重症急性胰腺炎合并甲状旁腺功能亢进高钙危象的临床分析  

Clinical Study of Severe Acute Pancreatitis Complicated with Hypercalcemia Crisis in Hyperparathyroidism

作　　者：刘维新[1] 刘威羽[1] 蔺虹名[1] 周正[1] 张庆敏[1] 

机构地区：[1]中国医科大学附属第一医院消化内科,沈阳110001

出　　处：《中国医科大学学报》2012年第5期446-449,共4页Journal of China Medical University

摘　　要：目的单纯重症急性胰腺炎及单纯甲状旁腺功能亢进症高钙危象在临床上均是危重疾病,本文探讨重症急性胰腺炎并发甲状旁腺功能亢进症高钙危象的临床表现、发病机制及诊治经验。方法回顾性分析重症急性胰腺炎合并甲状旁腺功能亢进症高钙危象患者的临床表现、实验室及影像学检查结果、治疗方法。结果本文4例患者在重症急性胰腺炎发病时血钙降低或正常,恢复期监测离子过程中发现血钙升高,考虑存在内分泌系统疾病,化验血清甲状旁腺激素并行超声定位,其中3例确诊为甲状旁腺瘤并均行手术切除,2例治疗痊愈,1例死亡,另1例未行手术治疗死亡。结论需注意胰腺炎并发甲状旁腺功能亢进症在临床表现、实验室检查及影像学特征方面的特异性,提高诊断,避免延误诊治。Objective Either severe acute pancreatitis or hypercalcemia crisis in hyperparathyroidism is a severe disease.The diagnosis is difficult and mortality is high in the patients with both conditions.Our aim was to study the clinical manifestations,mechanism,diagnosis and treatment of such cases.Methods A retrospective study was made on the clinical manifestations,results of laboratory and diagnostic tests and treatment of serve acute pancreatitis patients complicated with hypercalcemia crisis in hyperparathyroidism.Results At the attack of severe acute pancreatitis,the level of blood calcium was lower or normal,while during the recovery,blood calcium increased,which indicated endocrine diseases.After being examined with PTH and ultrasound or CT location,three cases were diagnosed as parathyroid adenoma and undergone resection.Two recovered,one died and another without operation also died.Conclusion Special attention should be paid to the clinical manifestations,results of laboratory and diagnostic tests and diagnosis of the patients with serve acute pancreatitis patients complicated with hyperparathyroidism.

关 键 词：急性重症胰腺炎 甲状旁腺功能亢进症 高钙危象 

分 类 号：R576[医药卫生—消化系统]