首页|甲状腺癌术后长期严重低钙血症经大剂量补钙症状控制一例报道

甲状腺癌术后长期严重低钙血症经大剂量补钙症状控制一例报道

Chronic severe hypocalcemia after thyroid cancer surgery was controlled basically after high dose calcium supplementation:1 case report

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甲状腺癌是颈部常见的恶性肿瘤,手术是其重要治疗手段.部分患者术后出现甲状旁腺功能减退和低钙血症,严重影响患者术后生活质量和预后.本文报道了 1例42岁甲状腺癌行甲状腺全切术后低钙血症6年的女性患者,大剂量口服补钙和活性维生素D仍频发低钙血症,长期面部肢体麻木抽搐、癫痫样发作伴意识丧失.入院后密切监测下足量补充钙剂(口服加静脉钙剂等补充)1周后症状明显缓解,出院时已能单纯口服补钙且剂量减少而维持血钙正常水平,自述长期肢体麻木、抽搐、腰痛、肩痛、走路不稳等症状基本消失,未再有癫痫样发作,随访半年血钙控制良好.
Thyroid cancer is the common malignant tumor in the neck,and surgery is the important treat-ment measure for it.Some patients suffer from hypoparathyroidism and hypocalcemia after thyroidectomy,which will seriously affect the patient's life quality and prognosis.This article reported a case of 42 years old female pa-tient with hypocalcemia for 6 years after total thyroidectomy due to thyroid cancer,who still had frequent hypocalce-mia with high dose of oral calcium and active vitamin D supplementation.Long-term and frequent facial and limb numbness,convulsions,epileptic-like seizures and sudden unconsciousness afflicted her due to hypocalcemia.Af-ter admission,her symptoms were obviously relieved after one week of adequate calcium supplementation through oral administration or intravenous infusion under close monitoring.Upon discharge she was able to maintain the normal level of blood calcium by decreased dose of oral calcium supplementation alone.Long-term limb numbness,convulsions,low back pain,shoulder pain,walking instability and other symptoms disappeared basically.The epi-leptic-like seizures did not recur.During six months of follow-up,her blood calcium was still well controlled in nor-mal level.

Thyroid cancerThyroidectomyHypocalcemiaHypoparathyroidismCalcium supple-mentation

程小春、邬斌、孔令泉、母力元、涂江渝、王元元、吴凯南

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重庆医科大学附属第一医院乳腺甲状腺外科,重庆 400016

重庆建设医院普外科,重庆 400050

甲状腺癌 甲状腺切除术 低钙血症 甲状旁腺功能减退 补钙

2024

中华内分泌外科杂志
中华医学会

中华内分泌外科杂志

CSTPCD
影响因子:0.657
ISSN:1674-6090
年,卷(期):2024.18(4)