甲状旁腺功能亢进症术前和术中定位病变甲状旁腺的研究进展
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重庆医科大学附属第一医院 超声科,重庆 400016

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彭钰蓓,重庆医科大学附属第一医院硕士研究生,主要从事甲状旁腺超声检查及穿刺方面的研究。

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Research progress of pre- and intraoperative localization of parathyroid gland in surgery for hyperparathyroidism
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Department of Ultrasound Diagnostics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

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    摘要:

    甲状旁腺是人体颈部的一个结节状内分泌腺体,位于甲状腺后方,其主要功能是分泌调节血钙的甲状旁腺激素(PTH)。甲状旁腺功能亢进症(HPT)是指甲状旁腺分泌过多PTH,从而引起血生化改变,导致相关系统功能的损害,严重影响患者的生活质量,甚至导致死亡。目前最主要的治疗方式是手术切除病变甲状旁腺,而准确定位对微创甲状旁腺切除术至关重要。因为它能提高手术成功率,最大限度地减少误伤甲状旁腺的发生率以及损伤相关的并发症。近几年来,随着技术设备的创新和普及,不同的定位方式有了更好的敏感度和准确率。随着临床研究的不断深入和更新,对于不同类型HPT的定位方式有了更好的指导意义。目前甲状旁腺微创外科技术已经取代了传统的广泛探查,在保证手术成功率的同时带来更少的损伤和并发症,这也是对甲状旁腺定位方式更高的要求。因此,笔者就目前HPT病变甲状旁腺定位方式的研究进展进行综述,旨在为临床HPT的手术治疗提供更优的定位选择以及一些新的思路和方向。

    Abstract:

    Parathyroid gland is a nodular endocrine gland in the neck of the human body, which is located behind the thyroid gland. Its main function is to secrete parathyroid hormone (PTH), which regulates blood calcium. Hyperparathyroidism (HPT) means that the parathyroid gland secretes abnormally high PTH levels, which causes blood biochemical changes, damage of related system function, seriously affects the quality of life of patients, and even leads to death. The most important treatment is surgical resection of the diseased parathyroid gland, and accurate location is significant for minimally invasive parathyroidectomy. Because it can improve the success rate of operation and minimize the incidence of accidental parathyroid injury and injury-related complications. In recent years, with the innovation and popularization of technology and equipment, different positioning methods provide better sensitivity and accuracy. The continuous deepening and updating of clinical research offer a better guiding significance for the localization of different types of HPT. At present, minimally invasive parathyroid surgery has replaced the traditional extensive exploration, which ensures the success rate of operation, brings fewer injuries and complications, and demands a higher requirement for parathyroid localization. Therefore, the author reviews the research progress of parathyroid localization in HPT to provide better localization choices and some new ideas and directions for the surgical treatment of HPT.

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彭钰蓓,叶梦醒,马可欣,寇震,刘丽萍.甲状旁腺功能亢进症术前和术中定位病变甲状旁腺的研究进展[J].中国普通外科杂志,2022,31(11):1518-1526.
DOI:10.7659/j. issn.1005-6947.2022.11.014

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  • 收稿日期:2022-05-26
  • 最后修改日期:2022-08-09
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  • 在线发布日期: 2022-12-07