Sekonder Hiperparatiroidili Hastalarda Subtotal Paratiroidektomi Sonuçlarımız
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Dosyalar
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Sekonder hiperparatiroidi kronik böbrek yetmezliğinin en önemli geç dönem bulgularından biridir. Bu çalışmada amacımız kliniğimizde 4 yıllık süre içinde kronik böbrek yetmezliğine bağlı gelişen sekonder hiperparatiroidi nedeniyle ameliyat edilen olguların analizini ve klinik özelliklerini retrospektif olarak değerlendirmektir. Yöntem: Ocak 2001 ile Mart 2005 tarihleri arasında kliniğimizde kronik böbrek yetmezliği sonucu gelişen sekonder hiperparatiroidi nedeniyle subtotal paratiroidektomi uygulanan 14 hasta retrospektif olarak değerlendirildi. Bulgular: Hastalarda en sık rastlanan semptom kas güçsüzlüğü ve kemik ağrıları idi. Kas güçsüzlüğü 10 hastada, kemik ağrıları ise 8 hastada mevcut idi. Ameliyat öncesi yapılan radyolojik incelemede çekilen el grafisinde 8 hastada (% 57) subperiostal rezorbsiyon saptandı. Bir hastada ise spontan kemik kırığı tespit edildi. Serum kalsiyum düzeyleri ortalama 12.2 0.9 (8.2-15.1) mg/dL, fosfor düzeyleri ortalama 6.31.8 (2.2-7.4) mg/dL, ALP düzeyi ise ortalama 873 243,5 (225-8884) U/L olarak ölçüldü. Hastaların tümünde parathormon değeri yüksek bulundu. Ortalama PTH değeri 878 (810-1257) pgr/ml olarak ölçüldü. Tüm hastalarda paratiroid bezleri anatomik olarak normal pozisyonda idi ve hastaların tümüne subtotal paratiroidektomi uygulandı. Sonuç: Böbrek yetmezliğine bağlı sekonder hiperparatiroidi kalsiyum ve vitamin D tedavisine cevap vermesine rağmen uzun dönemde cerrahi tedavi önem kazanmaktadır. Subtotal paratiroidektomi uygulanan vakalarda klinik olarak belirgin iyileşme, laboratuar bulgularında düzelme görülmüş ve kalıcı hipoparatiroidi görülmemiştir. Kronik böbrek yetmezlikli hastalarda gelişen sekonder hiperparatirodi tedavisinde subtotal paratiroidektominin en uygun cerrahi tedavi olduğunu düşünmekteyiz.
Objective: Secondary hyperparathyroidism is the most important late term feature of chronic renal failure. In this study, our aim was to investigate cases operated for secondary hyperparathyroidism occurred by chronic renal failure in 4 years period and the clinical features retrospectively. Methods: Fourteen patients who were confirmed subtotal parathyroidectomy for secondary hyperparathyroidy occurred by chronic renal failure were examined between January 2001-March 2005 in our clinic. Results: The most seen symptoms were muscle weakness and bone ache in the patients. There was muscle weakness in 10 patients and bone ache in 8 patients. In 8 patients there was subperiostal resorbtion in hand graphics made before operation. Spontaneous bone break was identified in 1 patient. Average serum calcium levels were 12.2± 0.9 (8.2-15.1) mg/dL, mean phosphorus levels were 6.3±1.8 (2.2-7.4) mg/dL, and mean ALP levels were 873± 243,5 (225-8884) U/L. PTH levels were found high in all patients. Mean PTH value was measured as 878 pgr/ml (810-1257). All parathyroids were in normal position anatomically and subtotal parathyroidectomy was performed to all patients. Conclusion: Although secondary hyperparathyroidy due to renal failure good to calcium and vitamin D treatment, in long term treatment surgery becomes more important. Subtotal parathyroidectomy significant healing was seen clinically, laboratory findings got better and no permanent hypoparathyroidy was seen. We believe that subtotal parathyroidectomy is the most suitable surgical treatment in secondary hyperparathyroidy in patents with chronic renal failure.
Objective: Secondary hyperparathyroidism is the most important late term feature of chronic renal failure. In this study, our aim was to investigate cases operated for secondary hyperparathyroidism occurred by chronic renal failure in 4 years period and the clinical features retrospectively. Methods: Fourteen patients who were confirmed subtotal parathyroidectomy for secondary hyperparathyroidy occurred by chronic renal failure were examined between January 2001-March 2005 in our clinic. Results: The most seen symptoms were muscle weakness and bone ache in the patients. There was muscle weakness in 10 patients and bone ache in 8 patients. In 8 patients there was subperiostal resorbtion in hand graphics made before operation. Spontaneous bone break was identified in 1 patient. Average serum calcium levels were 12.2± 0.9 (8.2-15.1) mg/dL, mean phosphorus levels were 6.3±1.8 (2.2-7.4) mg/dL, and mean ALP levels were 873± 243,5 (225-8884) U/L. PTH levels were found high in all patients. Mean PTH value was measured as 878 pgr/ml (810-1257). All parathyroids were in normal position anatomically and subtotal parathyroidectomy was performed to all patients. Conclusion: Although secondary hyperparathyroidy due to renal failure good to calcium and vitamin D treatment, in long term treatment surgery becomes more important. Subtotal parathyroidectomy significant healing was seen clinically, laboratory findings got better and no permanent hypoparathyroidy was seen. We believe that subtotal parathyroidectomy is the most suitable surgical treatment in secondary hyperparathyroidy in patents with chronic renal failure.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp, Sekonder hiperparatiroidi, paratiroidektomi, kronik böbrek yetmezliği, Secondary hyperparathyroidism, parathyroidectomy, chronic renal failure
Kaynak
Genel Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
15
Sayı
4
Künye
Erikoğlu, M., Tavlı, Ş., Türk, S., Tekin, Ş., (2005). Sekonder Hiperparatiroidili Hastalarda Subtotal Paratiroidektomi Sonuçlarımız. Genel Tıp Dergisi, 15(4), 143-146.
