静脉注射双膦酸盐类药物:从随机对照研究获得的高质量证据表明,双膦酸盐类药物(帕米膦酸二钠和唑来膦酸)能改善恶性肿瘤相关性的高钙血症。[7]Major P, Lortholary A, Hon J, et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol. 2001 Jan 15;19(2):558-67.http://www.ncbi.nlm.nih.gov/pubmed/11208851?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
静脉注射双膦酸盐类药物:从随机对照研究获得的高质量证据表明,双膦酸盐类药物(帕米膦酸二钠和唑来膦酸)能改善恶性肿瘤相关性的高钙血症。[7]Major P, Lortholary A, Hon J, et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol. 2001 Jan 15;19(2):558-67.http://www.ncbi.nlm.nih.gov/pubmed/11208851?tool=bestpractice.com
静脉给予生理盐水:尚无随机对照研究 (RCT) 来指导在恶性肿瘤相关性高钙血症时应如何进行生理盐水补液治疗。然而,常规推荐这种治疗方式:促进肠外容量的增加;增加肾小球滤过率;以及增加尿钙。[1]Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.http://www.ncbi.nlm.nih.gov/pubmed/15673803?tool=bestpractice.com[3]Horwitz MJ, Hodak SP, Steward AF. Non-parathyroid hypercalcemia. In: Rosen CJ, ed. Primer on the metabolic bone diseases and disorders of mineral metabolism. 8th ed. Washington, DC: American Society of Bone and Mineral Research; 2013:562-71.[4]Alberta Provincial Tumour Council. Oncologic emergencies: a guide for family physicians. Sep 2014 [internet publication].https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-oncologic-emergencies.pdf
系统评价或者受试者>200名的随机对照临床试验(RCT)。
静脉给予生理盐水:尚无随机对照研究 (RCT) 来指导在恶性肿瘤相关性高钙血症时应如何进行生理盐水补液治疗。然而,常规推荐这种治疗方式:促进肠外容量的增加;增加肾小球滤过率;以及增加尿钙。[1]Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.http://www.ncbi.nlm.nih.gov/pubmed/15673803?tool=bestpractice.com[3]Horwitz MJ, Hodak SP, Steward AF. Non-parathyroid hypercalcemia. In: Rosen CJ, ed. Primer on the metabolic bone diseases and disorders of mineral metabolism. 8th ed. Washington, DC: American Society of Bone and Mineral Research; 2013:562-71.[4]Alberta Provincial Tumour Council. Oncologic emergencies: a guide for family physicians. Sep 2014 [internet publication].https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-oncologic-emergencies.pdf
透析:有低质量的证据表明无钙透析能有效改善那些对生理盐水水化治疗抵抗的肾衰竭患者的高钙血症。[12]Koo WS, Jeon DS, Ahn SJ, et al. Calcium-free hemodialysis for the management of hypercalcemia. Nephron. 1996;72(3):424-8.http://www.ncbi.nlm.nih.gov/pubmed/8852491?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
透析:有低质量的证据表明无钙透析能有效改善那些对生理盐水水化治疗抵抗的肾衰竭患者的高钙血症。[12]Koo WS, Jeon DS, Ahn SJ, et al. Calcium-free hemodialysis for the management of hypercalcemia. Nephron. 1996;72(3):424-8.http://www.ncbi.nlm.nih.gov/pubmed/8852491?tool=bestpractice.com