以急性胰腺炎为首发症状的原发性甲状旁腺功能亢进两例病例报告并文献复习
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摘要
目的
研究急性胰腺炎与原发性甲状旁腺功能亢进的关系及以急性胰腺炎为临床表现的原发性甲状旁腺功能亢进的诊断与治疗。
方法
对收入我院的两例以急性胰腺炎为首发症状的原发性甲状旁腺功能亢进病例进行研究,结合以往国内外相关报告进行分析。
结果
两例患者均以“恶心、上腹痛”等消化道症状为主,且经相关检查与实验室检验均支持“急性胰腺炎”诊断。均按急性胰腺炎治疗无好转,并出现高钙危象后考虑可能为原发性甲状旁腺功能亢进。其中一例经调节血钙水平后接受手术治疗,预后良好；一例血钙调节不理想并出现心衰、呼衰抢救无效死亡。
结论
以急性胰腺炎为首发表现的原发性甲状旁腺功能亢进临床少见,容易误诊,应予重视；手术是治疗原发性甲状旁腺功能亢进的最直接有效方法。
Objective
In this article, we will discuss the relationship between acute pancreatitis and primary hyperparathyroidism and also we will learn the diagnosis and the treatment of the primary hyperparathyroidism which have the first presentation as acute pancreatitis.
Methods
Two cases of our hospital which shows the acute pancreatitis as the first presentation of primary hyperparathyroidism were studied and the similar literature were reviewed.
Results
Both of the two cases had the chief complaint of vomiting and upper abdominal pain, related examination and blood test also supported the diagnosis of acute pancreatitis. But the patients'condition did not improve when they were treated as acute pancreatitis and high calcium crisis occured during the treatment when we started to think that there may be a consideration of primary hyperparathyroidism. One of the two patients, surgery was taken after the control of the value of blood calcium and showed a favourable prognosis; one died of congestive heart failure and respiratory failure without surgery for the value of blood calcium was not well controlled.
Conclusions
Acute pancreatitis as the firs presentation of primary hyperparathyroidism which was rarely seen at clinical should be payed attention by us. Surgery is considered the most direct and effective way to cure primary hyperparah yroidism.
研究急性胰腺炎与原发性甲状旁腺功能亢进的关系及以急性胰腺炎为临床表现的原发性甲状旁腺功能亢进的诊断与治疗。
方法
对收入我院的两例以急性胰腺炎为首发症状的原发性甲状旁腺功能亢进病例进行研究,结合以往国内外相关报告进行分析。
结果
两例患者均以“恶心、上腹痛”等消化道症状为主,且经相关检查与实验室检验均支持“急性胰腺炎”诊断。均按急性胰腺炎治疗无好转,并出现高钙危象后考虑可能为原发性甲状旁腺功能亢进。其中一例经调节血钙水平后接受手术治疗,预后良好；一例血钙调节不理想并出现心衰、呼衰抢救无效死亡。
结论
以急性胰腺炎为首发表现的原发性甲状旁腺功能亢进临床少见,容易误诊,应予重视；手术是治疗原发性甲状旁腺功能亢进的最直接有效方法。
Objective
In this article, we will discuss the relationship between acute pancreatitis and primary hyperparathyroidism and also we will learn the diagnosis and the treatment of the primary hyperparathyroidism which have the first presentation as acute pancreatitis.
Methods
Two cases of our hospital which shows the acute pancreatitis as the first presentation of primary hyperparathyroidism were studied and the similar literature were reviewed.
Results
Both of the two cases had the chief complaint of vomiting and upper abdominal pain, related examination and blood test also supported the diagnosis of acute pancreatitis. But the patients'condition did not improve when they were treated as acute pancreatitis and high calcium crisis occured during the treatment when we started to think that there may be a consideration of primary hyperparathyroidism. One of the two patients, surgery was taken after the control of the value of blood calcium and showed a favourable prognosis; one died of congestive heart failure and respiratory failure without surgery for the value of blood calcium was not well controlled.
Conclusions
Acute pancreatitis as the firs presentation of primary hyperparathyroidism which was rarely seen at clinical should be payed attention by us. Surgery is considered the most direct and effective way to cure primary hyperparah yroidism.
引文
1. Carnaile B,Oudar C, Pattou F, et al. Pancreatitis and primary hyperparathyroidism: forty cases. Aust N Z J Surg,1998,68:117-119.
2. Agarwal A,George RK,Gupta SK,et al.Pancreatitis in patients with primary hyperparathyroidism. Indian J Gastroenterol,2003,22:224-225.
3.刘光宇,尹万红,等.1997～2007年我国原发性甲状旁腺功能亢进症的误诊情况分析[J].临床内科杂志,2007,24(11)：786-787
4.朱海杭,徐永居,张利,等.以急性胰腺炎为首发表现的甲状旁腺功能亢进一例.中华消化杂志,2007,27(6)：408-409.
5.陈曦,雷若庆,等.以急性胰腺炎为主要表现的原发性甲状旁腺功能亢进症二例报告.中华普通外科杂志,2007,22(7)：546-547.
6.夏维波,王淑雅,孟讯吾,等.以急性胰腺炎为首发表现的原发甲状旁腺功能亢进症一例.中华内科杂志,2005,44(6)：469.
7.陈宏,等.原发性甲状旁腺功能亢进与急性胰腺炎.中华普通外科杂志,2008,23(3)：240.
8.武正炎,等.原发性甲状旁腺功能亢进的诊断和治疗[J].内分泌外科杂志,2007,1(4)：221-222.
9.卢崇亮,等.原发性甲状旁腺功能亢进症的外科治疗[J].华夏医学,2007,2(20)：403-405.
10.阎德文,深圳,等.原发性甲状旁腺功能亢进症的诊断与治疗[J].内科急危重症杂志,2005,11(4)：154-158.
1 潘运龙,李文生.原发性甲状旁腺功能亢进诊断与手术治疗.实用医学杂志,2005,21(2)：162-164.
2 郑炳行,师天雄,等.原发性甲状旁腺功能亢进症的外科治疗.中国普通外科杂志,2008,17(5)：506-508.
3 武正炎,沈美萍,等.原发性甲状旁腺功能亢进症的外科治疗.内分泌外科杂志,2008,2(1)：10-12.
4 樊友本,张频,等.原发性甲状旁腺功能亢进的诊治.外科理论与实践,2005,10(6)：525-527.
5 姜兆明,等.原发性甲状旁腺机能亢进症的诊断和治疗.实用医技杂志,2006,13(3)：338-339.
6 袁时芳,马中,等.原发性甲状旁腺功能亢进症的定位诊断与手术治疗.中国普通外科杂志,2007,16(1)：24-28.
7 曹利军,刘戈,常家聪.原发性甲状旁腺功能亢进症的诊断及治疗.山东医药,2008,48(3)：58-59.
8 杨志强等.甲状旁腺腺瘤42例临床分析.天津医科大学学报,2006,12(1)：35-37.
9 胡雄强等.甲状旁腺腺瘤13例诊治分析.中国当代医学,2007,6(10)：53-54.
10毛岸荣,施俊义等.原发性甲状旁腺功能亢进外科诊治分析(附24例报告).临床外科杂志,2007,15(5)：347-348.
11解乃昌,林进令,陆云飞等.18例原发性甲状旁腺功能亢进症的诊治分析.中国普外基础与临床杂志,2007,14(1)：87-88.
12黄海泉,田文等.手术治疗原发性甲状旁腺功能亢进症26例.人民军医,2006,49(6)：341-342.
13李树松,龙仁平,李启荣等.手术治疗原发性甲状旁腺功能亢进症11例分析.中国普通外科杂志,2007,16(1)：97-98.
14宋旭波,王玉香等.34例原发性甲状旁腺功能亢进的临床分析.现代生物医学进展,2006,6(2)：65-66.
15马智勇等.原发性甲状旁腺功能亢进症诊断与手术治疗的体会.广东医学院学报,2006,24(3)：271-272.
16黄东航,游振辉等.原发性甲状旁腺功能亢进症的术前定位及手术治疗.福建医药杂志,2006,28(1)：18-19.
17张德君,丛玉布等.原发性甲状旁腺功能亢进症71例临床分析.中国伤残医学,2007,15(1)：65-66.
18陈琳,闻兆章等.原发性甲状旁腺功能亢进症9例的诊疗体会.第二军医大学学报,2006,27(5)：573-577.
19吕会增,陈图峰等.原发性甲状旁腺肿瘤的诊断和外科治疗.中国普通外科杂志,2008,17(5)：415-418.
20张佳佳,刘戈等.14例甲状旁腺肿瘤的临床分析.安徽医药,2009,13(6)：625-627.
21 蒿汉坤,王亚萍,朱磊等.21例甲状旁腺腺瘤的临床分析.上海医学,2008,31(5)：312-313.
22陈松涛,王欣平等．原发性甲状旁腺功能亢进症的外科治疗体会.吉林医学,2008,29(23)：2171-2172.
23朱伟平,李杰等.难治性肾性甲状旁腺功能亢进2例治疗分析．中国误诊学杂志,2010,10(3)：714.
24蒋世海,唐专红.甲状旁腺肿瘤的诊断和治疗.华夏医学,2009,22(2)：250-251.
25戎亚雄,史卫海等.甲状旁腺腺瘤的诊治分析.中国临床医学,2009,16(3)：478-479.
26王白石,王宁等.甲状旁腺腺瘤合并甲状旁腺功能亢进症临床分析.中国现代医药杂志,2009,11(6)：47-48.
27季兵,戚峰,刘彤等.甲状旁腺疾病的外科诊疗分析.天津医科大学学报,2009,15(3)：419-421.
28李昱骥,周建平,孔凡民,张浩等.原发性甲状旁腺功能亢进48例诊治分析.中国实用外科杂志,2008,28(3)：187-188.
29罗说明,张红等.前纵膈异位甲状旁腺腺瘤伴高钙危象1例报告.中国实用内科杂志,2009,29(12)：1156-1157.
2. Agarwal A,George RK,Gupta SK,et al.Pancreatitis in patients with primary hyperparathyroidism. Indian J Gastroenterol,2003,22:224-225.
3.刘光宇,尹万红,等.1997～2007年我国原发性甲状旁腺功能亢进症的误诊情况分析[J].临床内科杂志,2007,24(11)：786-787
4.朱海杭,徐永居,张利,等.以急性胰腺炎为首发表现的甲状旁腺功能亢进一例.中华消化杂志,2007,27(6)：408-409.
5.陈曦,雷若庆,等.以急性胰腺炎为主要表现的原发性甲状旁腺功能亢进症二例报告.中华普通外科杂志,2007,22(7)：546-547.
6.夏维波,王淑雅,孟讯吾,等.以急性胰腺炎为首发表现的原发甲状旁腺功能亢进症一例.中华内科杂志,2005,44(6)：469.
7.陈宏,等.原发性甲状旁腺功能亢进与急性胰腺炎.中华普通外科杂志,2008,23(3)：240.
8.武正炎,等.原发性甲状旁腺功能亢进的诊断和治疗[J].内分泌外科杂志,2007,1(4)：221-222.
9.卢崇亮,等.原发性甲状旁腺功能亢进症的外科治疗[J].华夏医学,2007,2(20)：403-405.
10.阎德文,深圳,等.原发性甲状旁腺功能亢进症的诊断与治疗[J].内科急危重症杂志,2005,11(4)：154-158.
1 潘运龙,李文生.原发性甲状旁腺功能亢进诊断与手术治疗.实用医学杂志,2005,21(2)：162-164.
2 郑炳行,师天雄,等.原发性甲状旁腺功能亢进症的外科治疗.中国普通外科杂志,2008,17(5)：506-508.
3 武正炎,沈美萍,等.原发性甲状旁腺功能亢进症的外科治疗.内分泌外科杂志,2008,2(1)：10-12.
4 樊友本,张频,等.原发性甲状旁腺功能亢进的诊治.外科理论与实践,2005,10(6)：525-527.
5 姜兆明,等.原发性甲状旁腺机能亢进症的诊断和治疗.实用医技杂志,2006,13(3)：338-339.
6 袁时芳,马中,等.原发性甲状旁腺功能亢进症的定位诊断与手术治疗.中国普通外科杂志,2007,16(1)：24-28.
7 曹利军,刘戈,常家聪.原发性甲状旁腺功能亢进症的诊断及治疗.山东医药,2008,48(3)：58-59.
8 杨志强等.甲状旁腺腺瘤42例临床分析.天津医科大学学报,2006,12(1)：35-37.
9 胡雄强等.甲状旁腺腺瘤13例诊治分析.中国当代医学,2007,6(10)：53-54.
10毛岸荣,施俊义等.原发性甲状旁腺功能亢进外科诊治分析(附24例报告).临床外科杂志,2007,15(5)：347-348.
11解乃昌,林进令,陆云飞等.18例原发性甲状旁腺功能亢进症的诊治分析.中国普外基础与临床杂志,2007,14(1)：87-88.
12黄海泉,田文等.手术治疗原发性甲状旁腺功能亢进症26例.人民军医,2006,49(6)：341-342.
13李树松,龙仁平,李启荣等.手术治疗原发性甲状旁腺功能亢进症11例分析.中国普通外科杂志,2007,16(1)：97-98.
14宋旭波,王玉香等.34例原发性甲状旁腺功能亢进的临床分析.现代生物医学进展,2006,6(2)：65-66.
15马智勇等.原发性甲状旁腺功能亢进症诊断与手术治疗的体会.广东医学院学报,2006,24(3)：271-272.
16黄东航,游振辉等.原发性甲状旁腺功能亢进症的术前定位及手术治疗.福建医药杂志,2006,28(1)：18-19.
17张德君,丛玉布等.原发性甲状旁腺功能亢进症71例临床分析.中国伤残医学,2007,15(1)：65-66.
18陈琳,闻兆章等.原发性甲状旁腺功能亢进症9例的诊疗体会.第二军医大学学报,2006,27(5)：573-577.
19吕会增,陈图峰等.原发性甲状旁腺肿瘤的诊断和外科治疗.中国普通外科杂志,2008,17(5)：415-418.
20张佳佳,刘戈等.14例甲状旁腺肿瘤的临床分析.安徽医药,2009,13(6)：625-627.
21 蒿汉坤,王亚萍,朱磊等.21例甲状旁腺腺瘤的临床分析.上海医学,2008,31(5)：312-313.
22陈松涛,王欣平等．原发性甲状旁腺功能亢进症的外科治疗体会.吉林医学,2008,29(23)：2171-2172.
23朱伟平,李杰等.难治性肾性甲状旁腺功能亢进2例治疗分析．中国误诊学杂志,2010,10(3)：714.
24蒋世海,唐专红.甲状旁腺肿瘤的诊断和治疗.华夏医学,2009,22(2)：250-251.
25戎亚雄,史卫海等.甲状旁腺腺瘤的诊治分析.中国临床医学,2009,16(3)：478-479.
26王白石,王宁等.甲状旁腺腺瘤合并甲状旁腺功能亢进症临床分析.中国现代医药杂志,2009,11(6)：47-48.
27季兵,戚峰,刘彤等.甲状旁腺疾病的外科诊疗分析.天津医科大学学报,2009,15(3)：419-421.
28李昱骥,周建平,孔凡民,张浩等.原发性甲状旁腺功能亢进48例诊治分析.中国实用外科杂志,2008,28(3)：187-188.
29罗说明,张红等.前纵膈异位甲状旁腺腺瘤伴高钙危象1例报告.中国实用内科杂志,2009,29(12)：1156-1157.