【Abstract】 Objective To study the therapeutic effect o£ parathyroidectomy combined with cervical transplantation on secondary hyperparathy perparthyroidism (SHPT). Methods A retrospective analysis was made on 83 patients with refractory SHPT underwent total parathyroidectomy (TPTX) and autologous neck transplantation in our hospital from July 2016 to July 2018. The incidence and scores of pain, pruritus and sleep quality before and 6 months after operation were collected. The indexes o£ preoperative, intraoperative and postoperative stages and intravenous grape supplementation during perioperative period were collected. The total amount of calcium gluconate and the survival rate of parathyroid gland transplantation were analyzed. Results The incidence o£ pain, pruritus and sleep disorder was significantly decreased before and after operation. Compared with preoperative, the intraoperative and post-operative stages, the incidence o£ iPTH, blood Ca and blood P decreased significantly during and after operation, and the incidence of blood Ca and blood P decreased significantly after operation, while the incidence of intraoperative blood Ca and blood P was not significantly decreased compared with that before operation. The incidence of intraoperative blood Ca and blood P decreased significantly after operation. Compared with preoperative ALP, there was no significant change or slight decrease of ALP in 1-3 days after operation. After one week o£ ALP, ALP increased continuously, peaked in most two weeks, then decreased continuously, or reached normal level. Preoperative parathyroid hormone level was positively correlated with alkaline phosphatase. The preoperative iPTH level and preoperative ALP were positively correlated with intravenous calcium gluconate supplementation. Conclusion Total parathyroidectomy combined with autologous transplantation is effective for refractory SHPT patients. It can significantly improve the clinical symptoms and quality of life o£ patients. The higher the iPTH and/or ALP of SHPT patients before operation, the more likely hypocalcemia will occur after operation. The longer the duration o£ bone starvation is, the more valuable it is for us to predict the occurrence of severe hypocalcemia after operation.