二次性甲状腺功能障碍症的副甲状腺切除术后的饥饿骨综合征:病原和当代临床考虑
Adina Coman1,2,3, Cristi Tarta1, Marco Marian1
1Researching Future Surgery II Research Center, Department X, Discipline of General Surgery II, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.
Journal of clinical medicine
|October 16, 2025
概括
二次性甲状腺功能障碍症手术可能导致饥饿骨综合征,的严重下降. 本综述解释了其原因,风险和管理,重点是预防和治疗这种并发症.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學.
- 手术病理学手术病理学
背景情况:
- 在慢性病 (CKD) 中的二次性甲状腺功能障碍症 (SHPT) 经常需要甲状腺切除术 (PTX).
- PTX可以触发饥饿骨综合征 (HBS),其特点是由于手术后骨快速吸收矿物质而出现严重的低血症.
- HBS源于突然停止的骨再吸收和在去矿物化骨中持续的骨形成之间的不平衡.
研究的目的:
- 在SHPT的背景下审查HBS的发病和管理.
- 为了阐明驱动HBS的分子机制.
- 确定手术前的风险因素,并概述术后的管理.
主要方法:
- 文献综述综合了关于SHPT中HBS病原和管理的当前知识.
- 详细探索分子机制,包括RANKL/OPG,Wnt/β-catenin,骨细胞信号和感应受体.
- 确定和分析关键的术前风险因素和术后临床过程.
主要成果:
- 由SHPT诱导的骨质炎纤维性囊性骨炎会产生一个巨大的未矿化骨质池,在PTX后容易发生快速矿化.
- HBS的主要危险因素包括高PTH和性酸酶,显著的骨缺乏,年龄较小,和总PTX.
- HBS呈现出一种可预测的术后过程,从急性低血症到逐渐恢复.
结论:
- 了解HBS的发病因子,特别是SHPT的高转换骨状况,对于管理这种并发症至关重要.
- 手术前的优化 (维生素D,仿药) 和手术后的积极补充/是关键的管理策略.
- 改善风险分层和术后护理可以改善接受PTX治疗SHPT的患者的治疗结果.
关键词:
在RANKL/OPG路径中.在Wnt/β-catenin信号传输中.骨周转率标志物 骨周转率标志物感应的受体是感应的受体.慢性脏疾病 慢性脏疾病内分泌手术并发症 内分泌手术并发症饥饿骨综合征是什么意思低血症是指低血症.副甲状腺切除术 (parathyroidectomy) 是一种切除甲状腺的方法.二次性副甲状腺功能障碍症.更多相关视频
07:12Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
4.7K
07:13Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
Published on: March 14, 2017
15.3K
相关概念视频
00:59The Parathyroid Glands
4.3K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
4.3K
01:17Hormones and Bone Tissue
3.7K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
3.7K
01:29Bone Disorders
5.0K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
5.0K
01:21Skeleton and Calcium Homeostasis
5.8K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
5.8K
01:24Chronic Kidney Disease II: Clinical Manifestations
547
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
547
01:02What is the Skeletal System?
56.7K
Overview
56.7K