目的 :探讨原发性甲状旁腺机能亢进症的诊断和手术处理方法。方法 :对我院 1981～ 1998年 19例原发性甲状旁腺机能亢进症的患者的临床表现、实验室检查和术前、术中定位方法及手术治疗进行了回顾性分析总结。结果 :持重部位骨关节疼痛、多发骨折为其主要征象 ,实验室检查有血钙、血甲状旁腺激素、血碱性磷酸酶及尿钙、尿磷升高和血磷降低。X线主要表现为骨质疏松、骨质变薄。B超、CT及 99m Tc造影三项结合可使术前定位准确率达 89%以上。手术中利用甲状腺胸腺韧带及甲状腺下动脉注射亚甲蓝染色可帮助寻找病变的甲状旁腺。结论 :原发性甲状旁腺机能亢进症的诊断需结合临床症状及辅助检查。术前、术中的准确定位及冰冻病理的定性检查是手术成功的关键。一侧甲状旁腺中仅有一个病变者可只行单侧探查 Objective: To investigate the diagnosis and surgical treatment of primary hyperparathyroidism. Methods: The clinical manifestations, laboratory tests, preoperative and intraoperative positioning methods and surgical treatment of 19 patients with primary hyperparathyroidism from 1981 to 1998 in our hospital were reviewed retrospectively. Results: Bone and joint pain in the weight-bearing area and multiple fractures were the main signs. Laboratory tests included serum calcium, parathyroid hormone, serum ALP, urinary calcium, elevated urinary phosphate and decreased blood phosphorus. X-ray is mainly manifested as osteoporosis, bone thinning. B ultrasound, CT and 99m Tc angiography combined with three preoperative positioning accuracy of 89% or more. Surgical use of thyroid thymus ligament and thyroid artery injection of methylene blue staining can help find the pathological parathyroid. Conclusion: The diagnosis of primary hyperparathyroidism should be combined with clinical symptoms and laboratory examinations. Preoperative and intraoperative accurate positioning and frozen pathological qualitative examination is the key to successful operation. Only one lesion on one side of the parathyroid gland may be examined unilaterally