術後性副甲状腺機能低下に対する治療-活性型ビタミンD3投与の検討-

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We report here the effect of activated vitamin D3 (Vit. D3) in postoperative hypoparathyroidism. We performed 42 total thyroidectomies and 43 sub-total thyroidectomies from 1978 to 1989.Hypoparathyroidism occurred in 36 patients (85.7%) after total thyroidectomy and 5 (11.6%) after sub-total thyroidectomy. We treated 18 of these patients with Vit. D3 only (43.9%) and 21 with Vit. D3+calcium (51.2%) orally. Treatment with Vit. D3 only is easier and more useful than that with Vit. D3 + calcium in controlling the serum calcium level of patients with hypoparathyroidism.We should monitor not only the serum calcium level but also the serum albumin to determine the real serum calcium level.With Vit. D3, which we prescribed in doses of 0.5-6.0μg (mean: 2.47±1.45μg) per day, we could control the serum calcium level well in patients with postoperative hypoparatyroidism without a high calcium level in the urine.It is probably concluded that Vit. D3 treatment alone is adequate for postoperative hypoparathyroidism patients, who have normal calcium uptake from the digestive tract, and it is the easiest and safest way to control the serum calcium level.
耳鼻咽喉科臨床学会の論文