甲狀腺功能亢進(jìn)癥病人的護(hù)理NursingofHyperthyroidismPatients32講解

甲狀腺功能亢進(jìn)癥病人的護(hù)理Nursingof

Hyperthyroidism

Patients廣西衛(wèi)生職業(yè)技術(shù)學(xué)院內(nèi)科護(hù)理教研室DepartmentofMedicineNursing,GuangxiMedicalCollege甲狀腺毒癥Thyrotoxicosis各種原因?qū)е卵h(huán)中甲狀腺激素過多，引起的以神經(jīng)、循環(huán)、消化等系統(tǒng)興奮性增高和代謝亢進(jìn)為主要表現(xiàn)的一組臨床綜合征Duetovariousreasons,thereareexcessivethyroidhormonesinthebloodcirculation,whichleadstoagroupofclinicalsyndromesmainlycharacterizedbyincreasedstimulationandhypermetabolismofnervous,circulatory,digestive,andothersystems甲狀腺毒癥Thyrotoxicosis甲狀腺功能亢進(jìn)癥Hyperthyroidism⒈彌漫性毒性甲狀腺腫（Graves病）Diffusetoxicgoiter(Gravesdisease)⒉多結(jié)節(jié)性毒性甲狀腺腫Multinodulartoxicgoiter⒊甲狀腺自主高功能腺瘤

Plummerdisease⒋碘致甲狀腺功能亢進(jìn)癥Iodine-inducedhyperthyroidism⒌橋本甲狀腺毒癥Hashitoxicosis⒍新生兒甲狀腺功能亢進(jìn)癥

Neonatalhyperthyroidism⒎垂體TSH腺瘤HypophysisTSHadenoma甲狀腺腺體本身產(chǎn)生TH過多ThethyroidglandproducesTHexcessively甲狀腺毒癥Thyrotoxicosis非甲狀腺功能亢進(jìn)類型Non-hyperthyroidtype⒈亞急性甲狀腺炎SubacuteThyroiditis⒉無痛性甲狀腺炎PainlessThyroiditis⒊橋本甲狀腺炎Hashimoto'sThyroiditis⒋產(chǎn)后甲狀腺炎（PPT）PostpartumThyroiditis(PPT)⒌外源甲狀腺激素替代Exogenousthyroidhormoneassubstitute⒍異位甲狀腺激素產(chǎn)生（卵巢甲狀腺腫等）Productionofectopicthyroidhormones甲狀腺的功能并不亢進(jìn)。包括破壞性甲狀腺毒癥和服用外源性甲狀腺激素Thyroidisnothyperactive.Includingdestructivethyrotoxicosisandtakingexogenousthyroidhormones概述Abstract彌漫性毒性甲狀腺腫Graves/Parry/Basedow病DiffusetoxicgoiterGraves/Parry/Basedowdisease器官特異性自身免疫?。═RAb）Organ-specificautoimmunedisease(TRAb)是甲狀腺功能亢進(jìn)癥最常見病因isthemostcommoncauseofhyperthyroidism概述Abstract約占全部甲亢的80%~85%accountingforapproximately80%to85%ofallhyperthyroidism患病率為1.1-1.6%whoseprevalenceis1.1-1.6%女性高發(fā)，女/男：4~6/1Frequentlyoccursinfemale,female/male:4~6/1高發(fā)年齡：20~50歲Highriskages:20~50yearsold病因與發(fā)病機(jī)制EtiologyandPathogenesis遺傳因素Geneticfactors環(huán)境因素Environmentalfactors免疫因素

Immunefactors

細(xì)菌感染、應(yīng)激、精神因素Bacterialinfections,stress,mentalfactorsGD的危險因素：吸煙、藥物、131I、局部創(chuàng)傷AdversefactorsforGD:smoking,drugs,131I,localtrauma病因與發(fā)病機(jī)制EtiologyandPathogenesis促甲狀腺激素釋放激素ThyrotropinReleasingHormoneTRHTRHT4/T3T4/T3負(fù)反饋Negativefeedback甲狀腺激素ThyroidhormonesTSHTSH促甲狀腺激素ThyroidStimulatingHormone下丘腦Hypothalamus垂體Hypophysis甲狀腺ThyroidTSH受體TSHReceptor病因與發(fā)病機(jī)制EtiologyandPathogenesisTSH受體抗體TSHReceptorAntibodiesTRAbTRAbTSAbTSAbTSBAbTSBAbTSH刺激阻斷性抗體TSHstimulationblockingantibodiesTSH刺激性抗體TSHstimulatoryantibodies90%-100%未經(jīng)治療的GD病人TRAb陽性90%-100%ofuntreatedGDpatientswerepositiveinTRAb與TSH受體結(jié)合BindstoTSHreceptorsTH分泌減少DecreasedTHsecretionTH分泌增多IncreasedTHsecretion病因與發(fā)病機(jī)制EtiologyandPathogenesis促甲狀腺激素釋放激素ThyrotropinReleasingHormoneTRHTRHTSHTSHT4/T3促甲狀腺激素ThyroidStimulatingHormone負(fù)反饋Negativefeedback甲狀腺激素Thyroidhormones下丘腦Hypothalamus垂體Hy