1. Introduction to the basic knowledge of thyroid diseases
The main common thyroid diseases include hyperthyroidism, referred to as hyperthyroidism, hypothyroidism, referred to as hypothyroidism or hypothyroidism, thyroid tumors, and thyroid tumors. inflammation, thyroid cysts, complications of hyperthyroidism, etc.
The thyroid is an important organ of the endocrine system. It is obviously different from other systems of the human body (such as the respiratory system, etc.), but it is closely connected with the nervous system, interacts with each other, and maintains the same function. The internal environment of the body is relatively stable. The thyroid gland is the largest endocrine gland in the human endocrine system.
Most people don’t know where the thyroid is located, but “big neck disease” is familiar to most people. In fact, “big neck disease” is thyroid enlargement, which tells us that the thyroid gland is located in the neck. front. To be more specific, the thyroid gland is located about 2-3 cm below the "Adam's apple" and can move up and down with the Adam's apple when swallowing.
Under normal circumstances, because the thyroid gland is very small and thin, it cannot be seen or touched in the neck. If the thyroid gland can be felt in the neck, even if it cannot be seen, it is considered to be enlarged. This degree of enlargement is often physiological, especially during female puberty and pregnancy, and is generally not a disease. results, but sometimes can also be pathological.
After being stimulated by nerve cells, the thyroid gland synthesizes and secretes thyroid hormones, which act on corresponding organs of the human body to exert physiological effects.
2. Knowledge about biological thyroid
Iodine is one of the essential trace elements for the human body. The total amount of iodine in a healthy adult is 30mg (20~50mg), of which 70~ 80 is present in the thyroid gland.
Physiological functions of iodine: 1. Promote biological oxidation. Thyroxine can promote biological oxidation in the tricarboxylic acid cycle, coordinate the coupling of biological oxidation and phosphorylation, and regulate energy conversion. 2. Regulate protein synthesis and decomposition. When protein intake is insufficient, thyroxine can promote protein synthesis; when protein intake is sufficient, thyroxine can promote protein decomposition.
3. Promote sugar and fat metabolism. Thyroxine can accelerate the absorption and utilization of sugar, promote the decomposition and oxidation of glycogen and fat, and regulate serum cholesterol and phospholipid concentrations. 4. Regulate water and salt metabolism. Thyroxine can promote water and salt in tissues to enter the blood and be excreted from the kidneys. When it is deficient, it can cause water and salt retention in tissues. Interstitial fluid containing a large amount of mucin will appear in the interstitial space, resulting in myxedema.
5. Promote the absorption and utilization of vitamins. Thyroxine can promote the absorption and utilization of niacin, the process of converting carotene into vitamin A and the synthesis of riboflavin into riboflavin adenine dinucleotide. 6. Enhance the activity of enzymes. Thyroxine can activate more than 100 enzymes in the body, such as cytochrome enzymes, succinate oxidase, alkaline phosphatase, etc., which play a role in material metabolism.
7. Promote growth and development Thyroxine promotes bone development and protein synthesis, and maintains the normal structure of the central nervous system. It is worth noting that excessive intake of iodine by the human body is also harmful. Excessive iodine in the daily diet can also cause "hyperthyroidism".
Whether you need to "supplement iodine" in addition to the normal iodine tungsten lamp meal, you must undergo a formal physical examination and listen to the doctor's advice. You must not blindly "supplement iodine". Iodine-containing preparations such as iodine tincture, compound iodine solution, iodine throat lozenges, iodine glycerin, etc. are widely used drugs in medical treatment. Iodine tincture is a common disinfectant drug in the home.
Iodine poisoning in children is often caused by mistaken intake or excessive dosage. Some people have mistakenly taken iodine tincture as cough syrup and given it to children. A small number of sick children are allergic to iodine, and severe reactions occur at therapeutic doses.
Children who accidentally take 3~4mL of iodine tincture can cause death. Children who mistakenly take high-concentration iodine have strong irritating and corrosive effects on the gastrointestinal tract. After absorption, it reacts with proteins in tissues and causes systemic poisoning symptoms.
After children accidentally take it, there is a smell of iodine in the mouth, burning and pain in the mouth, esophagus and stomach, and edema in the mouth and throat, which is brown. After recovery, it can cause scars and scars in the esophagus and stomach. narrow.
Sick children also have symptoms such as dizziness, headache, thirst, nausea, vomiting, diarrhea, fever, and blood in their feces.
Children with severe poisoning may have pale complexion, shortness of breath, cyanosis, tremors of limbs, confusion, loss of orientation, sensory impairment, disorganized speech, or even coma, shock, or toxic nephritis, hematuria, and proteinuria. urine, severe cases may cause acute renal failure. Sick children with allergies can cause anaphylactic shock.
Due to the strong corrosiveness of iodine preparations, it can cause laryngeal edema and even suffocation. In severe cases, mental symptoms and coma may occur. If timely rescue is not possible, it can cause severe hypoxia in the brain and damage the central nervous system, thus Affect the intellectual development of children. Therefore, we need to place iodine preparations in a safe place and prevent children from getting them casually. In particular, children should be educated not to take too many iodine lozenges. In addition, iodine tincture should be placed separately from cough syrup, and the name of biological iodine should be marked to prevent the iodine tincture from being mistakenly taken. Make cough syrup for children to prevent poisoning.
If you have taken a large amount of iodine preparations, you should be sent to the hospital immediately for rescue treatment, which can alleviate symptoms. Children who are poisoned by oral iodine preparations should immediately take orally a large amount of starchy food, such as rice soup, lotus root starch, noodles, porridge, bread, biscuits, etc., then induce vomiting, and then use 1 to 10% of starch liquid or rice water to lavage the stomach. You can also use 1% of sulfur Gastric lavage with sodium sulfate solution until the lavage fluid is no longer blue.
After gastric lavage, take catharsis, orally take rice soup, raw egg white, milk, vegetable oil, etc. to protect the gastric mucosa. For severe laryngeal edema, oxygen should be given. If suffocation occurs, the trachea should be cut immediately and artificial respiration should be performed.
At the same time, attention should also be paid to symptomatic treatment. The national standard requires 30 to 150 μg of iodine content per 100 grams of milk and rice noodles.
Excessive consumption of iodine can cause goiter. The safe upper limit of iodine intake for children announced by the Chinese Nutrition Society is 800 micrograms per day. In 2000, the society proposed a recommended daily dietary iodine intake of 50 micrograms for infants and 90 to 120 micrograms for children. 150 micrograms for adults.
The latest recommended daily iodine supply from the World Health Organization in 2001 is as follows: 90 micrograms/day for preschool children 0-59 months old, 120 micrograms/day for school-age children 6-12 years old, and 120 micrograms/day for adults over 12 years old. 150 micrograms/day for pregnant women and lactating women 200 micrograms/day Edit this paragraph How to supplement iodine in daily life 1. Eat iodized salt. The state stipulates that 20 micrograms of iodine should be added to every gram of table salt. The entire population can prevent iodine deficiency diseases by eating iodized salt, a simple, safe, effective and economical iodine supplementation measure.
Iodized salt is made by mixing potassium iodate with ordinary table salt in a certain proportion. Since iodine is a relatively active and easily volatile element, iodine-containing salt can lose 20 to 25% during storage. In addition, improper cooking methods will cause another 15 to 50% loss, so iodized salt needs to be used correctly.
1. Do not place it in a place where the temperature is high or exposed to sunlight. 2. The storage container must be tightly covered. 3. Quickly remove the lid. 4. Salt should be added when the dish is about to be taken out of the pot to prevent High temperature volatilization reduces the iodine content and reduces the effect. 2. Kelp, seaweed, sea cabbage, marine fish, shrimp, crab, and shellfish are also rich in iodine, so you can eat more.
3. Infants and young children should consume iodized milk powder. Considering that the diet of infants and young children is mainly dairy products, our country’s government also stipulates that iodine must be added to infant milk powder.
Edit this section Iodine deficiency in the fetal period 1. Miscarriage, stillbirth, congenital malformations, increased perinatal mortality, increased mortality in infants and young children; 2. Endemic cretinism 3. Neuromotor function Developmental retardation 4. Fetal hypothyroidism, neonatal hypothyroidism, neonatal goiter, childhood and adolescent goiter, adolescent hypothyroidism, subclinical cretinism, intellectual development disorder, physical development disorder, simple deafness Mute, adult goiter and its complications, hypothyroidism, intellectual disability, iodine-induced hyperthyroidism require people with iodine deficiency and suffer from thyroid hypertrophy, hypothyroidism and other diseases.
Physiological needs: The recommended intake of iodine for adults is 150ug/d; the maximum tolerated intake is 1000ug/d.
Excessive manifestations of high iodine intake for a long time.
3. What are the basic common sense about thyroid nodules?
When a mass of unknown nature appears in the thyroid gland, we call it "thyroid nodule".
Many fans asked me to talk about "thyroid nodules". They said that the company's one-stop inspection now makes half of the people have "nodules" on their thyroids. What is going on? Don’t worry, today we will share with you 10 hot issues that patients encounter every day. 1. What is the most important content in the thyroid ultrasound report? Ultrasound reports generally include general items, descriptions and diagnostic opinions. Generally speaking, the diagnostic opinion is the most important.
2. What is a thyroid nodule? How big a nodule needs attention? When a mass appears in the thyroid gland that is distinguishable from the surrounding tissue, it is called a "thyroid nodule". The nodule can be either neoplastic or non-neoplastic; if it is a tumor, it may be malignant or benign. of. The term "mass-occupying" in physical examination refers specifically to nodules that squeeze the surrounding tissue of the thyroid gland.
Although most thyroid nodules are benign, thyroid cancer only accounts for about 5-15% of cases. If early-stage nodules are not treated, they will further develop into thyroid cancer. Therefore, after the vast majority of patients are diagnosed with benign nodules, they must not be careless and must detect and treat them early.
3. Is the "calcification" in the ultrasound report cancer? ? Thyroid nodule calcification is considered to be the accumulation of calcium in the nodule, with different manifestations: some are small dot-like (≤1mm) microcalcifications; some are larger (gt; 1mm) coarse calcifications; some are Annular calcifications may occur. ? Calcification of thyroid nodules does not necessarily mean cancer. Each type of calcification has a different probability of malignancy. Generally speaking, the malignancy may be microcalcification gt; coarse calcification gt; annular calcification.
However, in order to avoid cancer, when calcification occurs, you must go to a regular hospital for professional treatment. 4..What is thyroid anhomogeneous echogenicity? Ultrasound imaging uses ultrasonic sound beams to scan the human body and obtains images of internal organs by receiving and processing reflected signals.
Echo represents the strength of the reflected signal. Normal thyroid echo is uniform. When the thyroid gland is diseased, hypoechoic, isoechoic, and hyperechoic mixed and uneven symptoms may appear. This can be seen in Hashimoto's thyroid disease. inflammation, hyperthyroidism and other diseases. 5. What is colloid retention? The thyroid gland is filled with follicles, and the follicular cavity is filled with colloid.
Any factors that affect the synthesis and transport of thyroid follicular colloid may lead to thyroid colloid retention, including genetic and environmental factors. Colloidal retention is common in benign nodules. The typical ultrasound manifestation is a strong echo in the nodule followed by a "comet tail" sign. Sometimes the performance is atypical and can be confused with calcification in the nodule.
6. What is a cystic-solid nodule? Thyroid nodules can be cystic or solid. When a nodule contains both cystic and solid components, it is called a cystic-solid nodule. Most of the cystic-solid nodules are benign.
7. What are the ultrasound characteristics of typical malignant nodules? Typical malignant nodules usually appear as low or extremely hypoechoic solid nodules on ultrasound, which may be accompanied by rough edges, calcifications (especially microcalcifications), and vertical growth (especially in nodules less than 1 cm). Suspicious features on ultrasound. 8. How to diagnose thyroid tumors? Under what circumstances should further examination be performed following an ultrasound report? Generally speaking, thyroid nodules can be roughly inferred based on ultrasound characteristics, and the diagnosis requires fine-needle aspiration cytology, coarse-needle aspiration, or surgical pathology results.
When ultrasound shows moderate to highly suspicious findings, such as: ① Hypoechoic nodules above 1cm; ② The above-mentioned malignant ultrasound signs appear (low or extremely hypoechoic, solid, and rough edges). Nodules (integrated, calcified, vertical growth); ③ When accompanied by suspected metastatic cervical lymph nodes; the following examinations are required: such as thyroid function test (additional thyroid radionuclide imaging evaluation is required for functional nodules); Fine-needle aspiration cytological examination can basically determine whether the nodule is benign or malignant; when the nodule is large, some patients need to undergo CT, PET-CT and other examinations to clarify its relationship with adjacent tissues (such as blood vessels, nerves, etc.). 9. What is ultrasound-guided thyroid puncture? Ultrasound-guided thyroid puncture is a technique that uses fine needle puncture to aspirate cells and other components from the thyroid lesion under ultrasound guidance.
The puncture needle is thin, safe and economical. It is currently the most reliable diagnostic method for distinguishing benign and malignant thyroid nodules. The reported complications such as pain and local bleeding are low in incidence and mild in severity. 10.What is thyroid nodule ablation? Ultrasound-guided ablation of thyroid nodules is a method of using ablation equipment to perform focused destruction of tissue in the lesion area under real-time ultrasound monitoring, which manifests as coagulative necrosis on histopathology.
4. General knowledge about goiter
Condition analysis: Goiter can be divided into three degrees: if the enlargement cannot be seen but can be touched, it is grade I; if it can be seen, If the swelling is palpable but within the sternocleidomastoid muscle, it is grade II; if it exceeds the outer edge of the sternocleidomastoid muscle, it is grade III. Common diseases that cause goiter are as follows: 1. Hyperthyroidism. The swollen thyroid gland is soft in texture and may tremble when palpated. You may hear a "humming"-like vascular murmur, which is an increase in blood vessels, thickening, and increased blood flow. result. 2. Simple goiter: Gland enlargement is very prominent and can be diffuse or nodular, without signs of hyperthyroidism. 3. Thyroid cancer: The mass may feel nodular, irregular, and hard when palpated. Because it develops slowly and sometimes is not large in size, it is easily confused with thyroid adenoma and anterior cervical lymph node enlargement. 4. Chronic lymphatic thyroiditis (Hashimoto's thyroiditis) shows diffuse or nodular swelling and is easily confused with thyroid cancer. Because enlarged inflammatory glands can push the common carotid artery backward, the pulse of the common carotid artery can be felt at the posterior edge of the gland. However, thyroid cancer often surrounds the common carotid artery within the cancer tissue. The common carotid artery pulse cannot be felt, which can be used for identification. 5. Parathyroid adenoma Parathyroid gland is located behind the thyroid gland. When adenoma occurs, the thyroid gland can protrude and move with swallowing during examination. It needs to be differentiated based on the clinical manifestations of hyperparathyroidism.
5. What are the basic common sense about thyroid nodules?
When a mass of unknown nature appears in the thyroid gland, we call it "thyroid nodule". Many fans asked me to talk about "thyroid nodules". They said that half of the company's one-stop inspections now have "nodules" on their thyroids. What is going on? Don’t worry, today I will share with you 10 hot issues that patients encounter every day.
1. What is the most important content in the thyroid ultrasound report?
Ultrasound reports generally include general items, descriptions and diagnostic opinions. Generally speaking, the diagnostic opinion is the most important.
2. What is a thyroid nodule? How big of a nodule is a cause for concern?
When there is a mass in the thyroid gland that is distinguishable from the surrounding tissue, it can be called a "thyroid nodule". The nodule can be either neoplastic or non-tumor; if it is a tumor, it may It may be malignant or benign. The term "mass-occupying" in physical examination refers specifically to nodules that squeeze the tissue surrounding the thyroid gland.
Although most thyroid nodules are benign, thyroid cancer only accounts for about 5-15% of cases. If early-stage nodules are not treated, they will further develop into thyroid cancer. Therefore, after the vast majority of patients are diagnosed with benign nodules, they must not be careless and must detect and treat them early.
3. Is the "calcification" in the ultrasound report cancer?
Calcification of thyroid nodules is considered to be the accumulation of calcium in the nodules, with different manifestations: some are tiny dot-like (≤1mm) microcalcifications; some are larger (gt; 1mm ) coarse calcification; some may show ring-shaped annular calcification.
Calcification of thyroid nodules does not necessarily mean cancer. Each type of calcification has a different probability of malignancy. Generally speaking, the malignancy may be microcalcification; coarse calcification; annular calcification. However, in order to avoid cancer, when calcification occurs, you must go to a regular hospital for professional treatment.
4..What is thyroid anchogeneity?
Ultrasound imaging uses ultrasonic sound beams to scan the human body and obtains images of internal organs by receiving and processing reflected signals. Echo represents the strength of the reflected signal. A normal thyroid has a uniform echo. When the thyroid gland is diseased, there may be mixed and uneven symptoms of hypoechoic, isoechoic, and hyperechoic. This can be seen in Hashimoto's thyroiditis, hyperthyroidism and other diseases.
5. What is colloid retention?
The thyroid gland is filled with follicles, and the follicular cavity is filled with colloid. Any factors that affect the synthesis and transport of thyroid follicular colloid may lead to thyroid colloid retention, including genetic and environmental factors.
Colloidal retention is common in benign nodules. The typical ultrasound manifestation is a strong echo in the nodule followed by a "comet tail" sign. Sometimes the performance is atypical and can be confused with calcification in the nodule.
6. What is a cystic-solid nodule?
Thyroid nodules can be cystic or solid. When a nodule contains both cystic and solid components, it is called a cystic-solid nodule. Most of the cystic-solid nodules are benign.
7. What are the ultrasound characteristics of typical malignant nodules?
Typical malignant nodules usually appear as low or extremely hypoechoic solid nodules on ultrasound, which may be accompanied by rough edges, calcifications (especially microcalcifications), and vertical growth (especially in lt; 1cm nodule) and other suspicious features on ultrasound.
8. How to diagnose thyroid tumors? Under what circumstances should further examination be performed following an ultrasound report?
Generally speaking, thyroid nodules can be roughly inferred based on ultrasound characteristics, and the diagnosis requires fine-needle aspiration cytology, coarse-needle aspiration or surgical pathology results. When ultrasound shows moderate to highly suspicious findings, such as:
① Hypoechoic nodules above 1cm;
② The above-mentioned malignant ultrasound signs (low or very low) Echo, solid, rough edges, calcification, vertical growth) nodules;
③When accompanied by suspected metastatic cervical lymph nodes;
The following examinations are required:
For example, thyroid function test (additional thyroid radionuclide imaging evaluation is required for functional nodules); fine-needle aspiration cytology examination can basically determine whether the nodules are benign or malignant; when the nodules are large, some patients CT, PET-CT and other examinations are also required to clarify its relationship with adjacent tissues (such as blood vessels, nerves, etc.).
9. What is ultrasound-guided thyroid puncture?
Ultrasound-guided thyroid puncture is a technique that uses fine needle puncture to aspirate cells and other components from the thyroid lesion under ultrasound guidance. The puncture needle is thin, safe and economical. It is currently the most reliable diagnostic method for identifying benign and malignant thyroid nodules. The reported complications such as pain and local bleeding are low in incidence and mild in severity.
10. What is thyroid nodule ablation?
Ultrasound-guided ablation of thyroid nodules is a type of focused destruction of tissue in the lesion area using ablation equipment under real-time ultrasound monitoring, which manifests as coagulative necrosis on histopathology.