Miculan J, Turner S, Paes B A
Neonatal Netw. 1993 Sep;12(6):25-34; quiz 34-8.
Every newborn infant should be screened for congenital hypothyroidism before discharge from the nursery. Neonatal screening for hypothyroidism was introduced to North America in 1972 and has been demonstrated to be cost effective in the prevention of neurological damage in children. Interpretation of diagnostic test results from such programs is based on understanding the physiology of the thyroid gland and recognition that neonatal hypothyroidism primarily stems from an embryological disorder of thyroid development rather than central causes involving the hypothalamic-pituitary axis. Early diagnosis of hypothyroidism is dependent on proper timing and collection of blood samples and an efficient screening program reporting accurate results. A thorough maternal and family history in conjunction with clinical signs and symptoms of hypothyroidism, biochemical tests, and radiological findings should be used to rapidly establish the diagnosis. Early detection and treatment with thyroxine normalizes skeletal maturation, physical growth, cognitive functioning, and motor development of affected newborns. Nurses play an important role in identification, management, and supportive care of infants with hypothyroidism so that maximal potential is achieved.
每个新生儿在从新生儿病房出院前都应接受先天性甲状腺功能减退症筛查。新生儿甲状腺功能减退症筛查于1972年引入北美，已被证明在预防儿童神经损伤方面具有成本效益。对此类项目诊断测试结果的解读基于对甲状腺生理的理解以及认识到新生儿甲状腺功能减退症主要源于甲状腺发育的胚胎学紊乱，而非涉及下丘脑 - 垂体轴的中枢性病因。甲状腺功能减退症的早期诊断取决于采血的正确时间和样本采集以及一个能报告准确结果的高效筛查项目。应结合甲状腺功能减退症的临床体征和症状、生化检查以及影像学检查结果，全面了解母亲和家族病史，以便迅速做出诊断。早期发现并用甲状腺素治疗可使受影响新生儿的骨骼成熟、身体生长、认知功能和运动发育恢复正常。护士在甲状腺功能减退症婴儿的识别、管理和支持性护理中发挥着重要作用，从而使婴儿发挥最大潜能。
