甲状腺功能亢进症病人的护理NursingofHyperthyroidismPatients13讲解

甲状腺功能亢进症病人的护理Nursingof

Hyperthyroidism

Patients广西卫生职业技术学院内科护理教研室DepartmentofMedicineNursing,GuangxiMedicalCollege甲状腺的解剖TheThyroidAnatomy甲状·腺

ThyroidGland

成年人最大的内分泌腺，位于颈前部，棕红色，呈“H”形，重约25g；由左右两叶、峡部及锥状叶组成。Itisthelargestendocrineglandinadultswhichislocatedinthefrontoftheneck,witha"H"shapebrown-redcolor,weighingabout25g;itconsistsofleftandrightlobes,isthmusandcone-shapedlobes.甲状腺激素ThyroidhormonesT4四碘甲状腺原氨酸（甲状腺素）90%T3三碘甲状腺原氨酸10%T4Tetraiodothyronine(thyroxine)90%T3Triiodothyronine10%甲状腺激素Thyroidhormones游离型的TH才有生物活性作用OnlyfreeTHhasbiologicalactivityFT3、FT4（极少数＜1%）99%以上是与血浆蛋白结合的形式存在—甲状腺素结合球蛋白、甲状腺素转运蛋白、白蛋白TT3、TT4FT3,FT4(onlyafew<1%)Morethan99%existsintheformofplasmaproteinbinding—Thyroxinebindingglobulin,transthyretin,albuminTT3、TT4甲状腺激素Thyroidhormones甲状腺激素T3、T4在甲状腺球蛋白Tg表面合成并储存ThyroidhormonesT3andT4aresynthesizedandstoredonthesurfaceofthyroglobulinTg甲状腺激素Thyroidhormones负反馈Negativefeedback下丘脑Hypothalamus促甲状腺激素释放激素ThyrotropinReleasingHormoneTRHTRH垂体HypophysisTSHTSHT4/T3T4/T3促甲状腺激素ThyroidStimulatingHormone负反馈Negativefeedback甲状腺激素Thyroidhormones甲状腺Thyroid负反馈Negativefeedback下丘脑Hypothalamus垂体Hypophysis甲状腺Thyroid负反馈Negativefeedback甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育PromotesgrowthanddevelopmentTH是胎儿和新生儿脑发育的关键激素，TH能与GH协同调控幼年期的生长发育。THisakeyhormoneforfetalandneonatalbraindevelopment,andwithGH,Thcanhaveacoordinatedregulationforgrowthanddevelopmentinchildhood.甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育Promotesgrowthanddevelopment胚胎期及幼儿期如果缺乏TH,可出现克汀病（呆小症），人类胎儿生长发育12周之前的甲状腺不具备聚碘和合成TH的能力。IfthereisalackofTHintheembryonicperiodandearlychildhood,cretinism(whichleadstoshortstatureandlowintelligence)mayoccur.Thethyroidglandbefore12weeksofhumanfetalgrowthanddevelopmentdoesnothavetheabilitytoaccumulateiodineandsynthesizeTH.甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育Promotesgrowthanddevelopment调节新陈代谢RegulatesMetabolism蛋白质生理情况，促进蛋白质合成分泌过多，促进蛋白质分解分泌不足，蛋白质合成减少ProteinPhysiologicalfunction:promotesproteinsynthesisExcessivesecretioncanpromoteproteolysisInsufficientsecretioncandecreaseproteinsynthesis增强能量代谢，产热量增加Enhancesenergymetabolismandincreasesheatproduction调节物质代谢Regulatessubstancemetabolism甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育Promotesgrowthanddevelopment调节新陈代谢RegulatesMetabolism糖：双向调节脂类生理情况，促进脂肪分解/清除<合成分泌过多,促进脂肪分解/清除＞合成GlucosebidirectionalregulationLipidsPhysiologicalfunction:promotesadiposelipolysis/clearance<synthesisExcessivesecretion,promotesadiposelipolysis/clearance>synthesis增强能量代谢，产热量增加Enhancesenergymetabolismandincreasesheatproduction调节物质代谢Regulatessubstancemetabolism甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育Promotesgrowthanddevelopment神经系统Nervoussystem心脏的影响Impactsonheart消化系统Digestivesystem影响器官系统Impactsonorgansystems神经系统:主要表现为兴奋作用Nervoussystem:mainlymanifestsasstimulation可使心率增快、心肌收缩力增强Potentiatesheartrateandmyocardialcontractility促进消化道的运动和消化腺的分泌Promotesthemovementofthedigestivetractandglandssecretion甲状腺激素——生理功能Thyroidhormones-physiologicalfunction促进生长发育Promotesgrowthanddevelopment呼吸系统Respiratorysystem泌尿系统Urinarysystem生殖系统Reproductivesystem影响器官系统Impactsonorgansystems增加呼吸频率和深度、促进肺泡表面活性物质的生成Increasesbreathingrespiratoryrateandvolume,promotespulmonarysurfactantgeneration增加肾小球滤过率，促进水排出Increasesglomerularfiltrationrateandpromotesmicturition可维持正常性欲和性腺功能Maintainsnormallibidoandgonadalfunction总结Summary01甲状腺激素的生理功能Physiologicalfunctionofth