儿童肾上腺危象的早期识别与治疗

张育才;任玉倩

【期刊名称】《中国小儿急救医学》

【年(卷),期】2015(000)010

【摘要】Adrenal crisis is a life-threatening emergency caused by the destruction or altered function of the adrenal gland with a primary deficit in cortisol secretion(primary adrenal insufficiency)or by hypotha-lamic-pituitary pathologies determining a deficit of adrenocorticotropic hormone(secondary adrenal insuffi-ciency).Infection and abrupt end glucocorticoid treatment are the major precipitating causes of adrenal crisis. Patients with adrenal crisis typically present with hypovolemic shock or hypotension,nausea,vomiting,and fe-ver responding well to parenteral hydrocortisone administration.The main laboratory findings include lower serum cortisol concentrations,hyponatremia,hypoglycaemia and/or hyperkalemia.Delay diagnosis of adrenal insufficiency leads to adrenal crisis which is potentially lethal complication.Empirical glucocorticoid replace-ment should be initiated as soon as the suspicious of adrenal crisis,or sooner if the patient presents in adrenal crisis in critically ill children.%肾上腺危象是肾上腺皮质功能障碍的危急重症，原因是由于肾上腺病变导致皮质激素缺乏(原发性肾上腺功能障碍)，或下丘脑-垂体-肾上腺轴功能障碍导致促肾上腺皮质激素分泌的缺陷，使受其调控的肾上腺糖皮质激素分泌