BMJ Best Practice
最后审核时间： 六月 2019
最近更新时间： 一月 2019

小结

定义

病史和查体

关键诊断因素

  • 甲状腺、甲状旁腺或喉部手术史
  • 慢性酒精中毒
  • 营养不良、吸收不良、腹泻
  • 肌肉颤搐、痉挛、痛性痉挛
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其他诊断因素

  • 焦虑
  • 毛发干枯、脆甲症
  • 白内障
  • 黏膜皮肤念珠菌病病史
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危险因素

  • 甲状腺手术
  • 甲状旁腺手术
  • 低镁血症
  • 中度和慢性母体高钙血症（新生儿低钙血症）
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诊断性检查

首要检查

  • 血清钙
  • 血清白蛋白
  • 心电图 (ECG)
  • 血浆全段 PTH
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需要考虑的检查

  • 24-小时尿钙、肌酐
  • 24-小时镁、肌酐
  • 肝功能检查
  • 动脉血气 (ABG) 分析
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新兴检查

  • 21-羟化酶或 1 型干扰素自身抗体
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治疗流程

推断

重度症状性低钙血症（白蛋白校正血清总钙量＜1.88 mmol [＜7.5 mg/dL]）

急性

无症状性术后暂时性低钙血症

疾病持续状态

轻至中度慢性低钙血症（白蛋白校正血清总钙量 1.87 - 2.13 mmol/L [7.5 - 8.5 mg/dL]）

中重度低钙血症（白蛋白校正血清总钙量＜1.88 mmol/L [＜7.5 mg/dL]）

贡献者

作者 查看所有

Professor of Medicine

University of California San Francisco

Endocrine Research Unit

San Francisco VA Medical Center

San Francisco

CA

利益冲突披露
DS worked as a consultant for SHIRE Pharmaceuticals. She has received honorarium from Neopharma, and served as an expert witness for a patient-based malpractice case. For the past 5 years, DS was a speaker for the annual patients and caregivers conference on hypoparathyroidism for the US-based Hypoparathyroidism Association, and is an unpaid member of their medical advisory board. DS has given many CME lectures on hypoparathyroidism and all kinds of calcium and bone and mineral disorders.

Professor of Surgery

Section of Endocrine Surgery

University of California San Francisco

San Francisco

CA

利益冲突披露
QYD declares that he has no competing interests.

Professors Dolores Shoback and Quan-Yang Duh would like to gratefully acknowledge Professor Ronald Merrell, a previous contributor to this topic. RM declares that he has no competing interests.

Adjunct Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

NC

利益冲突披露
WM declares that he has no competing interests.

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