Abstract: Objective To analyze the clinical features of primary hyperparathyroidism (PHPT) patients, reduce the diagnosis and treatment of the crossroads and complications. Methods Retrospective analysis of the patients with primary hyperparathyroidism diagnosed from January 2010 to March 2018 in Department of General Surgery of Beijing Jishuitan Hospital, general information, clinical manifestations and treatment, preoperative image location examination, reoperation data analysis and intraoperative specimen, postoperative pathology, parathyroid hormone (PTH) analysis, etc. Results The number of cases of primary hyperparathyroidism has increased year by year, and can be derived from clinical multi-disciplinary departments.According to their clinical manifestations, bone type and bone kidney type are common, each accounted for 53.2% and 24.6%, of which have a history of fracture 30 cases, accounting for 18%, Orthopedic surgery was performed in 24 cases, accounting for 14.4%, of which 2 or above orthopaedic surgery in 5 cases, accounting for 21% of orthopedic surgery patients. Patients with orthopedic events (fractures or suspected bone tumors) had significantly different PTH values than other patients (P=0.003).Eleven patients were not first operation, accounting for 6.6%, of which 5 were former ectopic parathyroid surgery, which accounted for 45.5% of reoperation. There was a significant difference in preoperative PTH among the parathyroid gland hyperplasia group,the parathyroid carcinoma group and the adenoma group (P<0.05). There was no significant difference in the wet weight between the three groups.Conclusion The clinical early diagnosis should be paid attention to PHPT patients, screening of patients with fracture, bone deformity or osteoporosis should be strengthened.It is difficult to determine the preoperative benign or malignant and PTH was significant. We should combine preoperative imaging and intraoperative rapid PTH detection technique to achieve accurate positioning, improve the success rate of operation, avoid multiple surgeries, or repeatedly explore during operation. For patients with recurrent disease, ectopic lesions or parathyroid carcinoma metastasis should be considered.

Key words: primary hyperparathyroidism (PHPT), parathyroid hormone (PTH), bone type