腹膜透析继发甲状旁腺功能亢进术后低钙危象1例

Experience of low calcium crisis after the operation in peritonea dialysis secondary hyperparathyroidism:a case report

1病例报告患者,男,67岁,因＂全身骨关节疼痛2年＂于2014年1月13日入院。既往史：48年前诊断为慢性肾小球肾炎,中医治疗。3年前在我院开始应用持续非卧床腹膜透析,使用低钙透析液（low-calcium dialysate,LCD;Ca2＋：1.25mmol/L）。近2年来全身骨关节逐渐疼痛加剧,无法行走。体检：尿毒症容貌,脐旁左2cm处见一5cm手术瘢痕,

We report a case of secondary hyperparathyroidism after peritoneal dialysis.After given the total parathyroidectomy and forearm autoplantation（PTX＋AT）,the patient presented with an acute low calcium crisis（tongue myoparalysis,tetany and ECG abnormalities）.As the conventional calcium treatment was invalid,the calcium solution was then changed,and replaced by the standard calcium dialysate with monitoring calcium ions.At the last,the patient was rescued.After a long term followed up,the patient＇s clinical symptoms were improved,and the parathyroid hormone（iPTH）level basically kept within the scope of the KDIGO guidelines.