— 生理適應 · MEDIUM · MCQ —
甲狀腺切除術後 24 小時，病人出現手指刺痛感及口周麻木。最可能的成因為何？
A client is 24 hours post-thyroidectomy. The nurse notes the client is experiencing tingling in the fingers and circumoral numbness. What is the most likely cause?
- AHypokalemia due to fluid loss因液體流失導致之低血鉀
- BHyperventilation causing respiratory alkalosis因過度換氣引起之呼吸性鹼中毒
- CHypocalcemia due to parathyroid injury✓ 正解因副甲狀腺受損導致之低血鈣
- DLaryngeal nerve damage post-surgery術後喉返神經損傷
— Explanation · 中文詳解 —
甲狀腺手術可能誤傷副甲狀腺，導致副甲狀腺素（PTH）分泌不足，進而引起血鈣過低（Hypocalcemia）。上述症狀為低血鈣的典型表現（手足搐搦前兆），需立即通知醫師檢查 Trousseau's sign 及 Chvostek's sign，並準備 calcium gluconate。
Thyroid surgery may inadvertently injure the parathyroid glands, leading to insufficient parathyroid hormone (PTH) secretion and resulting hypocalcemia. The described symptoms are classic manifestations of low calcium (precursors of tetany). The nurse must immediately notify the physician and assess for Trousseau's sign and Chvostek's sign, while preparing calcium gluconate.
✦ 台美臨床差異
美台臨床對於此術後併發症的預防與監測 Protocol 相似，皆強調術後第一時間內鈣離子濃度監測。