Ultrasound-guided percutaneous laser ablation for primary hyperparathyroidism

SHI Qian; SUN Yongkang; TANG Shengfei; LIAN Feng

doi:10.19732/j.cnki.2096-6210.2020.04.005

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Ultrasound-guided percutaneous laser ablation for primary hyperparathyroidism

更新时间：2025-12-15

- Ultrasound-guided percutaneous laser ablation for primary hyperparathyroidism
- Vol. 29, Issue 4, Pages: 370-374(2020)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2020.04.005
  CLC：
- Published Online：28 August 2020，
  
  Published：28 August 2020
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施倩,孙永康,唐胜飞,等. 超声引导下经皮激光消融治疗原发性甲状旁腺功能亢进症[J]. 肿瘤影像学, 2020, 29(4): 370-374 https://doi.

org/10.19732/j.cnki.2096-6210.2020.04.005
施倩,孙永康,唐胜飞,等. 超声引导下经皮激光消融治疗原发性甲状旁腺功能亢进症[J]. 肿瘤影像学, 2020, 29(4): 370-374 https://doi. DOI： 10.19732/j.cnki.2096-6210.2020.04.005.

org/10.19732/j.cnki.2096-6210.2020.04.005 DOI：

摘要

目的：

探讨超声引导下经皮激光消融治疗原发性甲状旁腺功能亢进症（primary hyperparathyroidism，PHPT）的可行性、安全性及治疗价值。

方法：

对3例PHPT患者行激光消融，功率3 W，采用多点、移动消融法，术后即刻超声造影评估消融范围。术前、术后检测全段甲状旁腺素（intact parathyroid hormone，iPTH）、血钙、血磷、碱性磷酸酶（alkaline phosphatase，ALP）等，并测量甲状旁腺结节容积的变化率。密切随访12个月。

结果：

3例PHPT结节经超声造影证实均一次性彻底消融。术后12个月，iPTH由术前（578.37568.66）ng/L降为（92.6219.83）ng/L，血钙由（3.200.43）mmol/L降为（2.350.03）mmol/L（

＜0.05），ALP由（303.53188.29）U/L下降为（99.707.86）U/L，血磷由术前（0.8300.098）mmol/L上升为（0.9230.120）mmol/L；术后iPTH显著下降，血钙、血磷及ALP测值均持续正常。PHPT结节容积缩小率＞95.73%。术后1例发生骨饥饿综合征，予以口服补钙后好转，未发生喉返神经损伤等严重并发症。

结论：

超声引导下经皮激光消融治疗PHPT是一种微创、安全、有效的方法，可显著降低iPTH、血钙值，并显著缩小PHPT结节，有望成为治疗PHPT的新方法之一。

Abstract

Objective:

To investigate the feasibility

safety and therapeutic value of ultrasound-guided percutaneous laser ablation for primary hyperparathyroidism (PHPT).

Methods:

Three patients with PHPT were treated with laser ablation. The multi-point ablation power was 3W

and the contrast-enhanced ultrasound was used to evaluate the ablation range immediately after surgery. The changes o

f intact parathyroid hormone (iPTH)

serum calcium

serum phosphorus

alkaline phosphatase (ALP) and parathyroid nodule volume were measured before and after operation for 12 months.

Results:

A total of 3 cases of PHPT nodules were completely ablated at one time

confirmed by contrast-enhanced ultrasound. 12 months after operation

iPTH decreased from (578.37 568.66) ng/L to (92.6219.83) ng/L

serum calcium decreased from (3.200.43) mmol/L to (2.350.03) mmol/L (

＜0.05)

and ALP decreased from (303.53188.29) U/L to (99.707.86) U/L. Serum phosphorus rose from (0.8300.098) mmol/L to (0.9230.120) mmol/L. Postoperative iPTH decreased significantly. The blood calcium

blood phosphorus and ALP continued to be normal levels. The nodule volume reduction rate was ＞95.73%. One case of postoperative bone starvation syndrome was treated with oral calcium supplementation

and no serious complications such as recurrent laryngeal nerve injury occurred.

Conclusion:

Ultrasound-guided percutaneous laser ablation of PHPT is a minimally invasive

safe and effective method

which can significantly reduce iPTH

serum calcium measurements and significantly reduce the volume of parathyroid nodules. It can be a new method for the treatment of PHPT.

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