医学观察
对于不符合外科治疗标准的无症状患者,75% 病情稳定可长达 10 年。25% 的患者病情会进展到符合甲状旁腺切除术的标准。但是,较年轻的患者(年龄< 50 岁)中高达 70% 的患者病情会发展到符合甲状旁腺切除术的标准。[92]Silverberg SJ, Shane E, Jacobs TP, et al. A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999 Oct 21;341(17):1249-55. [Erratum in: N Engl J Med. 2000 Jan 13;342(2):144.]http://www.nejm.org/doi/full/10.1056/NEJM199910213411701#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/10528034?tool=bestpractice.com PHPT 患者最常见的死亡原因是心血管疾病(卒中、心肌梗死)。高钙血症性心律失常罕见。
甲状旁腺切除术
甲状旁腺切除术治愈率超过 95%,如果是专家主刀,可高达 99%。[63]Udelsman R, Donovan PI. Minimally invasive parathyroid surgery. World J Surg. 2004 Dec;28(12):1224-6.http://www.ncbi.nlm.nih.gov/pubmed/15517494?tool=bestpractice.com[93]Grant CS, Thompson G, Farley D, et al. Primary hyperparathyroidism surgical management since the introduction of minimally invasive parathyroidectomy: Mayo Clinic experience. Arch Surg. 2005 May;140(5):472-8.http://archsurg.jamanetwork.com/article.aspx?articleid=508618http://www.ncbi.nlm.nih.gov/pubmed/15897443?tool=bestpractice.com