【已刪除】22 42 歲男性因高血鈣入院接受副甲狀腺瘤切除手術，術後出現低血鈣的現象，其最主要原因可能為下 列何者？
(A)因尿中鈣質排放量遽增導致鈣質流失
(B)因腸胃道鈣質排放增加導致鈣質流失
(C)鈣質沉積於骨中增加，導致血鈣急遽下降
(D)因手術中誘發的 stress 導致的激素變化所致

postsurgical hypoparathyroidism (PHypo) occurs after total thyroidectomy due to injury of parathyroid glands and/or their blood supply or after parathyroidectomy. PHypo results in hypocalcemia because parathyroid hormone (PTH) secretion is impaired and cannot mobilize calcium from bone, reabsorb calcium from the distal nephron and stimulate renal 1α-hydroxylase activity. It usually appears in the first days after surgery and it can be symptomatic or asymptomatic. Risk factors are low level of intraoperative PTH and presence of parathyroid gland in the pathological specimen. Patients usually present with paresthesia, cramps or tetany, but the disorder may also manifest acutely with seizures, bronchospasm, laryngospasm or cardiac rhythm disturbances. Standard treatment is vitamin D analogues and calcium supplementation.