Vilkhovoy S. The diagnostics and surgical treatment of primary and secondary hyperparathyroidism

The dissertation is devoted to increase the efficiency of diagnostics and surgical treatment of different forms and kinds of hyperparathyroidism During performance of the work it is established that primary hyperparathyroidism is diagnosed for 47,6 % patients which have characteristic clinical manifestation of different forms of the disease at their complex checkup with use of laboratory research methods and ultrasonography of neck's organs. The most valuable laboratory parameter for diagnostics primary hyperparathyroidism is the level of parathormone increase of which took place at 98,5% patients. Mixed form of primary hyperparathyroidism is diagnosed most often. All patients with valvular calcification of heart should be examined for cardial form of primary hyperparathyroidism. 37,8 % patients with chronic renal insufficiency which receive the treatment by a program of long-term hemodialysis have indications to surgical treatment because of the development of secondary hyperparathyroidism with presence of proof significant clinicoradiological manifestations and laboratory changes. Surgical treatment is executed to 32 patients, 22 with primary hyperparathyroidism and 10 with secondary hyperparathyroidism. In 56,6 % patients with primary hyperparathyroidism parathyroid adenomas take place. According to morphological research transition of secondary hyperparathyroidism into tertiary hyperparathyroidism is marked in 66,7 % patients. Simultaneous lesion of parathyroid glands and a thyroid gland have been established in 59,1 % cases. Surgical treatment of patients with different forms and kinds of hyperparathyroidism results in regress of clinical and laboratory manifestation and absence of the relapses of pathological conditions which come out from primary hyperparathyroidism and secondary hyperparathyroidism.