A Clinical Analysis Of 35 Cases Of Sporadic Parathyroidadenoma

Objective:To discuss surgical diagnosis of sporadic parathyroid adenoma and to analyze the surgical treatment efficacy.Methods:A total of 35 cases of parathyroid adenoma patients of Sir Run Run Shaw Hospital from May 2011 to December 2013 were collected in this assay. Cases excluding from secondary hyperparathyroidism and familial parathyroid adenoma all went through surgery, and were all confirmed by pathology diagnosis. After surgery, patients all went postoperative follow-up to two years. Clinical data of patients were collected before and 2 hours,1 day,2 days,3 days,2 weeks,3 months,6 months,1 year,1.5 years and 2 years postoperatively. All data were processed and analyzed by SPSS 19.0 software. The clinical symptoms, the diagnosis value of different imaging examinations and the efficacy ofsurgical treatmentwere summarized through analysis.Results:Comparing the initial reasons driving patients to go see doctors, the finding of masses in parathyroid gland by ultrasonic examination reached a proportion of 60%, 17.1% patients felt fatigue,14.3% patients had urinary stones and the other 8.6% patients had other symptoms. The sensitivity of various preoperative examination methods were as follows:ultrasound 91.4%(33/35), MIBI parathyroid scintigraphy 96.9%(31/32).The Spearman correlation coefficient between preoperative serum PTH levels and tumor sizewas 0.392, P value<0.05, which was considered significant. The Spearman correlation coefficient between preoperative serum PTH levels and calcium concentrationwas 0.642, P value<0.05, which was considered significant. The Spearman correlation coefficient between preoperative serum PTH levels and ALP levelswas 0.439, P value<0.05, which was considered significant. Comparingmulti-point of serum calcium concentration pre-and postoperatively by Kruskal-Wallis rank sum test, the result showed x2=116.933, P<0.05, there were significant differences. Pared-Wilcoxon rank sum test showed that there were significant difference of patient’s serum calcium concentration between pre-and postoperative surgery (one day after), u = 561.00, P<0.05.Comparingmulti-point of serum PTH levels pre-and postoperatively by Kruskal-Wallis rank sum test, the result showed x2=117.788, P<0.05, there were significant differences. Pared-Wilcoxon rank sum test showed that there were significant difference of patient’s serum PTH levels between pre-and postoperative surgery (one day after),u=528.00, P<0.05.Parathyroid hormone levels of all patients declined after surgery, and 51.5%(17/33) of patients had their serum calcium concentration back to normal. All patients had no evidence of recurrence, the efficiency of surgical treatment was 100%.Conclusion:The clinical symptoms of parathyroid adenoma patients are insidious. To detect the serum levels of parathyroid hormone and calciumcontribute to the early diagnosis, and preoperative ultrasound as well as99Tcm-methoxy isobutyl lisonitrile (MIBI) parathyroid scintigraphyhelps locate thetumor, wherein the MIBI parathyroid imaging has a higher sensitivity. Surgeryis the most recommended treatment of primary parathyroid adenoma in consideration of its exact effect of the rapid reduction of serum parathyroid hormone and calcium concentration as long as the low risk of short-term recurrence...