- 期刊
透析患者副甲狀腺切除後的骨飢餓症候群
Hungry Bone Syndrome After Parathyroidectomy in Dialysis Patients
摘要
長期透析患者常見次發性副甲狀腺機能亢進。若藥物治療無效，常需接受副甲狀腺切除手術，術後通常可見快速、輕度、短暫性血鈣降低。但當副甲狀腺切除術後總血清鈣濃度低於8.4 mg/dl（2.1 mmol/L），且／或持續低血鈣超過4天，便定義為骨飢餓症候群。對於高風險族群，副甲狀腺切除術後應嚴密監測血清鈣濃度。靜脈注射鈣劑的時機為快速及持續進行低血鈣，或低血鈣引起的症狀。適當的補充鈣片及活性維生素D3，可避免嚴重低血鈣症所造成的合併症。
並列摘要
Secondary hyperparathyroidism is common in long term dialysis patients. Parathyroidectomy is indicated in medical treatment failure patients. After the surgery, rapid, mild and transient hypocalcemia is common. Hungry bone syndrome is defined as serum calcium level below 8.4 mg/dl (2.1 mmol/L), and/or persist for more than 4 days after parathyroidectomy. For the high risk patients, close monitor serum calcium level is suggested after parathyroidectomy. Intravenous calcium injection is advised in rapid and progressive hypocalcemia, or symptoms caused by hypocalcemia. It is also suggested adequate calcium tablet and calcitriol supplementation to avoid the complications related to severe hypocalcemia.