老年高钙血症3例并文献复习

目的 分析老年高钙血症患者的临床特点及原因。方法 回顾性分析陕西省人民医院收治的3例老年高钙血症患者的临床表现及诊治经过,并对相关文献进行复习。结果 3例老年高钙血症患者临床表现各异,其中以嗜睡为首发症状1例,全身肌无力症状1例,言语障碍1例。3例均行多项检查,最后查血清钙,确诊高钙血症,给予大量补液、利尿、鲑鱼降钙素肌肉注射、床旁血液滤过等治疗措施后,血清钙水平明显下降,临床症状改善。结论 当老年人突发意识改变、全身肌无力、言语障碍时,应警惕高钙血症的可能性,及时测定血清钙离子。由于老年患者高钙血症的发病常常较为隐匿,且临床症状无特异性,在排除了心脑血管疾病急性发作且疗效不理想时,要拓展诊疗思路,注意排除高钙血症的可能性。

Clinical analysis of three elderly patients with hypercalcemia and literature review

Objective To analyze clinical characteristics and causes of elderly patients with hypercalcemia. Methods The clinical manifestations and diagnosis and treatment process of three elderly patients with hypercalcemia admitted to Shaanxi Provincial People's Hospital were retrospectively analyzed, and the related literature were reviewed. Results Clinical manifestations of the three elderly patients with hypercalcemia varied, one patient suffered from drowsiness as the initial symptom, one patient showed systemic myasthenia, and the other patient showed speech disorder. All the three patients received multiple examinations, and hypercalcemia was confirmed by checking the serum calcium level curve. The serum calcium level was significantly decreased and the clinical symptoms were effectively improved after massive fluid rehydration, diuresis, intramuscular injection of salmon calcitonin, continuous renal replacement therapy and similar therapeutic measures. Conclusion The elderly should be alerted to the possibility of hypercalcemia and timely determine the serum calcium if they suffer from sudden changes in consciousness, general myasthenia gravis and speech disorder. Normally, the incidence of hypercalcemia in elderly patients is relatively hidden and the clinical symptoms are not specific, it is necessary to expand the idea for diagnosis and treatment when the acute attack of cardio-cerebrovascular disease is ruled out and the curative effect is not satisfactory, and take note of eliminating the possibility of hypercalcemia.