thyroid storm in pashto presented by dr. asmatullah sapand
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دعامې روغتیا وزارت
دخوست دعامې روغتیاریاست
دخوست والیتي تخصصي روغتون
داکمال تخصص آمریت
دعمومي داخله ډېپارټمنټ
دکنفرانس موضوع
Thyroid Storm
څپاندهللا ډاکترعصمت : ترتیب کوونکی . ش. هـ ۱۳۹۵: کال
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Thyroid Storm
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Thyroid Storm
Thyroid storm چېthyrotoxic crisis هم ورته
حراني وایي د هایپرتایرایدیزم یو حاد، ژوندتهدیدوونکی او ب
حالت دی په کوم کې چې د زیات مقدار
شدید تایرایدهورمونونودافرازله کبله ټول اعراض اوعالیم ت
.کیږي
دایو ژوند تهدیدوونکی اوبیړنی حالت دی چې په وخت
.مداخلې سره په ښه ډول کنټرولیدلی شي
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Thyroid Storm
ته رسیږی %75-10ددرملنې سره بیا هم دمړینې کچه یی
او arrhythmia ،cardiac failureپه ځانګړی ډول د
hyperthermiaله کبله.
نوموړی حالت دhyperthyroidism په هغه ناروغانو
ه کې چې په ښه ډول تداوی شوی نه وی اویا هم له تشخیص
.پاتی شویوی رامنځته کیږی
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Thyroid Storm
دThyroid Stormتحریکوونکی فکتورونه
Infection Trauma
DKA MI
CVA PE
Surgery Withdrawal of thyroid
med
Iodine administration Palpation of thyroid
gland
Ingestion of thyroid
hormone
Unknown etiology (20-
25%)
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Thyroid Storm
کلینیکی بــــڼــــه:
ا، ډیری عمده نښی یی عبارت دی له تبی، تکی کاردی
دشعوری حالت ګډوډی، دلبدی، استفراق، بطنی درد،
.زیړی او زیاتو خولو څخه
ددی ترڅنګ د ناروغ په تاریخچه اوفزیکی معاینه کی د
exophthalmosاونورو ورته ستونزو حکایه او نښې
.موجودی وی
ممکن ناروغ دHeart failure د نښو سره مراجعه
.وکړی
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Thyroid Storm
Diagnosisتشخیص:
Thyroid stormله د طبی تاریجچی اوکلینیکی نښو
. رویه تشخیص کیږی
دThyroid storm دتشخیص لپاره یوه مهمه
وجود لريCriteriaتشخیصی
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Thyroid Storm
درمـــلـــنـــه:
ترټولو مهمه یی اول دهوایی الرو خالص ساتل، کافی
oxygenation دمایعاتواکفاء او ،cardiac
monitoringدی.
درملنه یی په پنځوعمده برخوکی ترسره کیږی:
عمومی تقویوی درملنه
دتایراید هورمونودجوړیدو څخه مخنیوی
د تایراید هورمونودآذادیدوڅخه مخنیوی
دتایراید هورمونونو دمحیطی تاثیراتو څخه مخنیوی
دتحریکوونکوفکوتورونو پیژندل او درملنه
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Thyroid Storm Drug Treatment of Thyroid Storm
Decrease de novo synthesis: Propylthiouracil 150-250mg PO 6-hrly
Methimazole 15-25mg PO q6h
Prevent release of hormone (after synthesis blockade initiated) Iodine potassium iodide 10 drops PO q8h one hour later
Prevent peripheral effects: B-Blocker Propranolol (IV) 0.5-2mg IV q4h or 20-120mg PO q6h
Other consideration: Corticosteroids Hydrocortisone 50 mg IV q 6h or dexamethasone 2 mg IV q 6 hr
Antipyretics Cooling blanket acetaminophen 650 mg PO q 4-6h
Antibiotics if infection is present.
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Thyroid Storm
ادامـــــــه......
و ؤ که ناروغ له پورته درملنی سره بیاهم مخ په خرابید
، Plasma transfusionنوپدی صورت کی د
Plasmapheresis او یاCharcoal Plasma
perfusionڅخه کار آخیستل کیږی .
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Thyroid Storm
Disposition
Admit to the ICU
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References :
HARRISON’S PRINCIPLE of INTERNAL MEDICINE 19th edition.
CURRENT MEDICAL diagnosis and treatment 2016th edition.
WASHINGTON MANUAL of medical therapeutic 33rd edition.
Web/Internet
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