继发性甲状旁腺功能亢进外科治疗的发展历程现状与目标
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摘要
继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)已成为慢性肾脏病(chronic kidney disease,CKD)常见的并发症之一,其手术治疗目前仍处于几种主流手术方式并存的状态,同时,手术方式的选择、手术指征的制定目前尚无完全统一标准。甲状旁腺疾病的多学科诊疗模式近年来逐步得到认可和实践,并值得进一步推广。降低手术并发症发生率及复发率,建立围手术期的安全评价模式,完善钙代谢评估及术后患者随访体系仍是今后努力的方向。该文对SHPT外科治疗的发展历程、现状与目标作一述评。
Secondary hyperparathyroidism( SHPT) has become one of the common complications of chronic kidney disease( CKD),but surgical treatment for SHPT is still in the state of the coexistence of several operation methods,and there is no unified standard for surgical indications and the choice of different operation methods. Multidisciplinary treatment for the parathyroid disease has been adopted by specialists and is worthy of further promotion.Future efforts need to be made to reduce operative complications,decrease recurrence rate,establish a perioperative evaluation pattern,perfect the assessment of calcium metabolism and establish a postoperative follow-up system. This article reviews the history,status quo and goal for surgical treatment of SHPT.
Secondary hyperparathyroidism( SHPT) has become one of the common complications of chronic kidney disease( CKD),but surgical treatment for SHPT is still in the state of the coexistence of several operation methods,and there is no unified standard for surgical indications and the choice of different operation methods. Multidisciplinary treatment for the parathyroid disease has been adopted by specialists and is worthy of further promotion.Future efforts need to be made to reduce operative complications,decrease recurrence rate,establish a perioperative evaluation pattern,perfect the assessment of calcium metabolism and establish a postoperative follow-up system. This article reviews the history,status quo and goal for surgical treatment of SHPT.
引文
1 Toneto MG,Prill S,Debon LM,et al.The history of the parathyroid surgery[J].Rev Col Bras Cir,2016,43(3):214-222.
2 Albright F.A page out of the history of hyperparathyroidism[J].JClin Endocrinol Metab,1948,8(8):637-657.
3 Rogers-Stevane J,Kauffman GL Jr.A historical perspective on surgery of the thyroid and parathyroid glands[J].Otolaryngol Clin North Am,2008,41(6):1059-1067.
4 Stanbury SW,Lumb GA,Nicholson WF.Elective subtotal parathyroidectomy for renal hyperparathyroidism[J].Lancet,1960,1(7128):793-799.
5 Ogg CS.Total parathyroidectomy in treatment of secondary(renal)hyperparathyroidism[J].Br Med J,1967,4(5575):331-334.
6 Bonnichon P.History of parathyroid surgery[J].J Chir(Paris),2006,143(2):88-92.
7 Wells SA Jr,Farndon JR,Dale JK,et al.Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation[J].Ann Surg,1980,192(4):451-458.
8 Alveryd A.Parathyroid glands in thyroid surgery.Ⅰ.Anatomy of parathyroid glands.Ⅱ.Postoperative hypoparathyroidism---identification and autotransplantation of parathyroid glands[J].Acta Chir Scand,1968,389:1-120.
9 Max MH,Flint LM,Richardson JD,et al.Total parathyroidectomy and parathyroid autotransplantation in patients with chronic renal failure[J].Surg Gynecol Obstet,1981,153(2):177-180.
10代文杰,徐德全.继发性甲状旁腺功能亢进外科治疗[J].中国实用外科杂志,2014,34(4):314-317.
11王海峰,张凌,姚力,等.三种不同甲状旁腺切除术治疗继发性甲状旁腺功能亢进425例疗效比较[J].中国血液净化,2016,15(9):455-458.
12张凌.继发性甲状旁腺功能亢进的治疗策略[J].中华肾病研究电子杂志,2015,4(3):118-122.
13 Liu ME,Qiu NC,Zha SL,et al.To assess the effects of parathyroidectomy(TPTX versus TPTX+AT)for Secondary Hyperparathyroidism in chronic renal failure:A Systematic Review and Meta-A-nalysis[J].Int J Surg,2017,44:353-362.
14 Li C,Lv L,Wang H,et al.Total parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism:systematic review and meta-analysis[J].Ren Fail,2017,39(1):678-687.
15田文,贺青卿,姜可伟,等.慢性肾功能衰竭继发甲状旁腺功能亢进外科临床实践专家共识[J].中国实用外科杂志,2016,36(5):481-486.
16 Meers C,Morton AR,Toffelmire EB.The pathophysiology and management of renal bone disease in dialysis patients[J].CANNTJ,1999,9(2):24-29,32-28,quiz 30-31,39-40.
17 Casey J,Li CH,Johnsson V,et al.Multidisciplinary approach for prescriptive management of mineral and bone metabolism in chronic kidney disease:development of a dietetic led protocol[J].J Ren Care,2006,32(4):187-191.
18 Foerster D,Chmielewski C.Severe secondary hyperparathyroidism[J].Nephrol Nurs J,2001,28(6):647-648.
19张凌.CKD-MBD甲状旁腺介入及外科治疗的体会[J].肾脏病与透析肾移植杂志,2015,24(2):152-153.
20 Bover J,FarréN,Andrés E,et al.Update on the treatment of chronic kidney disease-mineral and bone disorder[J].J Ren Care,2009,35(S1):19-27.
21 Chou FF,Chi SY,Hsieh KC.Hypoparathyroidism after total parathyroidectomy plus subcutaneous autotransplantation for secondary hyperparathyroidism---any side effects?[J].World J Surg,2010,34(10):2350-2354.
22 Veyrat M,Fessi H,Haymann JP,et al.Conservative three-quarter versus subtotal seven-eighths parathyroidectomy in secondary hyperparathyroidism[J].Eur Ann Otorhinolaryngol Head Neck Dis,2018,10(13):1879-1886.
2 Albright F.A page out of the history of hyperparathyroidism[J].JClin Endocrinol Metab,1948,8(8):637-657.
3 Rogers-Stevane J,Kauffman GL Jr.A historical perspective on surgery of the thyroid and parathyroid glands[J].Otolaryngol Clin North Am,2008,41(6):1059-1067.
4 Stanbury SW,Lumb GA,Nicholson WF.Elective subtotal parathyroidectomy for renal hyperparathyroidism[J].Lancet,1960,1(7128):793-799.
5 Ogg CS.Total parathyroidectomy in treatment of secondary(renal)hyperparathyroidism[J].Br Med J,1967,4(5575):331-334.
6 Bonnichon P.History of parathyroid surgery[J].J Chir(Paris),2006,143(2):88-92.
7 Wells SA Jr,Farndon JR,Dale JK,et al.Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation[J].Ann Surg,1980,192(4):451-458.
8 Alveryd A.Parathyroid glands in thyroid surgery.Ⅰ.Anatomy of parathyroid glands.Ⅱ.Postoperative hypoparathyroidism---identification and autotransplantation of parathyroid glands[J].Acta Chir Scand,1968,389:1-120.
9 Max MH,Flint LM,Richardson JD,et al.Total parathyroidectomy and parathyroid autotransplantation in patients with chronic renal failure[J].Surg Gynecol Obstet,1981,153(2):177-180.
10代文杰,徐德全.继发性甲状旁腺功能亢进外科治疗[J].中国实用外科杂志,2014,34(4):314-317.
11王海峰,张凌,姚力,等.三种不同甲状旁腺切除术治疗继发性甲状旁腺功能亢进425例疗效比较[J].中国血液净化,2016,15(9):455-458.
12张凌.继发性甲状旁腺功能亢进的治疗策略[J].中华肾病研究电子杂志,2015,4(3):118-122.
13 Liu ME,Qiu NC,Zha SL,et al.To assess the effects of parathyroidectomy(TPTX versus TPTX+AT)for Secondary Hyperparathyroidism in chronic renal failure:A Systematic Review and Meta-A-nalysis[J].Int J Surg,2017,44:353-362.
14 Li C,Lv L,Wang H,et al.Total parathyroidectomy versus total parathyroidectomy with autotransplantation for secondary hyperparathyroidism:systematic review and meta-analysis[J].Ren Fail,2017,39(1):678-687.
15田文,贺青卿,姜可伟,等.慢性肾功能衰竭继发甲状旁腺功能亢进外科临床实践专家共识[J].中国实用外科杂志,2016,36(5):481-486.
16 Meers C,Morton AR,Toffelmire EB.The pathophysiology and management of renal bone disease in dialysis patients[J].CANNTJ,1999,9(2):24-29,32-28,quiz 30-31,39-40.
17 Casey J,Li CH,Johnsson V,et al.Multidisciplinary approach for prescriptive management of mineral and bone metabolism in chronic kidney disease:development of a dietetic led protocol[J].J Ren Care,2006,32(4):187-191.
18 Foerster D,Chmielewski C.Severe secondary hyperparathyroidism[J].Nephrol Nurs J,2001,28(6):647-648.
19张凌.CKD-MBD甲状旁腺介入及外科治疗的体会[J].肾脏病与透析肾移植杂志,2015,24(2):152-153.
20 Bover J,FarréN,Andrés E,et al.Update on the treatment of chronic kidney disease-mineral and bone disorder[J].J Ren Care,2009,35(S1):19-27.
21 Chou FF,Chi SY,Hsieh KC.Hypoparathyroidism after total parathyroidectomy plus subcutaneous autotransplantation for secondary hyperparathyroidism---any side effects?[J].World J Surg,2010,34(10):2350-2354.
22 Veyrat M,Fessi H,Haymann JP,et al.Conservative three-quarter versus subtotal seven-eighths parathyroidectomy in secondary hyperparathyroidism[J].Eur Ann Otorhinolaryngol Head Neck Dis,2018,10(13):1879-1886.