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危象总结(Crisis summary)
危象总结(Crisis summary)
Clinical crisis, the critical sign of disease, is found in clinical departments. Identification and treatment of crisis is an important part of critical care medicine.
1 endocrine and metabolic system
1.1 pituitary crisis: this crisis is a variety of metabolic disorder and dysfunction of organ dysfunction caused by hypopituitarism and normal hormone replacement therapy. It is one of the life-threatening and severe cases. Diagnosis: Patients with hypopituitarism, in case of infection, trauma, surgery and other stress state, the emergence of serious metabolic disorder (hyponatremia, hypoglycemia), psychiatric symptoms (mental disorder, confusion, delirium, coma). The rescue measures are mostly caused by hypoglycemia and / or hyponatremia. It emphasizes the rapid correction of hypoglycemia, water and electrolyte disorders, rapid supplementation of related hormones, and active control of predisposing factors and treatment of complications.
1.2 thyroid crisis referred to as hyperthyroidism crisis or thyroid storm, acute hyperthyroidism disease is extremely aggravating, often endanger the lives of patients: diagnosis of Graves disease, thyroid adenoma or nodular goiter patients, sudden high fever ( 39 C), sweating, tachycardia ( 160 /min), frequent vomiting and diarrhea, anxiety, tremor, delirium, coma. Rescue measures: rapid inhibition of thyroid hormone synthesis and secretion (by anti thyroid drugs, iodine), thyroid hormone levels decreased rapidly in circulating blood (plasma exchange, dialysis), reduce the reaction around the organization of thyroxine (beta 2 adrenergic blocking agent, reserpine or guanethidine), protection of vital organs, prevention and treatment failure (be fever agent, glucocorticoid or artificial hibernation)
1.3 hypothyroidism crisis, referred to as hypothyroidism crisis, also known as mucous edema coma, is a serious clinical situation of thyroid dysfunction decompensation, threatening the patients life. Diagnosis: hypothyr
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