THYROID CRISES
THYROID CRISES
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DOI：
10.1016/s0025-7125(16)30478-3
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发表时间：
1991-01-01
影响因子：
5.9
通讯作者：
GAVIN, LA
中科院分区：
文献类型：
--
作者：
GAVIN, LA
在甲状腺毒症的特点设置，及时诊断和积极的治疗甲状腺风暴应导致一个成功的结果。然而，严重的风暴可能导致不可逆的心血管衰竭，特别是在可能具有甲状腺毒症不典型特征的老年患者中。基本的方法是在急诊科及时和最佳的治疗，一旦出现临床特征提示它的存在。在等待实验室确认的同时延迟引入治疗可能导致进一步的失代偿和死亡。黏液水肿昏迷的预防需要特别注意某些高危患者群体。这些人群包括有桥本甲状腺炎病史的老年妇女，或因甲状腺功能亢进而接受过放疗或甲状腺手术的老年妇女。告知这些患者甲状腺功能减退的症状和体征，并每年进行甲状腺功能检查，如血清促甲状腺激素（TSH）检查，以便在检测结果呈阳性时及早提供适当的治疗。
In the setting of characteristic features of thyrotoxicosis, the timely diagnosis and aggressive management of thyroid storm should result in a successful outcome. However, severe storm may lead to irreversible cardiovascular collapse, especially in the older patient who may have atypical features of thyrotoxicosis. The fundamental approach is prompt and optimal treatment in the emergency department once the presenting clinical features suggest its presence. Delay in the introduction of therapy while awaiting laboratory confirmation may result in further decompensation and death. The prevention of myxedema coma entails paying special attention to certain high-risk patient groups. These groups include older women with a history of Hashimoto's thyroiditis, or previous irradiation or thyroid surgery for hyperthyroidism. Inform such patients of the symptoms and signs of hypothyroidism, and perform annual thyroid function tests, such as a serum TSH, in order to provide early, adequate treatment once the test becomes positive.