- 期刊
- OpenAccess
Therapeutic Evaluation of Microwave Ablation in the Treatment of Secondary Hyperparathyroidism
摘要
BACKGROUND: Percutaneous microwave ablation (MWA) is a revolution of minimally invasive treatment for secondary hyperparathyroidism (SHPT). It has aroused more and more attention because of advantages of short operation time, small injury and remarkable curative effect. The aim of this research was to evaluate the short-term efficacy of ultrasonographically (US) guided MWA for SHPT. METHODS: Sixty-eight chronic kidney disease (CKD) patients with refractory SHPT who received MWA in our hospital from February 2014 to February 2016 were retrospectively analyzed. Curative effect judgement: The efficacy was evaluated according to different levels of intact parathyroid hormone (iPTH) after ablation (cure: ＜ 150 pg/mL; marked effect: 150-300 pg/mL; effective treatment: 301-500 pg/mL; ineffective treatment: ＞ 500 pg/mL). RESULTS: Sixty-eight SHPT individuals including 36 males and 32 females, at an average age of 51.48 ± 12.50 years, were enrolled in the study. After surgery, symptoms related to SHPT were drastically improved in all patients, including ostalgia, pruritus, restless legs, etc. The levels of iPTH dramatically decreased compared with baseline for 54 patients completed regular follow-up, which were 1,139.00 (814.82-1,504.73) pg/mL, 209.45 (107.75-355.40) pg/mL, 298.00 (182.25-518.50) pg/mL, 305.35 (159.03-512.00) pg/mL, and 230.50 (114.00-417.60) pg/mL at baseline, 1 day, 1 week, 1 month and 6 months after MWA respectively (P ＜ 0.001). The statistically significant changes were found for serum calcium or phosphate between baseline and 1day, 1 week, 1 month, and 6 months after MWA (P ＜ 0.001). The curative effect judgement of 68 patients at 1 day after MWA: patients who were cured, significantly effective, effective, and ineffective were 25%, 32.35%, 22.06%, and 20.59%, respectively. After 6 months follow-up, 54 patients completed follow-up who were cured, significantly effective, effective, and ineffective were 29.63%, 29.63%, 22.22%, and 18.52%, respectively. Hypocalcemia, as a main complication after MVA could be controlled ideally after calcium supplement treatment. In addition, complications encountered during or after MWA included hoarseness (2/68) and local hematoma (1/68). CONCLUSION: MWA is safe, effective and convenient, as well as can be used as a supplementary therapy for parathyroidectomy (PTX).
延伸閱讀
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