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

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。

S]urgery is the important treatment for each type of thyroid cancer.Single or multiple parathyroid 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 hypocalcemia 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 hyperparathyroidism,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 postoperative hypocalcemia,evaluate and diagnose it early,and actively intervene in every stage of before,during and after 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.