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Seven-Month Weaning Process in Primary Hypothyroidism with Myxedema Coma and Respiratory Failure-A Case Report

七個月的呼吸器脫離期於甲狀腺低下併黏液水腫昏迷-病例報告

摘要


甲狀腺功能不足很常見,診斷並不難也很容易治療,但卻常常為人所忽略。其臨床表現由最輕微的無症狀到最極端的黏液水腫昏迷併呼吸衰竭皆有可能。黏液水腫很罕見但有可能致命,其臨床症狀常呈非特異性且多樣化。我們在此報告一68歲男性患有原發性甲狀腺功能不足合併黏液水腫昏迷及呼吸衰竭的個案。其治療包括積極呼吸治療及口服甲狀腺素。雖然臨床治療效果很明顯,但卻需治療七個月後才得以成功脫離呼吸器。

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並列摘要


Hypothyroidism is common, often overlooked, readily diagnosed by laboratory testing, and eminently treatable. The clinical presentation varies from a subclinical form with insignificant symptoms to the most extreme form of myxedema coma with respiratory failure. Myxedema coma is rare but potentially lethal, the symptoms and signs are many and are often insidious. Here we report a rare case of a 68 years old male with primary hypothyroidism with myxedema coma and respiratory failure. The treatment included meticulous chest care and oral L-thyroxine replacement therapy. Despite dramatic clinical response, it took seven months for the patient to be completely liberated from mechanical ventilation.

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