Clinical Observation And Research Of Secondary Hyperparathyroidism Surgical Treatment

Purpose:To investigate curative effect and clinical usefulness of totalparathyroidectomy and total parathyroidectomy with autotransplantationfor renal secondary hyperparathyroidism and investigate the usefulnessfor localization of parathyroid nodes by B-ultrasonic before surgery.Materials and Methods: From March2009to October2013,42patientssuffered from renal secondary hyperparathyroidism underwentparathyroidectomy (18for total parathyroidectomy and24for totalparathyroidectomy with autotransplantation).Their serum iPTH．Calciumand phosphorus in the preoperative，postoperative and follow-up periodswere collected and compared． Their symptoms， postoperativecomplications and relapse were observed and analyzed to determine theefficacy of parathyroidectomy.Localization of parathyroid nodes byB-ultrasonicis studied for coincidence according to the outcome aftersurgery.Results:The postoperative iPTH，serum phosphorus and serunl calciumlowered significantly than those at preoperative period,which also showstatistics significance(P<0.05).Descending value of iPTH at same preoperative period,there is no statistics significance between totalparathyroidectomy group and total parathyroidectomy withautotransplantation group(p>0.05).Among42patients,133Parathyroidnodules are inspected by B-ultrasonicis at preoperative period and163parathyroid nodules are removed during the surgery.The detection ratereach81.60%.Conclusion:Both total parathyroidectomy and total parathyroidectomywith autotransplantation are efctive to treat severe renal secondaryhyperparathyroidism and they have similar curative effect in recent daysafter surgery. B-ultrasonic is feasible way for localizing parathyroidnodes before surgey.