以外科为主要治疗手段的高钙血症多是甲状旁腺功能亢进。其中原发性甲状旁腺功能亢进引起的高钙血症以单发甲状旁腺腺瘤为主，高甲状旁腺素（PTH）、高钙低磷用于定性诊断，超声和核素扫描有助于定位。手术采用腺瘤摘除即可，不主张过多探查。而继发于肾功能衰竭的甲状旁腺功能亢进以甲状旁腺增生为特征，漫长的肾功能衰竭与血液透析背景是其诊断的基础，高PTH、高钙高磷和超声分别用于定性和定位诊断，甲状旁腺切除是药物治疗无效者的首选，强调全切除的同时，建议加部分自体移植。

Hypercalcemia：Differential diagnosis, surgical treatment and evaluation        CHU Cheng-yu, WANG Hong-ying, ZOU Qiang. Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Corresponding author: ZOU Qiang, E-mail: zouqiang003@aliyun.com
Abstract    Surgery remains the main therapeutic approach in treating the hypercalcemia caused by hyperparathyroidism（HPT）. Most cases of primary HPT are due to a solitary parathyroid adenoma. Qualitative diagnosis may depend on elevated parathyroid hormone (PTH)，hypercalcemia and hypophosphatemia. Pre-operative imaging examination, including scintigraphy  and ultrasonography，may help to locate the lesion. The resection of adenoma is the choice for the operation and extensive exploration is unnecessary. Characterized by parathyroid hyperplasia, renal HPT is diagnosed on the basis of long-term renal failure and hemodialysis. Elevated PTH with elevated calcium and phosphorus as well as ultrasonography may be used in the qualitative identification and localization respectively. Parathyroidectomy may be indicated when the medical therapies are inefficient. Total parathyroidectomy with partial autotransplantation of parathyroid tissue is recommended.