Abstract

Objective

To compare the postoperative hypocalcemia between ultrasound-guided microwave ablation (MWA) and total parathyroidectomy (TPTX) for secondary hyperparathyroidism (SHPT).

Methods

The retrospective study reviewed 286 SHPT patients (171 received MWA and 115 underwent TPTX) between March 2018 and May 2019. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. A total of 184 SHPT patients (92 in each group) were finally enrolled, the occurrence and prognosis of postoperative hypocalcemia were compared. And the risk factors associated with severe hypocalcemia (SH) in each group were analyzed.

Results

Hypocalcemia encountered in 95cases (49 in the MWA group and 46 in the TPTX group). SH occurred in 76 cases (40 in the MWA group and 36 in the TPTX group). There were no statistically significant differences in the detection time, incidence, minimum value of serum calcium and symptomatic hypocalcemia between MWA and TPTX group (all p values > 0.05). Of patients developing hypocalcemia, serum calcium did not recover to normal range in 5 cases (10.2%) in the MWA group, while 13 cases (28.3%) were still hypocalcemia at 6 months follow-up in TPTX group (p = 0.035). The time to recovery from hypocalcemia in the TPTX group (mean 30 days, range 3–180 days) was longer than the WA group (mean 14 days, range 3–126 days) (p = 0.000). High serum alkaline phosphatase (ALP) level and low serum calcium level were the main risk factors of postoperative SH.

Conclusion

There was no difference in hypocalcemia between MWA and TPTX group. Hypocalcemia in the TPTX group might need a longer time to recover.

中文翻译：

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超声引导微波消融和全甲状旁腺切除术治疗继发性甲状旁腺功能亢进后的低钙血症：一项回顾性研究。

摘要

目的

为了比较继发性甲状旁腺功能亢进症（SHPT）的超声引导微波消融（MWA）和全甲状旁腺切除术（TPTX）之间的术后低钙血症。

方法

回顾性研究回顾了2018年3月至2019年5月之间的286例SHPT患者（其中171例接受了MWA，115例接受了TPTX）。倾向评分匹配用于收集一组具有相似基线特征的患者。最终纳入184例SHPT患者（每组92例），比较了术后低血钙的发生和预后。并分析了每组与严重低钙血症（SH）相关的危险因素。

结果

低钙血症发生在95例中（MWA组为49例，TPTX组为46例）。SH发生在76例中（MWA组40例，TPTX组36例）。MWA和TPTX组之间的检测时间，发生率，血清钙最低值和症状性低钙血症之间无统计学差异（所有p值> 0.05）。在发生低钙血症的患者中，MWA组中有5例（10.2％）的血清钙未恢复到正常范围，而TPTX组在6个月的随访中有13例（28.3％）仍为低钙血症（p  = 0.035）。TPTX组从低钙血症恢复的时间（平均30天，范围3–180天）比WA组更长（平均14天，范围3–126天）（p = 0.000）。血清碱性磷酸酶（ALP）高和血清钙水平低是术后SH的主要危险因素。

结论

MWA和TPTX组之间的低血钙没有差异。TPTX组的低钙血症可能需要更长的时间才能恢复。