SURGICAL TREATMENT OF SECONDARY HYPERPARATHYROIDISM
Objective To assess the clinical effectiveness of surgery in the treatment of secondary hyperparatbyroidism (SHPT).Methods Seventy-two patients with SHPT underwent total parathyroidectomy plus forearm grafting.The levels of blood parathyroid hormone (iPTH),calcium and phosphorus before surgery,one and seven days after surgery,as well as six months after surgery-were measured.The symptoms of bone pain,itch of skin and fatigue,before and after surgery,were compared.Results Operations were successfully completed in all the 72 patients.The number of resected parathyroid glands in each patient was as follows:three glands were removed in five eases,four glands in 65,five glands in one case,and six glands in one case.Pathological findings were parathyroid hyperplasia or adenomatous hyperplasia.The mean preoperative iPTH of the 72 patients was (2153.68 ±342.17)ng/L,that was markedly declined-one day,seven days and six months after surgery,the difference being statistically significant (F =830.008,P <0.05).The serum calcium level declined one and seven days after surgery,and it rebounded slightly six months after surgery,the difference was significant (F=259.811,P<0.05).Compared with before surgery,blood phosphorus level was significantly lower-one day,seven days and six months after surgery (F=85.540,P <0.05).The symptoms of bone pain,itch of skin and fatigue improved significantly after surgery.Conclusion Surgical therapy of secondary hyperparathyroidism is effective,safe and reliable,which can significantly improve the quality of life of the patients.