甲狀腺功能亢進癥病人的護理NursingofHyperthyroidismPatients13講解

甲狀腺功能亢進癥病人的護理Nursingof

Hyperthyroidism

Patients廣西衛(wèi)生職業(yè)技術(shù)學(xué)院內(nèi)科護理教研室DepartmentofMedicineNursing,GuangxiMedicalCollege甲狀腺的解剖TheThyroidAnatomy甲狀·腺

ThyroidGland

成年人最大的內(nèi)分泌腺，位于頸前部，棕紅色，呈“H”形，重約25g；由左右兩葉、峽部及錐狀葉組成。Itisthelargestendocrineglandinadultswhichislocatedinthefrontoftheneck,witha"H"shapebrown-redcolor,weighingabout25g;itconsistsofleftandrightlobes,isthmusandcone-shapedlobes.甲狀腺激素ThyroidhormonesT4四碘甲狀腺原氨酸（甲狀腺素）90%T3三碘甲狀腺原氨酸10%T4Tetraiodothyronine(thyroxine)90%T3Triiodothyronine10%甲狀腺激素Thyroidhormones游離型的TH才有生物活性作用OnlyfreeTHhasbiologicalactivityFT3、FT4（極少數(shù)＜1%）99%以上是與血漿蛋白結(jié)合的形式存在—甲狀腺素結(jié)合球蛋白、甲狀腺素轉(zhuǎn)運蛋白、白蛋白TT3、TT4FT3,FT4(onlyafew<1%)Morethan99%existsintheformofplasmaproteinbinding—Thyroxinebindingglobulin,transthyretin,albuminTT3、TT4甲狀腺激素Thyroidhormones甲狀腺激素T3、T4在甲狀腺球蛋白Tg表面合成并儲存ThyroidhormonesT3andT4aresynthesizedandstoredonthesurfaceofthyroglobulinTg甲狀腺激素Thyroidhormones負(fù)反饋Negativefeedback下丘腦Hypothalamus促甲狀腺激素釋放激素ThyrotropinReleasingHormoneTRHTRH垂體HypophysisTSHTSHT4/T3T4/T3促甲狀腺激素ThyroidStimulatingHormone負(fù)反饋Negativefeedback甲狀腺激素Thyroidhormones甲狀腺Thyroid負(fù)反饋Negativefeedback下丘腦Hypothalamus垂體Hypophysis甲狀腺Thyroid負(fù)反饋Negativefeedback甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育PromotesgrowthanddevelopmentTH是胎兒和新生兒腦發(fā)育的關(guān)鍵激素，TH能與GH協(xié)同調(diào)控幼年期的生長發(fā)育。THisakeyhormoneforfetalandneonatalbraindevelopment,andwithGH,Thcanhaveacoordinatedregulationforgrowthanddevelopmentinchildhood.甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育Promotesgrowthanddevelopment胚胎期及幼兒期如果缺乏TH,可出現(xiàn)克汀?。ù粜“Y），人類胎兒生長發(fā)育12周之前的甲狀腺不具備聚碘和合成TH的能力。IfthereisalackofTHintheembryonicperiodandearlychildhood,cretinism(whichleadstoshortstatureandlowintelligence)mayoccur.Thethyroidglandbefore12weeksofhumanfetalgrowthanddevelopmentdoesnothavetheabilitytoaccumulateiodineandsynthesizeTH.甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育Promotesgrowthanddevelopment調(diào)節(jié)新陳代謝RegulatesMetabolism蛋白質(zhì)生理情況，促進蛋白質(zhì)合成分泌過多，促進蛋白質(zhì)分解分泌不足，蛋白質(zhì)合成減少ProteinPhysiologicalfunction:promotesproteinsynthesisExcessivesecretioncanpromoteproteolysisInsufficientsecretioncandecreaseproteinsynthesis增強能量代謝，產(chǎn)熱量增加Enhancesenergymetabolismandincreasesheatproduction調(diào)節(jié)物質(zhì)代謝Regulatessubstancemetabolism甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育Promotesgrowthanddevelopment調(diào)節(jié)新陳代謝RegulatesMetabolism糖：雙向調(diào)節(jié)脂類生理情況，促進脂肪分解/清除<合成分泌過多,促進脂肪分解/清除＞合成GlucosebidirectionalregulationLipidsPhysiologicalfunction:promotesadiposelipolysis/clearance<synthesisExcessivesecretion,promotesadiposelipolysis/clearance>synthesis增強能量代謝，產(chǎn)熱量增加Enhancesenergymetabolismandincreasesheatproduction調(diào)節(jié)物質(zhì)代謝Regulatessubstancemetabolism甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育Promotesgrowthanddevelopment神經(jīng)系統(tǒng)Nervoussystem心臟的影響Impactsonheart消化系統(tǒng)Digestivesystem影響器官系統(tǒng)Impactsonorgansystems神經(jīng)系統(tǒng):主要表現(xiàn)為興奮作用Nervoussystem:mainlymanifestsasstimulation可使心率增快、心肌收縮力增強Potentiatesheartrateandmyocardialcontractility促進消化道的運動和消化腺的分泌Promotesthemovementofthedigestivetractandglandssecretion甲狀腺激素——生理功能Thyroidhormones-physiologicalfunction促進生長發(fā)育Promotesgrowthanddevelopment呼吸系統(tǒng)Respiratorysystem泌尿系統(tǒng)Urinarysystem生殖系統(tǒng)Reproductivesystem影響器官系統(tǒng)Impactsonorgansystems增加呼吸頻率和深度、促進肺泡表面活性物質(zhì)的生成Increasesbreathingrespiratoryrateandvolume,promotespulmonarysurfactantgeneration增加腎小球濾過率，促進水排出Increasesglomerularfiltrationrateandpromotesmicturition可維持正常性欲和性腺功能Maintainsnormallibidoandgonadalfunction總結(jié)Summary01甲狀腺激素的生理功能Physiologicalfunctionofth