Objective To analyze the factors for the first diagnosis, clinical features, treatment and prognosis of parathyroid adenoma(PA) patients.

Methods We reviewed the clinical date of 100 PA patients.

Results The median preoperative parathyroid hormone(PTH) levels were 201pg/ml and serum calcium were (2.84±0.34) mmol/L in 100 PA patients. The first diagnoses due to the skeletal system and urinary system symptoms were observed in 17% and 12% of patients(P=0.000); those due to hypercalcemia and parathyroid placeholder found in physical examination were 32% and 16% of patients(P=0.000). The 100 cases were composed of 62% bone types, 43% kidney type, 33% skeletal and renal involvements(P=0.000). The localization positive rate of ⁹⁹Tc^m-MIBI scan, ultrasonography, MRI and CT were 93.61%, 82.52%, 77.78% and 74%(P=0.057). Nineteen cases with bilateral neck explorations, 23 cases with unilateral neck exploration and 58 cases with no exploration were performed. Intraoperative parathyroid hormone monitoring during parathyroidectomy for PA was used commonly. PTH, serum calcium on postoperative day 1 significantly decreased and blood phosphorus increased obviously(P=0.000), while five cases developed chronic hypoparathyroidism.

Conclusion Blood calcium screening should be routinely used. PTH screening for patients with bone pain, fracture, urinary calculi and parathyroid placeholder is recommended. ⁹⁹Tc^m-MIBI scan is preferred for the localization. Intraoperative parathyroid hormone monitoring during parathyroidectomy can improve the success rate of operation.