Clinical Observation And Analysis Of Curative Effect Of SHPT Treated With Cinacalcet And Operation

Objective: A retrospective analysis of the clinical efficacy of xenacarcel and surgery for Secondary Hyperparathyroidism(SHPT)in patients with Maintenance Hemodialysis(MHD).Thus,it can better guide the clinical treatment of SHPT,improve the mineral and bone metabolism disorders of MHD patients,and improve the quality of life and long-term survival rate of patients.Methods: Clinical information of SHPT patients who received MHD treatment for more than half a year in Blood Purification Center of Yijishan Hospital,Wannan Medical College from September 2015 to September 2020 was collected and divided into two groups according to different treatment methods: group I(oral cinacalcet group): 40 cases and group II(surgical group): 30 cases.Both groups received conventional medical treatment(All patients were given oral antihypertensive drugs to control blood pressure according to their own conditions,and erythropoietin injection was given to improve renal anemia according to the degree of anemia.Meanwhile,balanced nutrition and dietary adjustment were paid attention to,and the intake of phosphorus in diet was controlled).Comparison: 1.Total clinical effective rate in the two groups of SHPT patients;2.Blood calcium,blood phosphorus and serum i PTH(Intact Parathyroid Hormone,i PTH)levels in 2 groups before treatment and at 4,12 and 24 weeks after treatment;3.Improvement of clinical symptoms of patients in both groups;4.Adverse reactions of patients in both groups;5.Economic benefits of treatment for patients in the two groups.Results: The blood calcium level,blood phosphorus level,calcium phosphorus product level and serum i PTH level of patients in group I(oral cinacalcet group)were significantly decreased compared with those before drug treatment(P<0.05),and the total effective rate(marked effect +effective rate)reached 80%,and the relevant clinical symptoms were significantly improved.The serum calcium level,blood phosphorus level,calcium phosphorus product level and serum i PTH level of patients in group II(surgical group)were significantly decreased compared with those before surgery(P<0.05),and the total effective rate(significant effect + effective rate)reached96.67%,which was higher than that in the oral cinacalcet group(P<0.05).The relevant clinical symptoms were significantly improved.Compared with the two groups,the blood calcium level,blood phosphorus level,calcium phosphorus product level and serum i PTH level in the surgery group were lower than those in the oral cinacalcet group(P<0.05).At 24 weeks of treatment,the overall economic benefit of the surgery group was better than that of the oral cinacalcet group.Conclusion: Both oral treatment and surgical treatment can improve the SHPT condition of MHD patients to a certain extent.At the same time,compared with the oral treatment group,surgical treatment showed significant advantages in reducing serum calcium,blood phosphorus,calcium phosphorus product and serum i PTH levels,and its total clinical effective rate,improvement degree of clinical symptoms and overall cost were also better than the oral treatment group.