Kobayashi T, Yokoyama K
Department of Anesthesiology, Daiichi Hospital, Nippon Medical School, Tokyo.
Masui. 1994 May;43(5):774-7.
Hypercalcemic crisis due to hyperparathyroidism which is resistant to medical treatment, is a rare clinical condition which requires prompt surgical intervention. This 78 year-old woman was hospitalized because of hypercalcemic crisis. Conservative treatment including hemodialysis was not successful. A progressive mental disorder was noted. The maximum preoperative calcium value was 18.5 mg.dl-1, and an emergency surgery was scheduled. Anesthetic management for the hypercalcemic state includes (1) good hydration, (2) protection of the cardiac function, and (3) consideration of specific pathological features like renal failure. Balanced anesthesia with analgesics, vecuronium bromide and calcium blocker (diltiazem 0.5 microgram.kg-1.min-1) had been advocated to maintain the stable circulatory state. Postoperatively, this patient went into hypocalcemic seizures and treatment was necessary for a long period of time.
因甲状旁腺功能亢进导致的高钙血症危象，对药物治疗无效，是一种罕见的临床病症，需要迅速进行手术干预。这位78岁的女性因高钙血症危象住院。包括血液透析在内的保守治疗未成功。出现了进行性精神障碍。术前血钙最高值为18.5mg.dl-1，遂安排了急诊手术。高钙血症状态的麻醉管理包括：（1）充分补液；（2）保护心功能；（3）考虑诸如肾衰竭等特定病理特征。有人主张使用镇痛药、维库溴铵和钙通道阻滞剂（地尔硫䓬0.5微克.kg-1.min-1）进行平衡麻醉，以维持稳定的循环状态。术后，该患者发生了低钙血症性惊厥，需要长期治疗。
