| Abstract | Cilj istraživanja: Glavni je cilj ovog istraživanja prikazati incidenciju kirurški zbrinutih bolesnika oboljelih od primarnog hiperparatireoidizma. Prikazani su i prosječna dob i raspodjela ispitanika po spolu, etiologija primarnog hiperparatireoidizma, najčešća lokacija adenoma te prosječne preoperativne i postoperativne vrijednosti serumskog kalcija.
Materijal i metode: Ovo povijesno presječno istraživanje obuhvatilo je 139 bolesnika oboljelih od primarnog hiperparatireoidizma koji su kirurški zbrinuti u Klinici za bolesti uha, nosa i grla s kirurgijom glave i vrata Kliničkog bolničkog centra Split u razdoblju od 1. siječnja 2013. do 31. prosinca 2017. godine. Podaci o ispitanicima prikupljeni su uvidom u pisani protokol Klinike i arhive povijesti bolesti. Podaci o dobi, spolu, dijagnozi, lokaciji adenoma, vrijednostima serumskog kalcija prije i prva tri dana iza kirurškog zahvata obrađeni su deskriptivnim statističkim metodama, a rezultati su prikazani tablično i grafički.
Rezultati: U Klinici za bolesti uha, nosa i grla s kirurgijom glave i vrata Kliničkog bolničkog centra Split u navedenom petogodišnjem razdoblju kirurški je zbrinuto ukupno 139 oboljelih od primarnog hiperparatireoidizma, a primijećena je tendencija rasta incidencije. Prosječna dob oboljelih u trenutku operacije iznosila je 59,08 godina (raspon od 22 do 84 godine). Žene su činile 82,73% ispitanika s omjerom 4,79:1. Najčešći uzrok primarnog hiperparatireoidizma bio je solitarni adenom paratireoidne žlijezde (92,24%). Multipli adenom imalo je 5,76% ispitanika, a hiperplaziju i karcinom nijedan ispitanik. U donjoj desnoj žlijezdi bilo je lokalizirano 46,26% adenoma, u donjoj lijevoj 40,14%, gornjoj lijevoj 7,48% i u gornjoj desnoj 6,12% adenoma. Povišenu razinu serumskog kalcija prije kirurškog zahvata imalo je 91,87% ispitanika, a normalne vrijednosti prvog dana nakon zahvata imalo je 65,85% ispitanika.
Zaključci: Incidencija oboljelih od primarnog hiperparatireoidizma koji se kirurški zrbinjavaju raste. Većina oboljelih su postmenopauzalne žene. Najčešći uzrok primarnog hiperparatireoidizma je solitarni adenom, a najčešća lokacija adenoma je u donjoj desnoj paratireoidnoj žlijezdi. Vrijednosti serumskog kalcija se većinom spuštaju u referentni interval već prvog postoperativnog dana što sugerira učinkovitost kirurškog liječenja. |
| Abstract (english) | Objectives: The aim of this study is to show the incidence of surgically treated patients with primary hyperparathyroidism. We also showed the average age and distribution of subjects by sex, etiology of primary hyperparathyroidism, the most common location of parathyroid adenoma and average blood calcium levels before and after the surgery.
Material and Methods: This retrospective cross-sectional study included 139 surgically treated patients with primary hyperparathyroidism at the Clinic for Ear, Nose and Throat Diseases with Head and Neck Surgery, University Hospital of Split from January 1st 2013 to December 31st 2017. The subjects’ data was collected from the archives of the Clinic. Data on age, sex, diagnosis, localization of adenoma and blood calcium levels before and during the first three days after the surgical procedure was processed by descriptive statistical methods and the results were shown in the form of tables and graphs.
Results: At the Clinic for Ear, Nose and Throat Diseases with Head and Neck Surgery, University Hospital of Split in the aforementioned five-year period, total of 139 patients with primary hyperparathyroidism were surgically treated and there was a noticeable tendency towards increasing incidence. The average age at the time of surgery was 59.08 years (range from 22 to 84 years). Women accounted for 82.73% of patients with a ratio of 4.79:1. The most common cause of primary hyperparathyroidism was the solitary adenoma (92.24%). Multiple adenoma was found in 5.76% of patients, however, hyperplasia and carcinoma were not found. Of all adenoma, 46.26% was located in the right inferior parathyroid gland, 40.14% in the left inferior gland, 7.48% in the left superior and 6.12% in the right superior gland. Before the surgery. elevated blood calcium level was found in 91.87% of patients and on the first postoperative day normal level was found in 65.85% of patients.
Conclusions: The incidence of primary hyperparathyroidism is increasing. Most of the patients are postmenopausal women. The most common cause of primary hyperparathyroidism is solitary adenoma and the most common adenoma site is in the right inferior parathyroid gland. The level of blood calcium in most cases returns to normal already on the first postoperative day which suggests the success of surgical treatment. |
