副甲状腺機能亢進症の外科 --臨床診断の問題--

Abstract

大阪大学泌尿器科学教室で経験した177例のPHPT例をretrospectiveに検討し, PHPTの臨床診断方法として以下の諸点を報告した.1) PHPTの診断には, まずPHPTの疾患概念を念頭に置き, 諸種の臨床症状・病変の問診・診療・検査をおこなうことが重要で, とくに尿路結石症例では単発・再発のいかんを問わず本症を1度は疑ってみるべきである.2)検査方法としては, s-Ca, s-Ca2+, s-Pi, %TRPの診断率がすぐれているが, 1回の検査のみでPHPTを否定することは避けるべきで, 数回以上の反復検査が必要である

During the period from June, 1959 to September 1983, 177 patients with primary hyperparathyroidism (PHPT) were treated in our Department. On the basis of this experience, a retrospective study has been made on the clinical diagnosis of PHPT. Repeated measurement of serum calcium, serum ionized calcium, serum phosphorus and %TRP was most useful for detecting patients with PHPT, in addition to careful observation of the many symptoms and disorders caused by PHPT. On the contrary, it is also stressed that PHPT can not be excluded even when a single measurement of any of the above stated items reveals a normal value.