原発性副甲状腺機能亢進症手術症例の検討

A clinical analysis of patients with primary hyperparathyroidism

はじめに

　原発性副甲状腺機能亢進症は，副甲状腺ホルモンの過剰分泌により引き起こされる疾患である。根治治療は手術による原因部位の摘出であり，術前の局在診断と確実な切除が重要である。無症候性の発見例も多く，手術症例は増加している^1）。多くは良性で，腫大腺の切除により治癒しうるが，特有の術後合併症も生じうる。当科で手術加療を行った症例につき臨床的検討を行ったので報告する。

　A clinical study of 47 patients with primary hyperparathyroidism treated surgically in our hospital from 2007 to 2015 was performed. Surgical success rate was 98％. Postoperative complications were hypocalcemia in nine cases, pseudogout attack in five cases, recurrent laryngeal nerve paralysis in two cases. Preoperative Ca, ALP, PTH and maximum diameter of the tumor were significantly higher in the patients who had postoperative hypocalcemia than in the patients who did not have postoperative hypocalcemia. Since recurrent laryngeal nerve paralysis is sometimes unavoidable in some cases with a benign adenoma, we need to pay much attention in those cases.