Thyrotoxic ib ntu zuj zus tuag tes tuag taw

Thyrotoxic ib ntu ib ntu tuag tes tuag taw yog qhov mob uas muaj qee ntu ntu ntawm cov leeg tsis muaj zog txaus. Nws tshwm sim hauv cov neeg uas muaj theem siab ntau ntawm cov thyroid hormones txaus hauv lawv cov ntshav (hyperthyroidism, thyrotoxicosis).

Qhov no yog qhov mob uas tsis tshua muaj tshwm sim tsuas yog tshwm sim rau cov neeg muaj kev ua haujlwm siab ntau ntawm cov thyroid (thyrotoxicosis). Cov txiv neej ntawm Neeg Esxias lossis Neeg Hispanic cov xeeb ntxwv tau cuam tshuam ntau zaus. Cov neeg feem ntau uas txhim kho cov thyroid hormones txaus siab tsis muaj kev pheej hmoo ntawm ib leeg ib ce tuag.

Muaj qhov tsis zoo sib xws, hu ua hypokalemic, lossis tsev neeg, tus tuag tes tuag taw. Nws yog ib qho mob uas muaj los thiab tsis muaj feem cuam tshuam nrog cov thyroid siab, tab sis muaj tib yam tsos mob.

Yam txaus ntshai muaj xws li tsev neeg keeb kwm ntawm tuag tes tuag taw thiab hyperthyroidism.

Cov tsos mob cuam tshuam tawm tsam cov leeg tsis muaj zog lossis tuag tes tuag taw. Kev tawm tsam ua rau lub sijhawm hloov ntawm cov leeg ib txwm ua. Kev tawm tsam feem ntau pib tom qab cov tsos mob ntawm hyperthyroidism tau tsim. Cov tsos mob hyperthyroid tuaj yeem hloov maj mam.

Qhov ntau zaus ntawm kev tawm tsam txawv ntawm txhua hnub mus rau xyoo. Kev mob ntawm cov leeg tsis muaj zog yuav nyob ntev rau ob peb teev lossis ob peb hnub.

Cov tsis muaj zog lossis tuag tes tuag taw:

• Muaj com thiab mus
• Muaj peev xwm nyob ntawm ob peb teev txog ntau hnub (tsawg)
• Feem ntau ntawm ob txhais ceg dua li ntawm caj npab
• Feem ntau pom muaj hauv lub xub pwg thiab lub duav
• Cuam tshuam los ntawm qhov hnyav, cov khoom noj muaj txiaj ntsig, muaj ntsev noj ntau ntau
• Ua rau thaum so tom qab qoj ib ce

Lwm cov tsos mob uas tsis tshua pom tshwm sim suav nrog qee yam hauv qab no:

• Ua pa nyuaj
• Hais lus nyuaj
• Nqos nyuaj
• Lub zeem muag hloov

Cov neeg muaj kev ceeb toom thaum muaj kev tawm tsam thiab tuaj yeem teb cov lus nug. Lub zog ib txwm rov los ntawm kev tawm tsam. Cov leeg tsis muaj zog tuaj yeem pib zuj zus nrog kev tawm tsam ntau zaus.

Cov tsos mob ntawm hyperthyroidism suav nrog:

• Dhau hws
• Lub plawv dhia ceev ceev
• Nkees
• Mob taub hau
• Thaum tshav kub kub intolerance
• Muaj ntau yam qab los noj mov
• Insomnia
• Ntau zaus tso quav
• Hnov hnov ​​mob plawv dhia ceev heev (mob hauv siab)
• Qhwv ntawm tes
• Sov, noo tawv
• Lub cev yuag

Tus kws kho mob yuav xav tias tuaj yeem tuag tes tuag taw raws li:

• Qeb tsis txaus cov thyroid hormones txaus
• Tsev neeg muaj keeb kwm ntawm qhov kev puas tsuaj no
• Qib poov tshuaj qis thaum muaj kev tawm tsam
• Cov tsos mob uas tuaj thiab mus rau hauv ntu

Kev kuaj mob muaj feem cuam tshuam tawm cov teeb meem cuam tshuam nrog cov poov tshuaj qis.

Tus kws kho mob yuav sim ua rau muaj kev tawm tsam los ntawm muab koj cov insulin thiab piam thaj (qabzib, uas txo cov poov tshuaj tsawg) lossis thyroid hormone.

Cov cim hauv qab no tuaj yeem pom thaum lub sijhawm nres:

• Tsawg dua los yog tsis muaj reflexes
• Lub plawv dhia tsis xwm yeem
• Cov poov tshuaj qes nyob hauv cov ntshav (cov qib poov tshuaj muaj ntau dua li ib txwm sib tua)

Nruab nrab ntawm kev tawm tsam, kev soj ntsuam yog qhov qub. Los yog, tej zaum yuav muaj cov tsos mob ntawm hyperthyroidism, xws li nthuav dav cov thyroid hloov pauv hauv qhov muag, tshee, plaub hau thiab ntsia thawv hloov.

Cov kev ntsuam xyuas hauv qab no yog siv los kuaj hyperthyroidism:

• Theem cov thyroid hormones txaus (T3 lossis T4)
• Tsawg cov ntshav TSH (cov thyroid stimulating hormone) qib
• Cov thyroid khaws thiab luam theej duab

Lwm qhov xeem tau:

• Txawv electrocardiogram (ECG) thaum muaj kev tawm tsam
• Siv tsis zoo electromyogram (EMG) thaum muaj kev tawm tsam
• Tsis tshua muaj ntshiab poov tshuaj thaum tawm tsam, tab sis ib txwm ntawm kev tawm tsam

Nqaij nqaij mus kuaj tej zaum kuj noj.

Poov tshuaj yuav tsum tau muab thaum lub sij hawm tawm tsam, feem ntau yog los ntawm qhov ncauj. Yog tias qhov tsis muaj zog yog qhov hnyav, koj yuav tsum tau txais potassium los ntawm txoj hlab ntshav (IV). Nco tseg: Koj tsuas yuav tau txais IV yog tias koj lub raum ua haujlwm tsis zoo thiab raug saib xyuas hauv tsev kho mob.

Kev tsis muaj zog uas cuam tshuam nrog cov leeg siv rau kev ua pa lossis nqos yog qhov xwm txheej. Cov neeg yuav tsum tau coj mus rau hauv tsev kho mob. Qhov ua tsis ncaj ncees heev ntawm lub siab kuj tuaj yeem tshwm sim thaum muaj kev tawm tsam.

Koj tus kws kho mob yuav qhia kom noj cov zaub mov uas muaj cov carbohydrates thiab ntsev kom tsawg los tiv thaiv kev tawm tsam. Cov tshuaj hu ua beta-blockers tuaj yeem txo tus naj npawb thiab qhov hnyav ntawm kev tawm tsam thaum koj hyperthyroidism raug tswj hwm.

Acetazolamide muaj txiaj ntsig zoo ntawm kev tiv thaiv kev tawm tsam rau cov neeg uas muaj mob tuag tes tuag taw. Nws feem ntau tsis muaj txiaj ntsig rau thyrotoxic periodic tuag tes tuag taw.

Yog hais tias tsis muaj tshuaj tua tsis tau thiab lub ntsws ua pa cuam tshuam, txoj kev tuag tuaj yeem tshwm sim.

Mob tsis tu ncua ntev mus ntev tuaj yeem ua rau cov leeg tsis muaj zog. Qhov kev qaug zog no tuaj yeem txuas ntxiv txawm tias muaj kev tawm tsam yog tias thyrotoxicosis tsis kho.

Thyrotoxic periodic paralysis teb tau zoo rau kev kho mob. Kho cov hyperthyroidism yuav tiv thaiv kev tawm tsam. Nws yuav txawm rov thim nqaij pob txha tsis muaj zog.

Yog tsis kho thyrotoxic ib ce tuag tes tuag taw tuaj yeem ua rau:

• Ua pa nyuaj, hais lus, los yog nqos thaum muaj kev tawm tsam (tsis tshua muaj)
• Lub plawv dhia tsis zoo thaum tawm tsam
• Cov leeg tsis muaj zog uas tsis zoo zuj zus thaum lub sijhawm ua ke

Hu rau tus xov tooj xwm ceev hauv zos (xws li 911) lossis mus rau chav kho mob ceev yog tias koj muaj lub zog tsis muaj zog. Qhov no tseem ceeb heev yog tias koj muaj tsev neeg keeb kwm ntawm kab mob ib ce los sis lub qog ua rau koj lub cev khiav tsis zoo.

Cov tsos mob ceev xws li:

• Ua pa nyuaj, hais lus, los yog nqos
• Ntog vim yog cov leeg tsis muaj zog

Kev qhuab qhia txog caj ces yuav qhia tau. Kev kho cov thyroid cuam tshuam tiv thaiv kev tawm tsam ntawm lub zog.

Periodic tuag tes tuag taw - thyrotoxic; Hyperthyroidism - tuag tes tuag taw ntu

• Lub qog ua haujlwm

Hollenberg A, Wiersinga WM. Cov mob hyperthyroid. Hauv: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Phau Ntawv ntawm EndocrinologyCov. Xab 14th. Philadelphia, PA: Elsevier; 2020: chap 12.

Kerchner GA, Ptacek LJ. Channelopathies: kev mob tshwm sim thiab hluav taws xob tsis zoo ntawm lub paj hlwb. Hauv: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology nyob rau hauv Kev Soj NtsuamCov. 7 tus ed. Philadelphia, PA: Elsevier; 2016: chap 99.

Selcen D. Cov leeg nqaij. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 393.