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内分泌代谢功能的监测 PowerPoint PPT Presentation


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内分泌代谢功能的监测. 郧阳医学院附属太和医院麻醉科 李 清. Monitoring of endocrine&metabolism function. 内分泌系统是人体内重要调节系统,使人体在复杂多变的生活环境中维持物质代谢和体内环境的动态平衡 创伤、感染、手术和麻醉使内分泌系统失调,尤以原有内分泌疾病者影响更大. 内分泌功能检查目的. 了解手术麻醉前病人内分泌功能状态有无异常并确定其性质及其严重程度 估计外科手术病人的 手术麻醉耐受性和安全性 ,以便作好麻醉前准备工作. 检查的内容. 病史 :家族史、遗传史、个人病史和手术史

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内分泌代谢功能的监测

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Monitoring of

endocrine&metabolism function


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  • XCT


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    • 24

    • 24


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  • ADH

  • ()ADH,


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TRH TRH(TSH),T3T4

ACTH

  • ACTH ACTH

  • ACTH ACTH


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()ACTH: ACTH

  • ACTHACTH(17-OHCS)


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  • 17-OHCS

  • 17-OHCS

  • ACTH


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()

  • DXM(CRH)ACTHDXMCRHACTH17-OHCS


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  • 17-OHCS50

  • 110nmol/L50


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()

  • >50<50ACTH

    --


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()

  • (cortisol)8AM


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  • :

    • (CBG)

    • ACTHACTH

  • :

    • CBG


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  • NANACA

  • CA546pmol/L


3 4 vma

3--4(VMA)

  • VMANAVMANA

  • 5.045.4mol/24h

  • 50.51262.5 mol/24h


T 4 tt 4 60 180nmol l

()T4(TT4) 60180nmol/L


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TT4

  • 23

  • -


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TT4

  • TT4


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()T3(TT3)

  • 12-3.4nmol/L2.15nmol/L

  • TT3

  • TT3


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()


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  • 31

  • 75g250ml(1.75g/kgg2.5ml)123


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  • 6.67mmol/L19.52mmol/L2(7.28mmol/L)3

  • 7.84mm01/L110mmol/L27.28mmol/L

  • 7.84mmol/L


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()

  • 50(0.5g/kg)3--530

  • 1/2123


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  • 1/211.1013.88mmol/L2

  • 27.77mmol/L


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()-

  • B

  • 1/2123


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  • 5~25mU/L17103

  • 2~3


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  • ()()()


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  • CO2


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()


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()()


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1

  • (Sheehans syndrome)


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2


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  • C02

  • 504060ml

  • 300-500mg/24hiv200-300mg/24hiv


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()

  • 12-36BMR12


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1


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2

  • 39120-140bpm

  • 40140-160bPm


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3

  • 24~48


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()

  • 1.

  • 60705l0l


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1)


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2)

  • RR()

  • pH<7.25<6.8C02BEBUN


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3)


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4)


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5)

  • iv4050U4050U30U30U2040U4pHCO211223341


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6)

  • 46U10002000mi34200mgdl(11.2mmol/L)1000ml2428


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7)

  • (pH<7.1HCO3<5-10mmol/LCO210vol-15vol)2pH7.2 CO230vol,


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2

  • l/61/10


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1)


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2)

  • 33.6mmol/L(600mg/dL)


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  • 3)

  • CVP


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()()

  • 1~2


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1

  • ()


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2

  • 160bpm

  • 40

  • NaCl


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3

  • 6

  • 504060mi


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()

  • 1


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2

  • 250mmHg1

  • EKG


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3

  • CO2

  • BPPEKG1/3200mmHg


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Bye.


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