摘要
目的探讨甲状旁腺全切除加自体移植术对尿毒症继发性甲状旁腺功能亢进症(SHPT)患者认知功能及生存质量的影响。方法选取2015年1月~2016年10月我院收治的58例尿毒症SHPT患者作为研究对象,既往甲状旁腺全切除史。对术前及术后1年患者的认知功能及生活质量的改善情况进行统计分析。结果手术切除甲状旁腺后术后第1、3、7、14、21天患者血甲状旁腺激素(i PTH)、血钙、血磷、碱性磷酸酶(ALP)低于手术前,血红蛋白(Hb)水平高于手术前,差异有统计学意义(P<0.05);手术后1年MMSE评分为(15.02±1.35)分,高于手术前的(7.54±0.21)分,差异有统计学意义(P<0.05);术后1年,SF-36总分明显高于手术前,差异有统计学意义(P<0.05),其PF、RP、BP、GH明显高于术前,差异有统计学意义(P<0.05),患者手术前后VT、SF、RE、MH比较,差异无统计学意义(P>0.05);术后1年OHR评分明显高于手术前,差异有统计学意义(P<0.05),其SPL、EKD、Sleep得分高于术前,差异有统计学意义(P<0.05),患者手术前后余项目比较,差异无统计学意义(P>0.05)。结论甲状旁腺切除能够提高SHPT患者的认知能力,并有效改善其生活质量,值得临床推广。
Objective To investigate the influence of total parathyroidectomy combined with autologous transplantation in the cognitive function and quality of life for uremia patients with secondary hyperparathyroidism（SHPT）.Methods A total of 58 SHPT patients with uremia who were admitted to our hospital from January 2015 to October 2016 were selected as the study subjects.They were with the past history of total resection of the parathyroid gland.The improvement of cognitive function and quality of life in the patients before the surgery and one year after the surgery were statistically analyzed.Results Blood parathyroid hormone（i PTH）,serum calcium,serum phosphorus,and alkaline phosphatase（ALP） were lower than those before surgery on the 1 st,3 rd,7 th,14 th,and 21 stdays after surgery for parathyroidectomy,the level of hemoglobin（Hb） was higher than that before surgery,and the difference was statistically significant（P〈0.05）;the MMSE score was（15.02±1.35） points at one year after the surgery,which was higher than that of（7.54±0.21）points before the surgery,and the difference was statistically significant（P〈0.05）;at 1 year after surgery,the total score of SF-36 was significantly higher than that before surgery,and the difference was statistically significant（P〈0.05）.The PF,RP,BP,and GH were significantly higher than those before the surgery,and the difference was statistically significant（P〈0.05）.There was no statistically significant difference in VT,SF,RE,and MH before and after the surgery（P〉0.05）.The OHR score at one year after the surgery was significantly higher than that before the surgery,and the difference was statistically significant（P〈0.05）.The SPL,EKD,and Sleep scores were higher than those before the surgery,and the difference was statistically significant（P 〈0.05）.There was no statistically significant difference in the other items before and after surgery（P〉0.05）.Conclusion Parathyroidectomy can improve the cognitive ability in the
作者
郭焕开
杨晓冉
梁锦云
刘彩玲
徐庆东
GUO Huan-kai;YANG Xiao-ran;LIANG Jin-yun;LIU Cai-ling;XU Qing-dong(Department of Nephrology,Jiangmen Central Hospital,Guangdong Province,Jiangmen 529000,Chin)
出处
《中国当代医药》
2018年第11期8-10,15,共4页
China Modern Medicine
基金
广东省江门市科技计划项目(2017A3013)
