制动性高钙血症

摘要

There are many causes of hypercalcemia , such as primary hyperparathyroidism , maligancy and vit-main D intoxication et al .Immobilization-an infrequent and overlooked risk factor-may be the underlying causes .Immobi-lization due to fractures, burns, paralysis, or other causes is known to induce hypercalcemia .Prolonged immobilization uncouples bone remodeling because of the lack of mechanical stress and bone destruction exceeds formation .Calcium is released into the extracellular fluid , and the excess calcium is excreted mainly by way of the kidney .When the kidney is unable to excrete the increased quantity of calcium as rapidly as it is formed , hypercalcemia occurs .Volume expansion and diuretics, rehabilitative exercises , and bone resorption inhibitor can be used to correct this problem .This review de-scribed incidence , mechanism and treatment of immobilization hypercalcemia .%高钙血症病因众多，如原发性甲状旁腺功能亢进症、恶性肿瘤和维生素D中毒等，其中制动是其中一种比较少见的原因，常被忽视。制动性高钙血症常见于骨折、脊柱损伤、四肢瘫痪、大面积烧伤等需要长期制动的患者。长期制动时，由于缺乏机械刺激，骨转换失衡，骨吸收率超过骨形成率，骨钙释放入血，当超过肾脏排泄钙的能力时导致高钙血症的发生。可通过恢复负重活动，积极扩容、利尿、抑制骨吸收等措施降低血钙。本文就制动性高钙血症的发生率、常见人群、发生机制及治疗等作一综述。