaging in the surgical treatment of secondary hyperparathyroidism.Methods Retrospective analysis on January 1,2015 to December 31,2020 in shihezi university medical school first affiliated hospital during gastrointestinal thyroid surgery surgical treatment of 50 cases of patients with secondary hyperparathyroidism,50 cases strictly follow into the exclusion standard screening,unified accept parathyroid cut + forearm completely autologous transplantation,The parathyroid tissue was routinely sent to the hospital for examination,and the results of postoperative examination were regarded as the gold standard.The sensitivity and accuracy of high-frequency color ultrasound,99 mTc-MIBI dual-time imaging and high-frequency color ultrasound combined with 99 mTc-MIBI dual-time imaging were statistically analyzed,and the differences and significance among them were analyzed.The preoperative and postoperative clinical symptoms of all patients were statistically analyzed and whether there was any difference between them.The results of serum parathyroid hormone,calcium,phosphorus and other laboratory tests before,1 day after and 7 days after surgery were statistically analyzed.Postoperative calcium supplementation was routine,and vital signs such as respiration,body temperature,voice and blood pressure were monitored,as well as blood calcium and drainage volume in order to calculate the incidence of complications in patients.The laboratory examination data and clinical symptoms of the patients 1 month,3 months and 6 months after surgery were counted to calculate the postoperative recurrence rate of the patients.Results The sensitivity,accuracy,false positive rate and false negative rate of 99 m TC-MIBI bitime-phase imaging and high-frequency color ultrasound in the diagnosis of secondary hyperparathyroidism were 84.57%,86.01%,0.00%,15.43%,and 76.57%,72.54%,66.67%,23.43%,respectively.The sensitivity,accuracy,false positive rate and false negative rate of high-frequency color ultrasound combined with 99 mTc-MIBI were 100.00%,97.93%,22.22% and 0.00%,respectively.The accuracy and sensitivity of high-frequency color ultrasound combined with 99 mTc-MIBI in the diagnosis of secondary hyperparathyroidism were higher than those of high-frequency color ultrasound,and the difference was statistically significant(P < 0.05).The accuracy and sensitivity of high-frequency color ultrasound combined with 99 mTc-MIBI were higher than those of 99 mTc-MIBI.The difference was statistically significant(P < 0.05).Among the 50 patients,41 patients had pruritus symptoms before surgery,and the symptoms were significantly relieved 7 days after surgery(P<0.05),the difference was statistically significant;pruritus was still significantly improved 3 months after surgery compared with that before surgery(P<0.05),the difference was statistically significant.Thirty-seven patients had osteoarthralgia before surgery,which was significantly relieved 7 days after surgery(P<0.05),and was still significantly improved 3 months after surgery(P<0.05),the difference was statistically significant.All the laboratory indicators were improved after the operation,and the success rate of the operation was 100%.The results of parathyroid hormone,blood phosphorus,blood calcium and other laboratory examinations 1 and 7 days after surgical treatment were all decreased compared with those before surgery,the difference was statistically significant(P < 0.05),indicating that the postoperative laboratory examination of the patient had a significant outcome.Two patients developed convulsion symptoms after the operation,and the convulsion symptoms disappeared after the increase of calcium intake.One patient developed hoarseness,which improved half a month later.It was considered that there might be slight injury or inflammatory stimulation.One patient developed incision infection,and the infection symptoms were improved after repeated dressing changes,and the incidence of postoperative complications was 8.00%.When the patient came to the hospital for review on the 6th month after the operation,two patients developed skin itching symptoms,and the parathyroid hormone was increased in the review.The recurrence rate after operation was 4.00%.Conclusion1.Preoperative positioning by color ultrasound combined with 99 mTc-MIBI dual-phase imaging can significantly improve the detection rate of parathyroid tissue.2.Preoperative positioning was performed by color ultrasound combined with 99 mTc-MIBI dual-phase imaging,and the success rate of the operation was 100%.3.After total parathyroidectomy +forearm transplantation,skin itching,bone and joint pain and other systemic symptoms were relieved,but there were still some patients with short-term recurrence after surgery. |
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