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病史摘要刘××,女,31岁,农民,于入院前4月出现怕热、多汗、食欲亢进、心悸、体重下降,伴突眼、视物模糊,曾于当地医院诊治,按甲状腺机能亢进症(简称甲亢)不规则服他巴唑2月,因自觉疗效不佳而停药。1月前上述症状加重,伴吞咽困难,说话不清呛咳。曾用“新斯的明”效果不理想,10天来呼吸困难,不能平卧而急诊入院。体检:急性病容,口唇发绀,端坐呼吸,消瘦,两上睑下垂,眼球轻度突出并固定,瞳孔等大。甲状腺弥漫性中等度增大,无血管杂音。
Summary of history Liu XX, female, aged 31, farmer, appeared in April before admission to be afraid of fever, hyperhidrosis, loss of appetite, heart palpitations, weight loss, with exophthalmos, blurred vision, had a local hospital diagnosis and treatment, according to thyroid function Hyperthyroidism (referred to as hyperthyroidism) irregular service methimazole February, due to poor efficacy and withdrawal. 1 month ago, the symptoms worsened, with swallowing difficulties, vomiting choking cough. Had used “neostigmine” effect is not satisfactory, 10 days of breathing difficulties, can not lie down and emergency admission. Physical examination: acute illness, cyanosis of the lips, sitting and breathing, weight loss, ptosis, eyeballs slightly prominent and fixed, pupils and other large. Diffuse thyroid moderate increase, no vascular noise.