Lammert Anne, Nowak Kai, Weber Roland, Rotter Nicole, Schölch Sebastian, Krämer Bernhard K, Lammert Alexander
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität Heidelberg, Universitätsmedizin Mannheim, Mannheim, Germany.
Klinik für Allgemein-, Gefäß- und Thoraxchirurgie, RoMed Klinikum, Rosenheim, Germany.
Laryngorhinootologie. 2021 Aug;100(8):610-617. doi: 10.1055/a-1381-8286. Epub 2021 Mar 2.
In Germany, 8000 patients are affected by postoperative hypoparathyroidism per year following surgery of the thyroid gland, parathyroidal glands and the larynx. Patients do not only suffer from paresthesia in the acute phase of this complication, but are also adversely affected by the fear of loss of control following episodes of tetany even years after the first episode.
Discussion of a diagnostic pathway and presentation of a management pathway for postoperative hypocalcemia.
Narrative review, analysis and discussion of current literature and expert recommendations.
Early determination of calcium and parathyroid hormone allows timely diagnosis and treatment of postoperative hypoparathyroidism. Active vitamin D is pivotal for the resorption of calcium. Only the combined treatment with active vitamin D and calcium can mitigate or prevent the postoperative drop of calcium levels.
A standard operating procedure (SOP) for postoperative hypoparathyroidism should be implemented in every surgical department. An SOP for diagnosis and treatment of postoperative hypoparathyroidism is proposed for institutional individualization and implementation.
在德国，每年有8000名患者在甲状腺、甲状旁腺和喉部手术后出现术后甲状旁腺功能减退。患者不仅在这种并发症的急性期会出现感觉异常，而且即使在首次发作数年之后，仍会因担心在手足搐搦发作后失去控制而受到不利影响。
讨论术后低钙血症的诊断途径并介绍管理途径。
对当前文献和专家建议进行叙述性综述、分析和讨论。
早期测定钙和甲状旁腺激素可及时诊断和治疗术后甲状旁腺功能减退。活性维生素D对钙的重吸收至关重要。只有活性维生素D和钙联合治疗才能减轻或预防术后钙水平下降。
每个外科科室都应实施术后甲状旁腺功能减退的标准操作程序（SOP）。建议制定术后甲状旁腺功能减退的诊断和治疗SOP，以便进行机构个体化和实施。
