POS-198 CLINICAL EFFECT OF PARATHYROIDECTOMY AND AUTOLOGOUS HOMOGENATE TRANSPLANTATION IN THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM

Abstract

To explore the clinical effect of total parathyroidectomy combined with forearm autologous homogenate transplantation in the treatment of renal secondary hyperparathyroidism. Patients with CKD-MBD and secondary hyperparathyroidism were randomly divided into two groups. The granule embedding group was treated with total parathyroidectomy and autologous forearm granule embedding transplantation, and the homogenate injection group was treated with total parathyroidectomy and autologous forearm homogenate transplantation. The levels of serum calcium, phosphorus, iPTH and bone metabolism were compared between the two groups before and after treatment. The occurrence and improvement of vascular calcification, soft tissue calcification, skin pruritus, bone pain, pathological fracture, myasthenia, cardiovascular events and withdrawal after operation intervention. Analysis and comparison of postoperative recurrence between the two groups. The changes of blood calcium, phosphorus, iPTH, AKP and other indicators in the two groups before and after operation were compared. The improvement and changes of the above indicators in the homogenate injection group were significantly better than those in the granule embedding group, and the difference was statistically significant (P < 0.05). The incidence and improvement of complications such as vascular calcification, soft tissue calcification, skin pruritus, bone pain, pathological fracture, myasthenia, cardiovascular events and withdrawal in the homogenate injection group were better than those in the granule embedding group (P < 0.05). The recurrence rate in the homogenate injection group was significantly lower than that in the granule embedding group (P < 0.05). Total parathyroidectomy combined with autologous forearm homogenate injection transplantation can effectively treat CKD complicated with refractory secondary hyperparathyroidism, and has the advantages of high success rate, small trauma and simple operation, which can be widely used in clinic.