【摘要】 随着透析技术的发展，慢性肾脏病 ( chronic kidney disease, CKD ) 患者的生存时间显著增长，使得继发性甲状旁腺功能亢进 ( secondary hyperparathyroidism, SHPT ) 的发病率不断增高。SHPT患者伴有严重的皮肤瘙痒、骨骼畸形、心血管异位钙化等临床症状导致患者生活质量极差，目前SHPT 主要以内科治疗为主，但对于难治性SHPT 患者药物治疗效果不佳、容易反复且费用较高，目前内科治疗还不能替代外科手术治疗SHPT 的办法，因此对于药物治疗没有效果的SHPT 患者，文献及慢性肾脏病-矿物质和骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)指南建议行甲状旁腺切除术(parathyroidectomy, PTX)治疗[1-4]，本文针对SHPT 的外科治疗进展做一综述。

【Abstract】With the development of dialysis technology, the incidence of secondary hyperparathyroidism (SHPT) increases significantly due to the longer survival of chronic kidney disease (CKD) patients. SHPT symptoms including skin itching, skeletal deformities and ectopic calcifications in cardiovascular system often severely hurt the quality of life in CKD patients. The main therapy for SHPT is medicine. However, medical treatment may be ineffective for some intractable SHPT patients, leading to relapse of the symptoms and higher medical expenses. Therefore, surgical treatment is necessary in some cases ineffective to drug treatment. The guidelines for chronic kidney disease-mineral and bone disorder (CKD-MBD) propose performing parathyroidectomy (PTX) for these SHPT patients. In this paper we reviewed the recent advances in surgical treatment of SHPT.