临床容易忽视的高血钙危象三例报告并文献复习.pdfVIP

临床误诊误治 ２０ 15 年 1 月 第 28 卷 第 1 期 Ｃｌｉｎｉｃａｌ Ｍｉｓｄｉａｇｎｏｓｉｓ ＆ Ｍｉｓｔｈｅｒａｐｙ熏 Ｖｏｌ．28熏 Ｎｏ．1熏 January ２０ 15 ·23 · 临床容易忽视的高血钙危象三例报告并文献复习 王越越,朱海燕,班　 雨,宋　 扬,孟庆义 　 　 [摘要]　 目的　 探讨高血钙危象的临床特点,总结诊治方法。 方法　 回顾分析我科近期收治的3例高血钙危象 的临床资料,并复习相关文献。 结果　 本组3 例均以运动、泌尿及神经等多系统临床症状急诊入院,血钙4.07 ~ 6.06 mmol/ L,3例入院均诊断为高血钙危象。 完善影像学及相关实验室检查结果以明确病因,1例病因为甲状旁腺腺 瘤;1例为卵巢癌全身转移;1例高度怀疑恶性肿瘤,但病情进展迅速,未及明确病因即死亡。 3例均行积极降血钙等 对症处理,1例预后良好,2例死亡。 结论　 高血钙危象的临床表现常累及神经、消化、泌尿、心血管、运动等多个系统, 缺乏特异性;完善相关实验室及影像学检查可以防止误漏诊,使患者得到早期有效的诊治,提高生存率。 　 　 [关键词]　 高钙血症;甲状旁腺功能亢进,原发性;卵巢肿瘤;漏诊;误诊 [中国图书资料分类号]　 R589.5　 　 　 [文献标志码]　 A　 　 　 　 [文章编号]　 1002-3429(2015)01-0023-05 [DOI]　 10.3969/ j.issn.1002-3429.2015.01.007 Hypercalcemic Crisis Which Tends to Be Clinically Overlooked (A Report of 3 Cases and the Literature Review) WANG Yue-yue,ZHU Hai-yan,BANYu,SONGYang,MENGQing-yi (Departmentof Emergency Medicine,ChinesePLA General Hospital,Beijing 100853,China) [Abstract]　 Objective　 To explore clinical featuresof hypercalcemic crisisand sharethe experiencesof diagnosisand treatment.Methods　 Clinical data of three patientswith hypercalcemic crisis in our department were retrospectively analyzed andrelevantliteraturewerealsoreviewed.Results　 Thethreepatientshadallrelatingclinical symptoms,includingmotor sys- tem,urinary system,nervoussystem,etc. Theywerediagnosedwithhypercalcemiccrisisonadmission,whoseserumcalcium was4.07-6.06 mmol/ L. Combinedwith the laboratory results and enhanced iconography findings,one patient was diagnosed ashavingparathyroidadenoma,onewasconfirmedashavingmalignanttumorwithmetastasisinmultipleorgans,andtheetiol- ogy of the third patient was uncertain duetotherapid diseaseprogression. Thelast onewashighly suspectedfor malignancy. The three patientswith hypercalcemic crisiswere given positive symptomatic treatment. One patient had an excellent progno- sis,buttheothertwodied.Conclusion　 Thepatientsof hypercalcemiccrisisarealwayscharacteristicofvariedclinical symp- toms including nervous system,diges