| Objective:To evaluate the effectiveness of domestic parathyroidectomy in the treatment of secondary hyperparathyroidism in maintenance hemodialysis patients.Which aims to provide a reliable evidence-based medical basis for the best surgical procedure for the development of SHPT in our clinical work.Methods:Wangfang Date,CNKI,CBM,VIP were searched for self-controlled studies related to using parathyroidectomy to treat maintenance hemodialysis patients with secondary hyperparathyroidism.manual retrieval has been published or unpublished literature reported,does not limit the retrieval period.The criteria for inclusion and rejection were identified,the literature was screened,the quality of the included literature was evaluated and the data were extracted,and the data were analyzed by Rev Man 5.3 software.Results: 1.The effect on PTH: the changes of PTH in 9 cases were analyzed in the last 1 week after operation.The results showed that the difference was statistically significant(SMD=5.12,95%CI(3.70,6.55),P<0.00001).8 cases were analyzed in the last 1 month after operation.The results showed that the difference was statistically significant(SMD=5.30,95%CI(3.76,6.85),P<0.00001).7 cases were analyzed in the last 3 months after operation.The results showed that the difference was statistically significant(SMD=4.75,95%CI(3.40,6.10),P<0.00001).10 cases were analyzed in the last 6 months after operation.The results showed that the difference was statistically significant(SMD=3.75,95%CI(2.89,4.61),P<0.00001).5 cases were analyzed in the last 1 year after operation.The results showed that the difference was statistically significant(SMD=3.38,95%CI(3.38,7.73),P<0.00001).2.The effect on Ca:the changes of Ca in 9 cases were analyzed in the last 1 week after operation.The results showed that the difference was statistically significant(WMD=0.68,95%CI(0.61,0.75),P<0.00001).8 cases were analyzed in the last 1 month after operation.The results showed that the difference was statistically significant(WMD=0.47,95%CI(0.28,0.66),P<0.00001).6 cases were analyzed in the last 3 months after operation.The results showed that the difference was statistically significant(WMD=0.49,95%CI(0.35,0.64),P<0.00001).9 cases were analyzed in the last 6 months after operation.The results showed that the difference was statistically significant(WMD=0.38,95%CI(0.26,0.49),P<0.00001).4 cases were analyzed in the last 1 year after operation.The results showed that the difference was statistically significant(WMD=0.31,95%CI(0.24,0.38),P<0.00001).3.The effect on P:the changes of P in 9 cases were analyzed in the last 1 week after operation.The results showed that the difference was statistically significant(WMD=1.05,95%CI(0.84,1.27),P<0.00001).8 cases were analyzed in the last 1 month after operation.the results showed that the difference was statistically significant(WMD=0.94,95%CI(0.71,1.17),P<0.00001).6 cases were analyzed in the last 3 months after operation.the results showed that the difference was statistically significant(WMD=0.94,95%CI(0.76,1.11),P<0.00001).9 cases were analyzed in the last 6 months after operation.The results showed that the difference was statistically significant(WMD=0.79,95%CI(0.63,0.95),P<0.00001).4 cases were analyzed in the last 1 year after operation.The results showed that the difference was statistically significant(WMD=0.85,95%CI(0.62,1.09),P<0.00001).4.The effect on ALP:the changes of ALP in 6 cases were analyzed in the last 1 week after operation.the results showed that there was no significant difference(WMD=-82.67,95%CI(-177.04,11.70),P=0.09).4 cases were analyzed in the last 1 month after operation,the results showed that there was no significant difference(WMD=0.29,95%CI(-42.44,43.01),P=0.99).3 cases were analyzed in the last 3 months after operation.The results showed that the difference was statistically significant(WMD=219.78,95%CI(34.30,405.26),P=0.02).5 cases were analyzed in the last 6 months after operation,the results showed that the difference was statistically significant(WMD=170.42,95%CI(93.49,247.36),P<0.0001).2 cases were analyzed in the last 1 year after operation.The results showed that the difference was not statistically significant(WMD=300.66,95%CI(-75.45,676.77),P=0.12).5.The effect on calcium and phosphorus product :the changes of calcium and phosphorus product in 3 cases were analyzed in the last 1 month and 3 months after operation.2 cases were analyzed in the last 6 months after operation,the results were statistically significant(WMD=45.70,95%CI(40.49,50.91),P<0.00001)(WMD=43.53,95%CI(38.01,49.05),P<0.00001)(WMD=43.78,95%CI(38.01,49.54),P<0.00001).6.The effect on Hb:the changes of Hb in the 3 cases were analyzed in the last 1 week after operation.the results showed that there was no significant difference(WMD=-0.73,95%CI(-8.54,7.08),P=0.85).5 cases were analyzed in the last 1 month after operation.the results showed that there was no significant difference(WMD=-2.21,95%CI(-6.24,1.83),P=0.28).5 cases were analyzed in the last 3 months after operation.The results showed that the difference was statistically significant(WMD=-5.51,95%CI(-10.07,-0.96),P=0.02).5 cases were analyzed in the last 6 months after operation.The results showed that the difference was statistically significant(WMD=-13.31,95%CI(-21.66,-4.96),P=0.002).2 cases were analyzed in the last 1 year after operation.The results showed that the difference was statistically significant(WMD=-32.45,95%CI(-42.20,-24.70),P<0.00001).Conclusions:The application of TPTX in the treatment of MHD patients with SHPT,can effectively reduce the blood PTH,serum phosphorus,calcium phosphorus product and blood ALP level.And have a positive effect on patients with renal anemia.At the same time,on pain,skin itching,muscle weakness and other clinical symptoms.Some patients showed radiographic change.Less complications and postoperative recurrence.However,there may be low calcium after the operation,according to individual differences in calcium treatment. |
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