关注甲状腺癌术后低钙血症的防治
Strengthening the prevention and treatment of postoperative hypocalcemia of thyroid cancer patients
程小春 1孔令泉 1母力元 1涂江渝 1王元元 1吴凯南1
作者信息
- 1. 重庆医科大学附属第一医院乳腺甲状腺外科,重庆 400016
- 折叠
摘要
手术治疗是各型甲状腺癌的重要治疗方法,手术可引起单个或多个甲状旁腺损伤或血液供给障碍,致术后甲状旁腺素明显下降和低钙血症.长期低钙血症,可造成患者生理和心理上的巨大痛苦.部分患者甲状旁腺虽能代偿,但长期负钙平衡、术后低血钙刺激其余甲状旁腺增生、肿大,导致甲状旁腺功能增强/亢进,引起骨质疏松、泌尿系统结石、转移性血管钙化、全身钙质异常迁徙沉着等并发症.故加强对甲状腺癌术后低钙血症病因、危害认识,早评估早发现,积极在甲状腺癌术前、术中、术后及长期随访各个环节进行干预,可有效降低低钙血症的发生和严重程度,提高患者生活质量和改善预后.
Abstract
Surgery is the important treatment for each type of thyroid cancer.Single or multiple parathy-roid injuries or blood supply disorders may occur during the operation,resulting in dramatic decline of parathyroid hormone and hypocalcemia after operation,which is common in clinical practice.After discharge,chronic hypocal-cemia can cause great physical and psychological pain to patients.Although the residual parathyroid glands can compensate after surgery in some cases,long-term negative calcium balance and postoperative hypocalcemia may cause excessive hyperplasia of the residual parathyroid glands,resulting in parathyroid hyperfunction or even hy-perparathyroidism,which can lead to osteoporosis,urinary calculi,metastatic vascular calcification,and systemic abnormal migratory calcium deposits.It's advisable to enhance the awareness of the cause and harm of the postop-erative hypocalcemia,evaluate and diagnose it early,and actively intervene in every stage of before,during and af-ter the operation and long-term follow-up,which can effectively reduce the occurrence and severity of hypocalcemia and improve the postoperative life quality and the prognosis.
关键词
甲状腺癌/低钙血症/甲状旁腺功能减退/甲状旁腺功能亢进Key words
Thyroid cancer/Hypocalcemia/Hypoparathyroidism/Hyperparathyroidism引用本文复制引用
出版年
2024
NETL
NSTL
万方数据