갑상선수술후의 저칼슘혈증

• 영문명: Postthyroidectomy Hypocalcemia
• 발행기관: 대한두경부종양학회
• 저자명: 최대화(Daeh Wa Choi) 김규열(Kyu Yul Kim) 고병균(Byung Kyun Ko) 남창우(Chang Woo Nam) 유화경(Hwa Kyung Yu) 조홍래(Hong Rae Cho)
• 간행물 정보: 『대한두경부종양학회지』제15권 제1호, 52~60쪽, 전체 9쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 1999.05.30

영문 초록

Objectives: For investigation of the differentiation between transient and permanent hypocalcemia, we focused on a postoperative calcium requirement and an interval of normalization in serum hypocalcemic level and studied for the causes of postoperative hypocalcemia. Material and Method: Postthyroidectomy hypocalcemia was studied in 193 patients who were admitted from January, 1991 to December, 1998 and underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. We compared postoperative serum calcium, phosphate and ionized calcium levels among three groups which were lobectomy, subtotal thyroidectomy and total thyroidectomy, respectively. Result: All patients revealed postoperative decline in serum calcium and ionized calcium, especially, the lowest serum calcium level was seen in 48 hours after surgery. Serum calcium level was returned to normal in five to six postoperative days in most patients. But 24 patients required calcium supplementation due to symptomatic hypocalcemia. In this series, we discovered that the important period for monitoring of serum calcium level was 24 to 96 hours after surgery. If the calcium replacement therapy was not required in the first 72 hours after surgery, it would not be needed during the remainder of the patient's hospital course. Symptomatic transient hypocalcemia was 22 cases(11.4%) and permanent hypocalcemia was 2 cases(1%). Conclusion : We found that hypoalbuminemia, preoperative hyperthyroidism and impairment of blood supply to parathyroid were the main causes of postthyroidectomy hypocalcemia. We also thought that the interval from initial medication to normalization in serum calcium level, and the increase of requirement in calcium and vitamin D were the important factors for differentiation between transient and permanent hypocalcemia.

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키워드

Thyroidectomy Hypocalcemia