CAJ | 학술논문

目的：分析总结高钙危象的病因、临床特点和诊治要点，以减少漏诊和误诊。方法回顾性分析21例高钙危象患者的资料。结果21例患者中，原发性甲状旁腺功能亢进11例，恶性肿瘤6例，其他原因4例。其临床表现以消化道、泌尿系统和神经精神表现为主，其中10例患者在诊治前期存在不同程度的漏诊或误诊。在给予补液、利尿、应用降钙素、二磷酸盐、糖皮质激素及血液透析等治疗措施下，控制血钙并针对原发病进行治疗后，18例患者病情缓解，余3例死亡。结论高钙危象的病因以原发性甲状旁腺功能亢进和恶性肿瘤较多见，其临床表现缺乏特异性，常与相关系统原发疾病相混淆，有较高的漏诊率。血钙升高伴有消化系统、泌尿系统和神经精神系统异常表现，是高钙危象的早期诊断线索。
목적：분석총결고개위상적병인、림상특점화진치요점，이감소루진화오진。방법회고성분석21례고개위상환자적자료。결과21례환자중，원발성갑상방선공능항진11례，악성종류6례，기타원인4례。기림상표현이소화도、비뇨계통화신경정신표현위주，기중10례환자재진치전기존재불동정도적루진혹오진。재급여보액、이뇨、응용강개소、이린산염、당피질격소급혈액투석등치료조시하，공제혈개병침대원발병진행치료후，18례환자병정완해，여3례사망。결론고개위상적병인이원발성갑상방선공능항진화악성종류교다견，기림상표현결핍특이성，상여상관계통원발질병상혼효，유교고적루진솔。혈개승고반유소화계통、비뇨계통화신경정신계통이상표현，시고개위상적조기진단선색。
Objective To investigate the etiology , clinic characteristics , the key points in diagnosis and treatment of hypercalcemic crisis for avoiding the missed or erroneous diagnosis .Methods Data of 21 cases with hypercalcemic crisis was retrospectively analyzed .Results The causes of disease for the 21 patients were consisted of 12 primary hyperparathyroidism , 5 malignant tumor and 4 others. Clinical symptoms commonly involved gestrointestinal system , urinary system and neuropsychiatric systems .10 cases were missed diagnosed or mis -diagnosed at the early stage .After some of the following therapy including adequate rehydration , diuretic , calcitonin , bisphosphonates , glucocorticoids and hemodialysis , 18 cases were recovered , but the other 3 were dead.Conclusion Primary hyperparathyroidism and malignant tumor are the main causes of hypercalcemic crisis , the clinical manifestations of which are lack of specility and always confused with other similar diseases , so it would lead to a high rate of missed diagnosis .The elevation of serum calcemia accompanied by abnormal indications in digested , urinary and neuropsychiatric systems is essential clues for early diagnosis of hypercalcemia crisis .