目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄（OR=1.131）、睡眠差（OR=2.557）、合并3种及以上慢性病（OR=3.990）、抑郁（OR=3.296）、营养不良风险（OR=4.005）为老年脆性骨折患者术前衰弱的危险因素,BMI正常（OR=0.206）是保护因素（均P<0.05）。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。

       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures．Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected．Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale（CES-D-10）, the Generalized Anxiety Disorder Scale（GAD-7）, and the Nutritional Risk Screening 2002（NRS-2002）．Logistic regression was used to analyze factors influencing preoperative frailty．Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%．Logistic regression analysis revealed the following risk factors for preoperative frailty：age（OR=1.131）, poor sleep quality（OR=2.557）, multiple chronic comorbidities（OR=3.990）, depression（OR=3.296）, nutritional risk（OR=4.005）．Normal body mass index（OR=0.206）was a protective factor．Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients．Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients．