COMA IN MYXEDEMA - REPORT OF A CASE AND REVIEW OF WORLD LITERATURE
COMA IN MYXEDEMA - REPORT OF A CASE AND REVIEW OF WORLD LITERATURE
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DOI：
10.1001/archinte.1963.03620300054010
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发表时间：
1963-01-01
影响因子：
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通讯作者：
FORESTER, CF
中科院分区：
文献类型：
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作者：
FORESTER, CF
这份报告描述了一位老年妇女的粘液水肿性昏迷。报告还分析了该病例和自1911年以来报告的76例类似病例的临床和实验室特征、导致高死亡率(66%)的因素以及治疗结果。临床上，寒冷的天气和降低体温是重要的；60名患者中只有29名出现休克。实验室检查没有预后价值。通过对77例病例的分析发现，显著的特征是治疗普遍失败，原因是(1)害怕向粘液性水肿症患者注射大剂量速效甲状腺激素，(2)未能识别和治疗因高碳酸血症、低血糖或肾上腺素减少而导致的继发性昏迷。应将原发性昏迷视为需要每12小时使用大剂量三碘甲腺原氨酸的医疗紧急情况。这种治疗在继发性粘液水肿性昏迷中是否有害尚不能确定。
This report describes myxedema coma in an elderly woman. It also presents an analysis of the clinical and laboratory features, factors responsible for the high rate of mortality (66%), and results of treatment in this and 76 similar cases reported since 1911. Clinically, cold weather and lowering of body temperature were important; shock was present in only 29 of 60 patients. Laboratory tests were of no prognostic value. The notable feature found by analysis of the 77 cases was the common failure of therapy due to (1) fear of administering large doses of fast-acting thyroid hormone to patients with myxedema, and (2) failure to recognize and treat secondary coma due to hypercapnia, hypoglycemia, or hypoadrenalism. Primary coma should be regarded as a medical emergency requiring use of large doses of triiodothyronine every 12 hours. Whether such treatment is detrimental in secondary myxedema coma could not be determined.