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B-ultrasound shows solid or cystic solidity, internal echo is uneven, border is unclear, irregular, cystic papillary changes, thyroid nodules are rich in blood flow; hoarseness, which is recurrent laryngeal nerve injury or edema Lu Yao: The thyroid gland is located on both sides of the larynx and upper trachea. It consists of two lateral lobes and isthmus. The isthmus connects the two glandular lobes into one body and is “H” shaped across the upper part of the trachea. Under normal circumstances, the neck is invisible and cannot touch the thyroid gland. The thyroid gland is the largest endocrine organ in the human body. Thyroxine regulates the metabolic activities and growth of various tissues and organs throughout the body. Nodular goiter is suspected of malignant transformation.

4, surgical treatment: About some of the sick time is very long, the tumor is very hard and has a tendency to malignant, also reminded of active surgical resection.

It is necessary to make timely use of surgical treatment and pathological section to confirm the diagnosis of good and malignant.

After the operation, the Chinese medicine will be used to consolidate the treatment to prevent seizures. Because surgery is only a local treatment, tumor growth in a certain part of the body is a local phenomenon of systemic diseases. For most tumor patients, local treatment can not solve the problem, and the symptoms are not cured. A large number of recurrence and metastasis cases after tumor surgery are sufficient to show that local treatment is difficult to cure the tumor.

Treatment of thyroid adenoma: 1. Sclerotherapy: benign nodules confirmed by diagnosis.

How to treat thyroid nodules, especially autonomic thyroid nodules and adenomas, parathyroid adenomas, etc. can be used for this treatment.

Surgical treatment is the basic treatment for all types of thyroid cancer except for undifferentiated cancer, and it is used to treat iodine 131, thyroid hormone and external irradiation. Western medicine treatment of thyroid nodules: 3, thyroid hormone inhibition treatment: 2) iodine supplement: iodine supplementation should be reasonable for iodine deficiency, after the supplement can see different degrees of thyroid retraction.

The available preparations include compound iodine oral solution (Lugol solution), potassium iodide, and lipiodol intramuscular injection.

is currently rarely used.

Again is the isotope scan, which aids in the diagnosis.

Isotope scanning is the detection of how much iodine a thyroid gland can take.

In general, warm nodules, that is, the thyroid gland absorbs more isotopes, most of which are benign adenomas; if it is a cold nodule, consider the possibility of malignancy.

Luyao: No matter which doctor is the surgeon, there is a possibility of recurrence.

Because thyroid adenoma may be unilateral only when it develops, it does not mean that there will be no adenoma in the future. This has something to do with personal physique, so recurrence is possible.

Whether a second operation is needed after recurrence requires a professional doctor to judge. The purpose of taking the medicine is to ensure that the level of thyroxine in the body is within the normal range; on the other hand, to prevent the recurrence of the adenoma - because once the thyroid function is insufficient, it will compensatoryly proliferate and grow up, and the original potential is small. The adenoma also slowly proliferates and grows up, which will soon recur. Treatment of thyroid cancer: nodular goiter secondary to hyperfunction; treatment of different types of thyroid nodules: 3, radiotherapy: autonomous functional / high-function thyroid nodules and adenoma due to concentrated iodine Function, can be properly treated.

3) Treatment of Traditional Chinese Medicine: Resolving phlegm and softening method: Only those with large neck and no special symptoms are qi stagnation and stagnation syndrome, and should be treated with algae, kelp, zibei, green skin and sea pumice. , Pinellia, etc.

In addition, eat seafood such as kelp and jellyfish or foods rich in iodine.

The dosage of eucalyptus is not enough. The final blood test results should prevail.

The blood test requires an empty stomach and the medication is checked. Patients who take oral eucalyptus after surgery need to review thyroid function in the 6th week; in the following 1 year, they will be reviewed once every 3-6 months; after 1 year of surgery, they can be reviewed in June.

NetEase Health: How to prevent thyroid nodules in daily life? Netease Health: What do you need to pay attention to after eating thyroid nodules? 5. Thyroid tumors. Including benign thyroid tumors, thyroid cancer and metastatic cancer.

Finally, a needle biopsy is not an examination that must be done, but it is the most intuitive pathological examination to judge the benign and malignant nodules.

The needle biopsy is guided by ultrasound, taking some pathological tissue on the thyroid gland, and then cytological examination to determine the benign and malignant mass of the tumor, the accuracy is very high.

However, because thyroid surgery can not only obtain diseased tissue, do pathological examination, but also remove the tumor at the same time, so if the thyroid mass reaches the surgical indication, surgery is more appropriate than a needle biopsy. After oral administration, you should take other medicines or foods after a sufficient interval: 1 hour from vitamins, high blood pressure medicines, and tonics; 2 hours from iron or calcium foods or medicines; and milk and bean foods 4 hours apart; 12 hours apart from cholestyramine or lipid-lowering resin.

Note: Soy products and coffee foods will affect the absorption of excellent music. 1. Surgical treatment: Surgical treatment of thyroid cancer includes surgery of the thyroid itself and cleaning of the cervical lymph nodes. Some patients have performed well and have good neuroprotection, but there is still hoarseness. This is because the nerves are exposed after surgery, just like a wire, there should be insulation outside, but after surgery, the nerves ' The insulation layer is gone.

In addition, hematoma and scars that appear after surgery can also affect the function of the nerves. This condition will be hoarse after surgery, but it does not mean that the surgery is not done well.

But now, thyroid surgery has a minimally invasive neck scarless thyroidectomy - laparoscopic thyroid surgery, which is characterized by the separation of surgical lesions and incisions that are unique to endoscopic surgery, with the help of endoscopes and special The auxiliary function of the operating instrument, such as an ultrasonic scalpel, miniaturizes the surgical incision and transfers it to a more concealed part of the chest. To put it simply, it is a surgery that uses minimally invasive cosmetic methods to treat thyroid diseases. Some people call it 'thyroid cosmetic surgery', which is the preferred procedure for young women.

Second, in order to avoid damage to the recurrent laryngeal nerve during thyroid nodule surgery, it is often dissected, which may cause edema of the recurrent laryngeal nerve or affect its blood supply, so that patients may have a speech after surgery. The phenomenon of strenuousness. 1, simple nodular goiter: general simple nodular goiter, whether it is a single nodule and multiple nodules, if it is a warm nodule or cold nodules can try thyroid preparations. Give thyroid powder (tablet) 40 ~ 80mg, divided into 1 or 2 times a day orally. Or use levothyroxine sodium (L-T4) tablets, each time 50 ~ 75μg, 1 or 2 times a day.

After treatment, the enlarged nodules can be used until they disappear completely. If the nodules do not disappear after treatment, the thyroid nodules should be treated. The thyroid function should be observed during the treatment.

Surgical treatment should also be used for functional autonomic nodules, and changes in thyroid function should be observed after surgery.

Clinically, there have been more than 10 years of resection of thyroid adenoma, and it still recurs and can be treated again.

In addition, endocrine disorders, life stress and thyroid nodules also have a certain relationship, so pay attention to emotions, relax, try not to be angry.

Regular physical examination is a good way to detect thyroid tumors early.

Lu Yao: Neck wound healing is not only related to the surgeon's suture technique, but also to the patient's own skin physique, that is, whether the patient is a scar. If it is a scar, even if the surgeon's wound is stitched well, the patient's neck wound will leave scars.

For those with skeletal thyroid gland, if you are very concerned about neck injury, it is recommended to choose a neck without scar endoscopic thyroid surgery. The most effective treatment for thyroid adenomas is surgical resection.

Because about 10% of adenomas can undergo malignant transformation and surgery is more complicated after recurrence, simple ablation of adenomas is not recommended. At present, it is recommended to surgically remove the affected side of the gland, and simultaneously explore the lymph nodes around the ipsilateral gland, and if necessary, do a rapid frozen pathological examination to prevent missing cancer. For high-functioning adenomas, appropriate preoperative preparation is needed to prevent postoperative thyroid crisis.

4) indications for surgical treatment: malignant thyroid tumors, ie thyroid cancer, most of them are low-grade and moderately malignant. The survival rate of patients is relatively high. The average 5-year survival rate after surgery is 83%-95%.

However, the nodules of a small number of patients are highly malignant (ie, undifferentiated cancer), which is seriously life-threatening and should be taken seriously.

Netease Health: After thyroid adenoma surgery, do you still need to take the medicine? 2, a small number of cold nodules for thyroid hypoplasia: can be used for thyroid preparations for 4 to 6 months, such as nodules, can be exempted from surgical treatment, such as nodules are not reduced, but grow rapidly, involving the surrounding tissue, should be considered For malignant cancer, strive for surgical treatment as soon as possible. Surgical treatment is often thoroughly cleaned, often with hypothyroidism after surgery, and must be replaced with thyroid hormone for life. And there is the possibility of preventing recurrence. 'The cancer cells of thyroid cancer grow slowly, and the malignancy is not very high. Another thyroid cancer is the most common papillary carcinoma. It is not easy to metastasize from the blood, mainly lymphatic metastasis. Therefore, most patients only transfer in the neck and Recurrence, easy to treat.

” Treatment of nodular goiter: retrosternal goiter; Luyao: The following conditions should be noted, the nodules may have malignant potential: In the previous physical examination for thyroid examination, surgical palpation was used.

The position of the thyroid gland is relatively hidden. Even a doctor with extensive experience often finds small thyroid nodules. Therefore, the detection rate of thyroid nodules is low.

It is not too much to worry about finding a thyroid nodule. A thyroid nodule is not the same as thyroid cancer. Thyroid nodules can be divided into benign nodules, such as nodular goiter, thyroid adenoma, etc.; and malignant nodules, which are thyroid cancer. The thyroid examination is a conventional method with B-ultrasound. Under the examination of high-resolution B-ultrasound, the benign and malignant nodules can be preliminarily judged.

Benign nodules are mostly cystic and have clear boundaries.

Malignant nodules are mostly solid nodules, the boundaries are not clear, the shape is irregular, the blood flow signal is rich, there is calcification, and the lymph nodes around the thyroid gland are also abnormal.

It is important to note that as long as the dosage is changed, it will take 6 weeks, and at least 4 weeks later, because the half-life of Youjiale is 7 days. 2, thyroid hormone inhibition diagnosis and treatment: in the short-term diagnosis and treatment once invalid, then the diagnosis and treatment of thyroid nodules should be at least half a year.

Women who are premenopausal need to suppress TSH with larger doses. If the nodule is reduced, the thyroxine can be taken down to maintain the TSH at a normal limit. 1) Thyroid hormone: The usual amount of dry thyroid preparation is 90-180mg per day, the course of treatment is generally 3-6 months. If there is recurrence after stopping the drug, the treatment can be repeated to maintain the normal range of basal metabolic rate, levothyroxine (youjiale) For young patients in the early stage, 100ug treatment per day, 150-200ug per day in the second month, serum TSH concentration can be estimated to determine the degree of thyroid inhibition. Patients with older or long-term multinodular goiter should be tested for serum high-sensitivity TSH or TRH stimulation before levothyroxine treatment to determine if there is significant functional autonomy, if the base TSH is Low or undetectable and TSH low or absent response to TRH, suggesting functional autonomy, it is not appropriate to use levothyroxine for inhibitory treatment, if the functional autonomy can be ruled out, levothyroxine treatment can be used, the starting dose is not daily. Should exceed 50ug, gradually increase the dose until the TSH value reaches the inhibition endpoint.

Nodular goiter is not as good for levothyroxine as diffuse goiter, but it also has a certain inhibitory effect on further swelling.

Li Ling graduated from Bethune Medical University in 1999 with a bachelor's degree in clinical medicine. In 2005, she went to the Department of Endocrinology of Union Hospital for further study. She is currently the deputy chief physician of the Department of Endocrinology at Beijing Electric Power Hospital.

Engaged in endocrine professional work for 12 years, is now responsible for the endocrinology business, has rich experience in endocrine and diabetes professional technology, especially good at diabetes and its various complications, diagnosis and treatment of thyroid diseases, can solve endocrine, diabetes professional Responsible for the difficult problem.

NetEase Health: How do you know if your thyroid nodules are benign or malignant? Most of the adolescent goiter can resolve on its own. For the goiter caused by iodine deficiency, iodide is rarely used now, and the appropriate amount of thyroid hormone preparation is used to suppress excessive endogenous TSH secretion, supplement the deficiency of endogenous thyroid hormone, and achieve the purpose of relieving thyroid hyperplasia. It is suitable for goiter caused by various causes, especially the pathological changes before the occurrence of colloidal goiter, can have significant effect. Taking too much iodide can cause dysfunction of the thyroid gland. It is naturally useful to be able to identify and prevent thyroid material.

A huge goiter affects life and workers; compression of the trachea, esophagus, or recurrent laryngeal nerve causes clinical symptoms; vocal dysregulation is caused by damage to the superior laryngeal nerve and the ring muscle. Regarding whether nerve damage can be recovered, it is necessary to look at the specific situation.

During the operation, if the nerve is only pulled, but it is not cut, it can be recovered in 2-3 months; if the nerve is cut, it may not be recovered.

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