甲状旁腺增生致反复泌尿系结石1例报告并文献复习

目的：总结甲状旁腺增生导致的反复泌尿系结石的诊断和治疗经验，提高泌尿外科医师对此病的认识、分析和治疗水平。方法：回顾性分析1例由甲状旁腺增生导致的反复泌尿系结石患者的临床资料：因反复泌尿系结石伴双上肢骨痛十余年，反复行体外冲击波碎石、输尿管镜碎石及相关骨科治疗，症状控制不理想。本次就诊时在详细追问病史下经科室会诊考虑为甲状旁腺机能亢进导致的泌尿系结石，遂经实验室检查证实。联合甲状腺乳腺外科进行手术。结果：术后患者症状明显缓解，病理检查结果为甲状旁腺增生。泌尿外科遂为患者清除输尿管结石。术后随访2年，未再发结石和骨痛。结论：泌尿外科医师在接诊反复结石患者时应考虑有甲状旁腺机能亢进的可能性；甲状旁腺激素检查有助于临床诊断；多学科团队模式可提高该类患者的诊疗效果。

Repeated urinary calculi caused from parathyroid hyperplasia： a case report and literature review

Objective： To Summary the experience on diagnosis and treatment of urinary calculi caused from parathyroid hyperplasia, and to improve awareness and therapeutic level of urological physicians. Methods： The clinical data of a patient with repeated urinary stones due to parathyroid hyperplasia was retrospectively analyzed as follow： urinary calculi occurred frequently with both upper limhs pain for more than ten years, repeated extracor- poreal shock wave ]ithotripsy（ESWL）, ureteroscopic ]ithotripsy（URSl.） and related orthopedic treatment were used, and the symptom control was not ideal. This case was suggested to be hyperparathyroidism according to a detailed medical history obtained from the patient at this time by our urology department. The diagnosis was con- firmed further by the laboratory examinations and the surgery was conducted by thyroid and breast department. Results：After parathyroidectomy, the patient symptom was relieved and pathological result was disclosed to be parathyroid hyperplasia. The patient went ahead to receive stones clearance in bilateral ureters in urology depart- ment. Followed up for two years, no recurrence was reported on stone and bone pain. Conclusions：The urologists should consider the possibility of hyperparathyroidism when encountered patients with repeated stones. The para- thyroid hormone test can help diagnose. The pattern of multidisciplinary team may be in use of improving the pa- tient＇s therapeutic effect.