Schweitzer V G, Thompson N W, Harness J K, Nishiyama R H
Arch Surg. 1978 Apr;113(4):373-81. doi: 10.1001/archsurg.1978.01370160031004.
Hypercalcemic crisis is a rare but often fatal complication of hyperparathyroidism (HPT). The reported mortality of 60% has been related to delay in diagnosis and appropriate treatment. During a 16-year period (1961 to 1977), 29 patients with severe symptomatic hypercalcemia caused by primary HPT were treated at the Surgical Service at the University of Michigan Hospital. This group represents 6% of the patients with primary HPT treated during this period. All but one patient had an exploration of the neck when the serum calcium level had been decreased to 12 mg/100 ml by intravenous hydration with saline, furosemide diuresis, and mithramycin when a hypocalcemic agent was required. One comatose patient died of irreversible shock. All of the 28 patients who had parathyroidectomies survived the early postoperative period. One patient died three weeks later of a myocardial infarction. This study demonstrates that emergent nonoperative care of parathyroid crisis, followed promptly by parathyroidectomy, can be successful in nearly all cases.
高钙血症危象是甲状旁腺功能亢进症（HPT）一种罕见但常致命的并发症。报告显示，60%的死亡率与诊断和恰当治疗的延误有关。在16年期间（1961年至1977年），密歇根大学医院外科治疗了29例由原发性HPT导致的严重症状性高钙血症患者。该组患者占此期间接受治疗的原发性HPT患者的6%。除1例患者外，所有患者在血清钙水平通过生理盐水静脉补液、速尿利尿以及在需要使用降钙血症药物时使用光辉霉素降至12mg/100ml后均接受了颈部探查。1例昏迷患者死于不可逆休克。接受甲状旁腺切除术的28例患者均度过了术后早期。1例患者在三周后死于心肌梗死。本研究表明，甲状旁腺危象的紧急非手术治疗，随后立即进行甲状旁腺切除术，几乎在所有病例中均可成功。
