甲状腺功能亢进症病人的护理NursingofHyperthyroidismPatients32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甲状腺毒症Thyrotoxicosis各种原因导致血循环中甲状腺激素过多，引起的以神经、循环、消化等系统兴奋性增高和代谢亢进为主要表现的一组临床综合征Duetovariousreasons,thereareexcessivethyroidhormonesinthebloodcirculation,whichleadstoagroupofclinicalsyndromesmainlycharacterizedbyincreasedstimulationandhypermetabolismofnervous,circulatory,digestive,andothersystems甲状腺毒症Thyrotoxicosis甲状腺功能亢进症Hyperthyroidism⒈弥漫性毒性甲状腺肿（Graves病）Diffusetoxicgoiter(Gravesdisease)⒉多结节性毒性甲状腺肿Multinodulartoxicgoiter⒊甲状腺自主高功能腺瘤

Plummerdisease⒋碘致甲状腺功能亢进症Iodine-inducedhyperthyroidism⒌桥本甲状腺毒症Hashitoxicosis⒍新生儿甲状腺功能亢进症

Neonatalhyperthyroidism⒎垂体TSH腺瘤HypophysisTSHadenoma甲状腺腺体本身产生TH过多ThethyroidglandproducesTHexcessively甲状腺毒症Thyrotoxicosis非甲状腺功能亢进类型Non-hyperthyroidtype⒈亚急性甲状腺炎SubacuteThyroiditis⒉无痛性甲状腺炎PainlessThyroiditis⒊桥本甲状腺炎Hashimoto'sThyroiditis⒋产后甲状腺炎（PPT）PostpartumThyroiditis(PPT)⒌外源甲状腺激素替代Exogenousthyroidhormoneassubstitute⒍异位甲状腺激素产生（卵巢甲状腺肿等）Productionofectopicthyroidhormones甲状腺的功能并不亢进。包括破坏性甲状腺毒症和服用外源性甲状腺激素Thyroidisnothyperactive.Includingdestructivethyrotoxicosisandtakingexogenousthyroidhormones概述Abstract弥漫性毒性甲状腺肿Graves/Parry/Basedow病DiffusetoxicgoiterGraves/Parry/Basedowdisease器官特异性自身免疫病（TRAb）Organ-specificautoimmunedisease(TRAb)是甲状腺功能亢进症最常见病因isthemostcommoncauseofhyperthyroidism概述Abstract约占全部甲亢的80%~85%accountingforapproximately80%to85%ofallhyperthyroidism患病率为1.1-1.6%whoseprevalenceis1.1-1.6%女性高发，女/男：4~6/1Frequentlyoccursinfemale,female/male:4~6/1高发年龄：20~50岁Highriskages:20~50yearsold病因与发病机制EtiologyandPathogenesis遗传因素Geneticfactors环境因素Environmentalfactors免疫因素

Immunefactors

细菌感染、应激、精神因素Bacterialinfections,stress,mentalfactorsGD的危险因素：吸烟、药物、131I、局部创伤AdversefactorsforGD:smoking,drugs,131I,localtrauma病因与发病机制EtiologyandPathogenesis促甲状腺激素释放激素ThyrotropinReleasingHormoneTRHTRHT4/T3T4/T3负反馈Negativefeedback甲状腺激素ThyroidhormonesTSHTSH促甲状腺激素ThyroidStimulatingHormone下丘脑Hypothalamus垂体Hypophysis甲状腺ThyroidTSH受体TSHReceptor病因与发病机制EtiologyandPathogenesisTSH受体抗体TSHReceptorAntibodiesTRAbTRAbTSAbTSAbTSBAbTSBAbTSH刺激阻断性抗体TSHstimulationblockingantibodiesTSH刺激性抗体TSHstimulatoryantibodies90%-100%未经治疗的GD病人TRAb阳性90%-100%ofuntreatedGDpatientswerepositiveinTRAb与TSH受体结合BindstoTSHreceptorsTH分泌减少DecreasedTHsecretionTH分泌增多IncreasedTHsecretion病因与发病机制EtiologyandPathogenesis促甲状腺激素释放激素ThyrotropinReleasingHormoneTRHTRHTSHTSHT4/T3促甲状腺激素ThyroidStimulatingHormone负反馈Negativefeedback甲状腺激素Thyroidhormones下丘脑Hypothalamus垂体Hy