Szubin L, Kacker A, Kakani R, Komisar A, Blaugrund S
Department of Otolaryngology, Lenox Hill Hospital, New York, NY 10021, USA.
Ear Nose Throat J. 1996 Sep;75(9):612-4, 616.
Postoperative hypocalcemia was studied in 40 patients undergoing total thyroidectomy for a malignancy or massive goiter. Parameters evaluated included serum calcium, phosphate and magnesium levels. All patients exhibited a postoperative decline in serum calcium, however, the lowest serum calcium level was not seen until 48 hours after surgery. Serum calcium levels returned to normal in five to six days after surgery in 37 patients. Five patients required calcium supplementation for either symptomatic hypocalcemia or serum calcium levels lower than 7.0 mg/dl. Only three of these five patients were discharged home on oral calcium supplements. In this series, we discovered that the critical period for monitoring of serum calcium was 24 to 96 hours after surgery. If serum calcium replacement was not needed in the first 72 hours after surgery, it would not be needed during the remainder of the patient's hospital course. In addition, we found that serum magnesium levels should also be monitored in the postoperative period and corrected if low.
对40例因恶性肿瘤或巨大甲状腺肿接受全甲状腺切除术的患者进行了术后低钙血症的研究。评估的参数包括血清钙、磷和镁水平。所有患者术后血清钙均下降，然而，术后48小时才出现最低血清钙水平。37例患者术后五至六天血清钙水平恢复正常。5例患者因症状性低钙血症或血清钙水平低于7.0mg/dl需要补钙。这5例患者中只有3例出院时口服钙剂。在本系列研究中，我们发现术后监测血清钙的关键时期是术后24至96小时。如果术后72小时内不需要补充血清钙，那么在患者住院期间的其余时间也不需要补充。此外，我们发现术后也应监测血清镁水平，若低则予以纠正。
