耳鼻咽喉科实践中甲状旁腺切除术的结局与并发症：一项单中心、10年回顾性观察研究
Outcomes and complications of parathyroidectomy in otorhinolaryngology practice: A single-institution, 10-year retrospective observational study.
文献信息
| PMID | 42849194 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jaromír Astl |
| 作者单位 | Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Postgraduate Education in Medicine, Department of Otorhinolaryngology, Czech Republic. |
| 期刊 | American journal of otolaryngology |
| SCI 分区 | Q2 |
| IF | 1.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 甲状旁腺切除术与一系列潜在并发症相关，包括喉返神经（RLN）损伤、永久性低钙血症、术后出血、伤口感染以及甲状旁腺功能亢进症（HPT）复发。本研究的目的是评估223例甲状旁腺手术的结局，并确定手术相关并发症的发生率。
方法： 这项回顾性观察研究分析了2013年至2022年间实施的甲状旁腺切除术病例。收集并评估了人口学数据和术后并发症。结合术前和围手术期诊断方法，评估了甲状旁腺腺瘤、增生、癌和囊肿手术切除的成功率。
结果： 共实施了223例甲状旁腺切除术。0.91%的病例观察到单侧永久性RLN麻痹（95% CI，0.11-3.21%）。未观察到双侧永久性声带麻痹。98.43%的病例对甲状旁腺切除术出现阳性反应（95% CI，96.1-99.72%）。13.26%发生暂时性高钙血症（95% CI，9.41-18.35%）。16例因持续性HPT或HPT复发而需要再次手术。
结论： 术前多模态影像学检查与精确的甲状旁腺功能亢进症诊断相结合，对于降低甲状旁腺手术中定位失败的风险至关重要。超声和闪烁显像提供了最有效的诊断方法。对于再次手术，推荐使用术中神经监测。
英文摘要
BACKGROUND: Parathyroidectomy is associated with a spectrum of potential complications, including recurrent laryngeal nerve (RLN) injury, permanent hypocalcemia, postoperative hemorrhage, wound infection, and recurrence of hyperparathyroidism (HPT). The objective of this study was to evaluate the outcomes of 223 parathyroid procedures and to determine the incidence of procedure-related complications.
METHODS: This retrospective observational study analyzed parathyroidectomy cases performed between 2013 and 2022. Demographic data and postoperative complications were collected and assessed. The success rates of surgical removal of parathyroid adenomas, hyperplasia, carcinomas, and cysts were evaluated in relation to preoperative and perioperative diagnostic methods.
RESULTS: A total of 223 parathyroidectomy procedures were performed. Unilateral permanent RLN palsy was observed in 0.91% of cases (95% CI, 0.11-3.21%). Bilateral permanent vocal cord palsy was not observed. A positive response to the parathyroidectomy was observed in 98.43% (95% CI, 96.1-99.72%). Temporary hypercalcemia developed in 13.26% (95% CI, 9.41-18.35%). Revision surgery for persistent HPT or recurrence of HPT was necessary in 16 cases.
CONCLUSION: The combination of preoperative multimodal imaging and precise hyperparathyroidism diagnosis is essential for reducing the risk of unsuccessful localization in parathyroid surgery. Ultrasound and scintigraphy offers the most effective diagnostic method. Intraoperative neuromonitoring is recommended for revision surgeries.