摘要
目的比较甲状旁腺全切除及自体前臂肌肉移植术和前臂腕屈肌前筋膜超声引导匀浆注射移植术治疗继发性甲状旁腺功能亢进的效果。方法回顾性分析2011年3月至2020年3月湖北医药学院附属东风医院接受甲状旁腺全切除加自体前臂移植术共110例慢性肾功能衰竭终末期患者的临床资料,其中对照组手术方式为甲状旁腺切除+自体前臂肌肉移植术,观察组为甲状旁腺切除+自体前臂腕屈肌前筋膜超声引导匀浆注射移植术,比较两组围手术期至术后3个月内移植物功能。结果两组患者术后30min,1.3个月的血清甲状旁腺激素(iPTH)、血钙、血磷及血钙磷乘积水平差异均无统计学意义(均P>0.05)。观察组二维超声模拟椭圆弥散体积小于对照组,差异有统计学意义[(2.51±0.41)cm^(3)比(1.91±0.55)cm^(3),t=6.519,P<0.001]。观察组三维超声实际体积与观察组术后3个月血清iPTH值线性回归方程式为Y1=47.728+122.337 X,r_(1)=0.892,P<0.05,呈正相关性;观察组二维超南模拟椭圆弥散体积与观察组术后3个月血清iPTH值线性回归方程式为Y2=121.408±81.736X,r_(2)=0.883,P<0.05,呈正相关性。结论与肌肉移植术相比,甲状旁腺腕屈肌前筋膜超声引导匀浆注射移植术后血清iPTH、血钙、血磷、血钙磷乘积恢复水平基本相同,但操作更方便,弥散体积更小。
Objectives To evaluate forearm intramuscular autograft Tx 1s.forearm subecutaneous ultrasound-guided homogenate injection transplantation.Methods One hundred-ten end-stage chronic renal failure patients who after total parathyroidectomy and autologous forearm Tx from Mar 2011 to Mar 2020 were enrolled for retrospective analysis.The control group received autologous parathyroid forearm intramuscular autograft Tx,and the observation group had the anterior fascia of the flexor carpus ultrasound-guided homogenate injection Tx.We evaluated the efects of transplantation between the two groups.Results There were no significant differences in the levels of iPTH,blood calcium,blood phosphorus,and calcium-phosphorus product between the two groups of patients 30 minutes,1 month,and 3 months after surgery.The two-dimensional ultrasound simulated llipse dispersion volume in the observation group is much smaller than that in the control group[(2.51±0.41)cm^(3)vs.(1.91±0.55)cm^(3),t=6.519,<0.001]The linear regression equation of the actual volume of the three-dimensional ultrasound in the observation group and the iPTH value in the observation group after 3 monthsis Y1=47.728+122.337X,r_(1)=0.892,P<0.05.The linear regression equation of the two-dimensional ultrasound simulated ellipse dfusion volume in the observation group and the iPTH value in the observation group at 3 months after operation was Y2=121.408+81.736X,r_(2)=0.883,P<0.05.Conclusion Compared with intramuscular Tx,the recovery levels of iPTH,caleium,phosphorus and calcium-phosphorus product after the anterior fascia of the flexor carpus ultrasound-guided homogenate parathyroid glands injection Tx are similar,but its operation is more simple and diffusion volume is smaller.
作者
李浩
李华玉
李蓬
沈丰
方大正
Li Hao;LI Huayu;Li Peng;Shen Feng;Fang Dazheng(Thyroid Center,Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan 442000,China;Department of Ultrasonicy Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan 442000,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第2期127-131,共5页
Chinese Journal of General Surgery
