The Effect of Different Surgical Methods in the Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis
Objective:To investigate the treatment effect of total parathyroidectomy alone and combined with autologous forearm transplantation in maintenance hemodialysis patients with secondary hyperparathyroidism,and to analyze the effects of different surgical methods on carotid atherosclerosis and motor function.Method:A total of 76 cases of secondary hyperparathyroidism in maintenance hemodialysis patients admitted to General Hospital of Benxi Iron Steel of Liaoning Health Industry Group from September 2019 to September 2023 were selected as the research objects,they were divided into the control group and the test group by random number table method,with 38 cases in each group.The control group received total parathyroidectomy,the test group received total parathyroidectomy+autologous forearm transplantation.The biochemical indicators[parathyroid hormone(PTH),phosphorus(P),calcium(Ca)],carotid atherosclerosis indicators[carotid artery middle thickness(IMT),peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)],motor function index[grip strength,6 minute walking distance(6MWD)],and the incidence of complications between two groups were compared.Result:After 3 months of surgery,the levels of PTH,P and Ca in the test group were higher than those in the control group,the differences were statistically significant(P<0.05).After 3 months of surgery,the levels of IMT,PSV,EDV and RI in the test group were lower than those in the control group,the differences were statistically significant(P<0.05).After 3 months of surgery,the grip strength and 6MWD level in the test group were better than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the test group and the control group(P>0.05).Conclusion:Compared with total parathyroidectomy alone,total parathyroidectomy combined with autologous forearm transplantation in the treatment of secondary hyperparathyroidism in maintenance hemodialysis is more conducive to improving biochemical indicators,reducing carotid atherosclerosis,improving patients'motor function,and the combined operation does not increase the probability of complications.