Secondary hyperparathyroidism is one of the most common complications of chronic renal failure, causing serious harm to multiple systems and seriously affecting the quality of life and survival of patients. It is worthwhile to promote this treatment to benefit more patients with uremic secondary hyperparathyroidism. Pre-operative investigations: routine pre-operative general investigations: routine blood tests, liver and kidney functions, coagulation, electrolytes, pre-transfusion tests, electrocardiogram, chest X-ray, cardiac ultrasound, etc. to assess the patient’s tolerance to surgery. Other targeted special examinations: parathyroid and thyroid high frequency color Doppler ultrasound, ECT scan i.e. 99mTc a methoxyisobaric duplex scan; whole segment parathyroid hormone. Preoperative preparation: stop anticoagulants one week before surgery, take oral osteopontin 0.25ug twice a day and calcium carbonate 1.5-2g three times a day; perform heparin-free hemodialysis one day before surgery; exercise cardiopulmonary function. Postoperative management: Routinely monitor vital signs after surgery, prepare tracheotomy kits at the patient’s bedside, and regularly observe incisional drainage and any respiratory difficulties. Pay special attention to the presence of convulsions and other symptoms of low calcium, and test serum calcium, phosphorus and alkaline phosphatase levels on the next day after surgery, and then recheck them once a day, until a week later when they are tested weekly. Calcium supplementation principles: keep total serum calcium above 1.8 mmol/Ll, routine postoperative intravenous infusion of calcium gluconate or fasting oral calcium carbonate to reach elemental calcium 1-2 g/d and oral bone triol 0.5 μg/d; if serum calcium is lower than 1.8 mmol/L or convulsions occur, immediately give 1 g of calcium gluconate intravenous push (each g of calcium gluconate contains 90 mg of elemental calcium) and take 1 g of Calcium gluconate/h was maintained by micro-intravenous pump, while the oral calcitriol dose was increased to a maximum amount of 4 μg/d. Later, the intravenous calcium supplementation was gradually reduced and maintained by oral calcium supplementation + calcitriol; if the serum calcium was greater than 2.8 mmol/L, the amount of calcium preparation and calcitriol was reduced by half or discontinued. Half or full dose of heparin hemodialysis was performed 1-2 days after surgery depending on the wound condition. Surgical complications: Hypocalcemia is the most common postoperative complication and is considered to be caused by a rapid decline in parathyroid hormone and increased bone mineralization leading to bone starvation syndrome and delayed graft function. Close testing of blood calcium levels and appropriate calcium and vitamin D supplementation are required. other complications including laryngeal return nerve injury, wound infection, hematoma, wound dehiscence, hypotension, cardiac arrhythmia, and recurrence have a low incidence. According to relevant data, after parathyroidectomy for patients with refractory secondary hyperparathyroidism, almost all patients with postoperative bone pain and pruritus were significantly relieved on the same day or the next day after surgery; most patients with other symptoms, including muscle weakness, restless legs, insomnia, and dryness, improved rapidly in the recent postoperative period; patients with regressed human syndrome stopped shortening in height; some patients were unable to walk before surgery, and those requiring wheelchairs could walk on their own. The use of EPO was reduced, and the effect after use was significantly improved compared with that before surgery; most of the detected parathyroid hormone levels could be reduced to normal levels, and calcium and phosphorus indexes could be maintained within the normal range, and the nutritional status was significantly relieved; some male patients’ sexual function could also be improved after surgery.