关键词: 透析, 继发性甲状旁腺功能亢进, 甲状旁腺切除术, 低钙血症, 危险因素

Abstract: Ｏｂｊｅｃｔｉｖｅ：We aim to identify the prevalence and potential risk factors of early hypocalcemia in patients with secondary hyperparathyroidism (SHPT) after total parathyroidectomy plus forearm autotransplantation (TPTX+AT) retrospectively.
Ｍｅｔｈｏｄｏｌｏｇｙ：Patients with SHPT underwent TPTX+AT in our center from November 2015 to November 2018 were reviewed. Preoperative and postoperative laboratory values including serum calcium, phosphorus, parathyroid hormone (PTH) and alkaline phosphatase (ALP) were collected. Logistic stepwise regression with the forward selection of variables was adopted to evaluate the independent variables as predictors of hypocalcemia.
Ｒｅｓｕｌｔｓ：Among all 254 patients, hypocalcemia episodes occurred in 107 patients (42.13％). When patients were divided into two groups according to whether hypocalcemia occurred postoperatively, the proportion of hemodialysis patients was as high as 82％ in the Hypocalcemia Group while only 65％ in the Non-hypocalcemia Group (P<0.01). Multivariate logistic regression analysis showed that the hemodialysis modality (OR=2.155, 95％CI 1.164~3.991; P=0.015) and PTH≥1 656 (OR=1.771, 95％CI 1.021~3.072; P=0.042), ALP≥242 (OR=1.739, 95％CI 1.002~3.018; P=0.049) were the independent risk factor of hypocalcemia 1 week after of TPTX+AT.
Ｃｏｎｃｌｕｓｉｏｎ：Patients with high ALP, high PTH preoperatively and undergoing maintenance hemodialysis are more likely to occur hypocalcemia after PTX who should be monitored closely and given more attention.

Key words: dialysis, secondary hyperparathyroidism, parathyroidectomy, hypocalcemia, risk factors