超声引导下PTC针穿刺无水乙醇注射治疗继发性甲状旁腺功能亢进的临床观察.docVIP

超声引导下PTC针穿刺无水乙醇注射治疗继发性甲状旁腺功能亢进的临床观察? 30?誊用临约:2…l第l5奄第l5JournalofClinicalMedicineml】raclic…’’……川 超声引导下PTC针穿刺无水乙醇注射治疗继发性 甲状旁腺功能亢进的临床观察 章旭,曹娟,印获,王国华,丁浩,李海涛 (汀竹奈必r人民院肾内科,汀苏泰兴,225400) 摘要:目的观察终术期肾嵌粥患者继发Lti状旁腺功能亢进使用趟声l导FVI’C针穿刺尤水乙醇注乌1f治疗的效 方法选择28例维持性m液透析继发性I1]状旁腺功能亢进(iPTH~44pmol/mI)的忠者,在超引下他用IYF(;针进行Iti状 旁腺穿刺,无,K乙雕注射治疗,观察注射前后iPT,卜I,碱性磷酸酶,血清,磷及多普趣声甲状旁隙流的变化结果PEITl 冶疗I11『刘比iP”FFtf1J{卜降,皮肤缓瘪}IJ1缓解,骨关节痛减轻,甲状旁腺增腺体的Mi.fk;”Jj减少有J统汁:蓐, 结论fEITI术II前扫阡脞J7_J状旁腺切除(,X)条什不够的单位依然是清疗雕渐一VI-sHII,的仃效力法 关键词:}1I状旁腺功能C进;继发性;超声ijl导;穿刺 中图分类号:R582文献标志码:A文章编号: Clinicalobservationofpercutaneousethanolinjection byPTCneedleunderultrasonicguidance treatingsecondaryhyperparathyroidism znANGXu,CAOJuan,YINDi,WANGGuo—hua,DINGHao,LIHaitao (Ta/aPeopleHospital,Tai.:ring,Jiangsu,22540()) ABSTRACT:OhjcctivcToobserveeffectofpercutaneousethanolinjectiontherapy(PEIlI) byPFCneedleunderuhrasonicguidancetreatingforsecondaryhyperparathyroidism(SHPT)ofend — stageFenaldisease.MethodsFwenty—eighthemodialysispatientswithsecondaryhyper— parathyroidismweretrealedwithpercutaneousethanolinjectionbyPTCneedleunderuhras()nic guidance./’heparathyroidhormone,alkalinephosphatase,serumcalcium,phosph()rus,andbkx)d flowsignalsoftheglandunderultrasonicguidancewereobservedbeforeandaftertreatment.Re. suitsFhelevelsofiPTHandthebloodflowsignalsoftheglandweresignificantlydecreasedwhile thesymptomssuchastheskinpruritus,bone—arthrosispainwereimprovedsignificantlyafter treatment.There.aresignificantdifferences.ConclusionPEITPisallefficienttreatmentforSH— PTwhilenoteveryhospitalhasenoughfacilitytosupportparathyroidectomy(Pf,X). KEYWORDS:hyperparathyrojdisn1;secondary;ultra~micguidanceinjection 继发性甲状旁腺功能几进(SHPT)是终术期 肾衰竭患背的常见并发症.随着透析技术的不断 进步,透析患者的生存期相应延长.但长期维持 性液透析患者中,部分患者出现难治性SHPT, m清甲状旁腺激素(PTH)增高l1』j显,常伴有不同 程度的皮肤瘙痒,关节痛,m管,软组织转移性钙 化等症状,使透析患者的生存质量受到lr很大影 响.作者在彩色多普勒超声引导下使用PTC针 经皮穿刺到增生的甲状旁腺,在甲状旁腺内注射 收稿日期:20l104—13 无水乙醇(PEIFP),对治疗前后患者的临眯症 状,血清全段甲状旁腺激素(iPTH)水平,治疗腺 体的变化等指标和表现进行临床观察,对该技术 的治疗适应症和临床gT;tl中应该注意的题进行 探讨. 1资料与方法 1.1一般资料 2(108年9川～20l1年2在本院维持性【fI