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《臨床上的各種危象（Clinical crises）.doc》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、臨床上的各種危象(Clinicalcrises)SendoutasummaryofthevariousclinicalcrisesthatIhopewillhelpyouwhenyou'reonnightshiftandoutoftheemergencydepartment!!ClinicalcrisissummaryClinicalcrisis,thecriticalsignofdisease,isfoundinclinicaldepartments?Identificationandtreatmentofcr
2、isisisanimportantpartofcriticalcaremedicine.1endoerineandmetabolicsystem1.1pituitarycrisis:thiscrisisisavarietyofmetabolicdisorderanddysfunctionoforgandysfunctioncausedbyhypopituitarismandnormalhormonereplacementtherapy.Itisoneofthelife-threateningandsevereca
3、ses?Diagnosticpoints:Patientswithhypopituitarismsufferfromseverestress,suchasinfection,trauma,surgery,andseveremetabolicdisorder(hyponatremia,hypoglycemia),mentaisymptoms(mentaldisorders,unconsciousness,delirium),coma.Rescuemeasures:Mostofthemarecausedbyhypog
4、lycemiaand/orhyponatremia?Itemphasizestherapidcorrectionofhypoglycemia,waterelectrolytedisorders,rapidsupplementationofrelatedhormones,andactivecontrolofpredisposingfactorsandtreatmentofcomplications.1.2thyroidcrisisReferredtoashyperthyroidismcrisis,orthyroid
5、storm,hyperthyroidismisanacuteexacerbationofthedisease,oftendangerousandpatientlifeDiagnosticpoints:Gravesdisease,thyroidadenomaornodulargoiterpatients,suddenhighfever(>39C),sweating,tachycardia(>160/min),frequentvomitinganddiarrhea,anxiety,tremor,delirium,co
6、ma?Rescuemeasures:Rapidinhibitionofthyroidhormonesynthesisandsecretion(byantithyroiddrugs,iodine),thyroidhormonelevelsdecreasedrapidlyincirculatingblood(plasmaexchange,dialysis),reducethereactionaroundtheorganizationofthyroxine(beta2adrenergicblockingagent,re
7、serpineorguanethidine),protectionofvitalorgans,preventionandtreatmentfailure(beantipyretic,sugarcorticosteroidsorartificialhibernation)1.3hypothyroidismcrisisHypothyroidismcrisis,alsoknownasmucousedemacoma,isaseriousclinicalconditionofhypothyroidism,threateni
8、ngthepatient5slife?Diagnosticpoints:Hypothyroidismischaracterizedbysuddenonsetofmentaldisorders(disorientation,confusion,unconsciousness,lethargy,coma),absolutelowbodytemperature(<30~35DE
