离体甲状旁腺冻存及延迟自体移植治疗甲状旁腺功能低下的进展
In Vitro Parathyroid Cryopreservation and Delayedautologous Transplantation in the Treatment of Hypoparathyroid Function Progress

甲状旁腺功能低下常见于甲状腺全切术后甲状旁腺功能低下以及终末期肾脏病行维持性血液透析继发性甲状旁腺功能亢进术后，表现为颜面及手足麻木、抽搐等症状，需要口服钙和维生素D治疗、频繁的实验室检测，甚至急诊住院，长期低钙对骨代谢、眼部健康、心血管、肾脏和神经功能障碍产生不良影响，严重影响了患者的生活质量。目前甲状旁腺激素替代治疗的药物重组人甲状旁腺激素还在临床实验中，甲状旁腺自体再移植能较好地治疗术后甲状旁腺功能减退，但需要对离体甲状旁腺进行预处理、冻存后，根据病情需要，重新进行再移植。无论在国内还是国外，针对这方面的研究都比较匮乏。本文就术中甲状旁腺的辨识、甲状旁腺组织的预处理、甲状旁腺组织冰冻保存液的配制、冰冻保存、冻存时间以及移植部位进行了梳理，期望随着研究的深入，会有专属于人体的甲状旁腺冰冻保存技术的共识和标准颁布，让甲状旁腺功能低下的患者得到治愈。
Hypoparathyroidism is commonly seen in hypoparathyroidism after total thyroidectomy and hyperparathyroidism after end-stage renal disease and maintenance hemodialysis secondary hyperparathyroidism, which presents symptoms such as numbness and convulsion of hands and feet, requiring oral calcium and vitamin D treatment, frequent laboratory tests, and even emergency hospitalization. Chronic low calcium has adverse effects on bone metabolism, eye health, cardiovascular, kidney and neurological dysfunction, and seriously affects patients’ quality of life. At present, recombinant human parathyroid hormone for parathyroid hormone replacement therapy is still in clinical trials. Parathyroid autologous retransplantation can effectively treat postoperative hypoparathyroidism. However, preconditioning and freezing of isolated parathyroid glands are required prior to retransplantation. No matter at home or abroad, the research on this aspect is relatively scarce. In this paper, the identification of parathyroid glands during surgery, the pretreatment of parathyroid tissues, the preparation of cryopreservation solution for parathyroid tissues, cryopreservation time and transplantation site were combed. It is expected that with the deepening of the research, a consensus and standard of human parathyroid cryopreservation technology will be is-sued, so that patients with hypoparathyroid function can be cured.