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1、·314·中国实用外科杂志2014年4月第34卷第4期［15］RubinMR,BilezikianJP,McMahonDJ,etal.Thenaturalhis-150001,ChinatoryofprimaryhyperparathyroidismwithorwithoutparathyroidCorrespondingauthor:DAIWen-jie,E-mail:davidhmu@163.surgeryafter15years［J］.JClinEndocrinolMetab，2008，93com(9):3462-3470.AbstractSecondar
2、yhyperparathyroidism(SHPT)referstoa［16］BollerslevJ,JanssonS,MollerupCL,etal.Medicalobservation,derangementincalciumhomeostasisleadingtoacomparedwithparathyroidectomy,forasymptomaticprimarycompensatoryincreaseinparathyroidhormone(PTH)hyperparathyroidism:aprospective,randomizedtrial［J］
3、.Jsecretion.MostSHPTpatientsdependonmedication.SHPTClinEndocrinolMetab，2007，92(5):1687-1692.requiringparathyroidectomy(PTx)occursmorecommonlyin［17］BilezikianJP,SilverbergSJ.Clinicalpractice.Asymptomaticprogressivechronickidneydisease(CKD)andinlong-termprimaryhyper-parathyroidism［J］.N
4、EnglJMed，2004，350lithiumtherapy.Atpresent,afterthoughtfulreviewwhich(17)：1746-1751.procedureisthemostsuitableoperativeprocedureforpatients［18］BollandMJ,GreyAB,Orr-WalkerBJ,etal.ProspectivewithadvancedSHPTstillcan’tbedetermined.Thedecision10-yearstudyofpostmenopausalwomenwithasymptoma
5、ticmaydependonthesurgeon'spreferenceandtheclinicalstatusprimaryhyperparathyroidism［J］.NZMedJ，2008，121(1277):ofthepatients.Importantpatientissuesinchoosingaspecific18-29.（2014-02-06收稿）procedureiswhetherthepatientisacandidateforkidneytransplantation,patientage,expectedsurvivalafterPTx,
6、andthepatient'sabilitytoobtainandcomplywithmedication.For文章编号：1005-2208（2014）04-0314-04patientswhorequirelong-termhemodialysisafterPTx,theriskforrecurrenceisnotnegligible,asitiseasierandsaferto继发性甲状旁腺功能removeresidualparathyroidtissuefromtheforearmat亢进外科治疗recurrenceascomparedwithaneck
7、reexploration.Thus,totalPTxwithforearmautograftisthepreferredoptioninapatient代文杰，徐德全whohastocontinuehemodialysisforlongperiodsafterPTx.Keywordssecondaryhyperparathyroidism;parathyroidecto⁃my【摘要】继发性甲状旁腺功能亢进（secondaryhyperparathy-roidism，SHPT），是指钙离子动态平衡紊乱导致代偿性甲状甲状旁腺是调节人体钙磷代谢，维持体内钙、磷内环境
8、旁腺素（PTH）的过度分
