临床容易忽视的高血钙危象三例报告并文献复习-论文.pdf

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1、临床误诊误治2015年1月第28卷第1期ClinicalMisdiagnosis＆Mistherapy，Vo1．28，No．1，January2015·23·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4．07～6．06mmol／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，

2、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)O1·0023·05[DOI]10．3969／j．issn．1002．3429．2015．01．007HypercalcemicCrisisWhichTendstoBeCli

3、nicallyOverlooked(AReportof3CasesandtheLiteratureReview)WANGYue·yue，ZHUHal—yan，BANYu，SONGYang，MENGQing—yi(DepartmentofEmergencyMedicine，ChinesePLAGeneralHospital，Beijing100853，China)[Abstract]ObjectiveToexploreclinicalfeaturesofhypercalcemiccrisisandsharetheexperiencesofdiagnosisandtreatment．

4、MethodsClinicaldataofthreepatientswithhypercaleemiecrisisinourdepartmentwereretrospectivelyanalyzedandrelevantliteraturewerealsoreviewed．ResultsThethreepatientshadallrelatingclinicalsymptoms，includingmotorsys—tern，urinarysystem，nervoussystem，etc．Theywerediagnosedwithhypercalcemiccrisisonadmis

5、sion，whoseserumcalciumwas4．07—6．06mmol／L．Combinedwiththelaboratoryresultsandenhancediconographyfindings，onepatientwasdiagnosedashavingparathyroidadenoma，onewasconfirmedashavingmalignanttumorwithmetastasisinmuhipleorgans，andtheetiol—ogyofthethirdpatientwasuncertainduetotherapiddiseaseprogressi

6、on．Thelastonewashighlysuspectedformalignancy．Thethreepatientswithhypercalcemiccrisisweregivenpositivesymptomatictreatment．Onepatienthadanexcellentprogno—sis，buttheothertwodied．ConclusionThepatientsofhypercalcemiccrisisarealwayscharacteristicofvariedclinicalsymp·tomsincludingnervoussystem，dige

7、stivesystem，urinarysystemandSOon，withlackofspecificity．Relevantlaboratoryandimagingexaminationsmaybehelpfulinearlydiagnosisandeffectivetreatment，avoidingmisdiagnosisandmisseddiagnosis，andimprovingthepatient~survivalrate．[Keywords]Hypercalcemi