455 Cases Of Hyperparathyroidism Patient Records Retrospectively

Objectives:To analysis the clinical manifestations and surgical treatment in patients with hyperparathyroidism.Methods:Retrospective analysis of455patients with hyperparathyroidism in Peking Union Medical College Hospital between Oct1974and Dec2008. There were299women (65.7%) and156men (34.3%), M/F ratio was1:1.92. Mean onset age was40.33±16.61years (5-86years). Design and establish Database to collect data.Results:372cases (81.8%) with skeletal manifestations, most of them (65.8%) presented with ostealgia or arthralgia. The2nd was urinary system,252cases (55.4%)with urinary symptoms, and most of them(36.3%) with nephrolithiasis.27cases (81.8%) presented with peptic ulcer diseases, and9cases (2.0%)with pancreatitis. The sensitivity of elevated serum iCa (93.4%) was better than Ca (73.2%) as the diagnosis method of primary hyperparathyroidism. The sensitivity of BUS and99mTc-MIBI in preoperative localization of the enlarged parathyroid glands was81.1%and84.1%respectively, the overall sensitivity was95.6%by combination of BUS and MIBI. Most cases (86.6%) with abnormal digits X-ray appearing.378cases underwent parathyroidectomy, the cure rate was97.0%.104cases underwent minimally invasive parathyroidectomy, the cure rate was97.1%.318cases (86.4%) with normal parathyroid glands locations, and50cases (13.6%) were ectopic. The pathology of264cases (71.7%) was adenoma,91cases (24.7%) was hyperplasia,11cases (3.0%) was carcinoma, and two cases was parathyroid cyst.257cases (68.0%) presented with hypocalcaemia manifestations, and159cases (66.0%) recovered within7days.Conclusions:The clinical manifestations of Chinese patients with hyperparathyroidism were more severe than foreign country patients. The cure rate was similar between traditional double exploration and minimally invasive parathyroidectomy.