Devereaux Danielle, Tewelde Semhar Z
Department of Emergency Medicine, University of Maryland Medical System, University of Maryland, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
Department of Emergency Medicine, University of Maryland Medical System, University of Maryland, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.
Emerg Med Clin North Am. 2014 May;32(2):277-92. doi: 10.1016/j.emc.2013.12.001. Epub 2014 Mar 15.
Hyperthyroidism and thyrotoxicosis are hypermetabolic conditions that cause significant morbidity and mortality. The diagnosis can be difficult because symptoms can mimic many other disease states leading to inaccurate or untimely diagnoses and management. Thyroid storm is the most severe form of thyrotoxicosis, hallmarked by altered sensorium, and, if untreated, is associated with significant mortality. Thyroid storm should be considered in the differential of any patient presenting with altered mental status. The emergency medicine physician who can rapidly recognize thyrotoxicosis, identify the precipitating event, appropriately and comprehensively begin medical management, and facilitate disposition will undoubtedly save a life.
甲状腺功能亢进症和甲状腺毒症是导致显著发病率和死亡率的高代谢状态。诊断可能很困难,因为症状可能与许多其他疾病状态相似,导致诊断和治疗不准确或不及时。甲状腺危象是甲状腺毒症最严重的形式,其特征是意识改变,若不治疗,会有显著的死亡率。对于任何出现精神状态改变的患者,鉴别诊断时都应考虑甲状腺危象。能够快速识别甲状腺毒症、确定诱发事件、适当且全面地开始药物治疗并安排处置的急诊医生无疑将挽救一条生命。