The main common thyroid diseases are hyperthyroidism, hypothyroidism, hypothyroidism, thyroma, thyroiditis, thyroid cyst and hyperthyroidism complications.

Thyroid gland is an important organ of endocrine system, which is obviously different from other human systems (such as respiratory system), but it is closely related to nervous system, interacting and cooperating with each other to maintain the relative stability of internal environment. Thyroid gland is the largest endocrine gland in human endocrine system.

Most people don't know where the thyroid gland is, but most people are familiar with "big neck disease". In fact, "big neck disease" is goiter, which tells us that the thyroid gland is located in the front of the neck. More specifically, 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 can't be seen or touched in the neck. If you can touch the thyroid gland in the neck, even if you can't see it, it is considered goiter. This degree of increase is often physiological, especially in female adolescence and pregnancy, which is generally not the result of disease, but sometimes it may be pathological.

After receiving nerve, the thyroid gland synthesizes and secretes thyroid hormone, which acts on the corresponding organs of human body and exerts physiological effects.

2. Knowledge about biological thyroid gland

Iodine is one of the essential trace elements for human body. The total amount of iodine in healthy adults is 30 mg (20 ~ 50 mg), of which 70%~80% exists in the thyroid gland.

Physiological function of iodine: 1. Promoting biological oxidation of thyroxine can promote biological oxidation in the tricarboxylic acid cycle, coordinate the coupling of biological oxidation and phosphorylation, and regulate energy conversion. 2. Adjust the synthesis and decomposition of protein. When protein intake is insufficient, thyroxine can promote the synthesis of protein; When protein is ingested sufficiently, thyroxine can promote the decomposition of protein.

3. Promote the metabolism of sugar and fat. Thyroxine can accelerate the absorption and utilization of sugar, promote the decomposition and oxidation of glycogen and fat, and regulate the concentration of serum cholesterol and phospholipids. 4. Regulating 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, and interstitial fluid containing a large amount of mucin appears, resulting in mucinous edema.

5. Promoting the absorption of vitamins The utilization of thyroxine can promote the absorption and utilization of nicotinic acid, the process of transforming carotene into vitamin A and the process of synthesizing riboflavin adenine dinucleotide from riboflavin. 6. Enhance enzyme activity. Thyroxine can activate more than 65,438+000 kinds of enzymes in the body, such as cytochrome enzyme system, succinate oxidase system and alkaline phosphatase. , and play a role in substance 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 iodine intake is also harmful, and excessive iodine intake in daily diet can also cause hyperthyroidism.

Whether it is necessary to "supplement iodine" in addition to iodine tungsten lamp's normal diet, we must go through a formal physical examination and follow the doctor's advice, and we must not blindly "supplement iodine". Iodine tincture, compound iodine solution, iodine throat tablets, iodine glycerin and other iodine preparations are widely used in medical treatment. Iodine tincture is a common disinfectant in the family.

Iodine poisoning in children is mostly caused by mistake or overdose. Someone once mistook tincture of iodine for cough syrup and gave it to children. A few sick children are allergic to iodine, and the therapeutic dose also has a serious reaction.

Children can die if they take 3~4mL of iodine tincture by mistake. Children take high concentration iodine by mistake, which has a strong corrosive effect on gastrointestinal tract. After absorption, it reacts with protein in tissues, causing systemic poisoning.

After children take it by mistake, there is iodine smell in the mouth, burning pain in the mouth, esophagus and heartburn, edema and brown in the mouth and throat, which can cause scars and strictures in the esophagus and stomach after recovery. The sick children also have dizziness, headache, thirst, nausea, vomiting, diarrhea, fever and other symptoms, and blood can be carried in the feces.

Children with severe poisoning have pallor, shortness of breath, cyanosis, limb tremor, confusion, disorientation, sensory disorder, speech disorder, even coma and shock, or toxic nephritis, hematuria and proteinuria, which can cause acute renal failure in severe cases. Allergic children can cause anaphylactic shock.

Due to the strong corrosiveness of iodine preparation, it can cause laryngeal edema, even suffocation, and even mental symptoms and coma in severe cases. If it cannot be rescued in time, it will cause severe hypoxia in the brain and damage the central nervous system, thus affecting the child's intellectual development. Therefore, iodine preparations should be kept in a safe place, and children should not be allowed to get them casually, especially iodine throat tablets. In addition, iodine tincture should be placed separately from cough syrup, and the name of biological iodine should be marked to prevent iodine tincture from being mistaken for cough syrup for children to prevent poisoning.

If you take a lot of iodine preparations, you should immediately send them to the hospital for emergency treatment, which can alleviate the symptoms. Children poisoned by oral iodine preparation should be given plenty of starchy food immediately, such as rice soup, lotus root starch, noodles, porridge, bread, biscuits, etc. Then induce vomiting, and then gastric lavage with 1%~ 10% starch solution or rice soup, or gastric lavage with 1% sodium thiosulfate solution until the washed liquid is blue.

Catharsis after gastric lavage, oral rice soup, raw egg white, milk, vegetable oil, etc. To protect the gastric mucosa. Severe laryngeal edema should be given oxygen, and when suffocation occurs, the trachea should be cut immediately and artificial respiration should be carried out.

At the same time, we should pay attention to symptomatic treatment. The national standard requires that the iodine content of milk rice flour per 100g is 30-150μ g. ..

Excessive intake of iodine can lead to goiter. The safe upper limit of children's iodine intake announced by the Nutrition Society of China is 800 micrograms per day, but the Institute recommended the daily iodine intake in 2000, which is 50 micrograms for infants, 90~ 120 micrograms for children and 150 micrograms for adults.

The latest recommended daily iodine supply of the World Health Organization in 20001is as follows: 90 micrograms per day for preschool children aged 0-59 months; 6- 12 school-age children; 0/20 micrograms per day for adults aged 0/2 years; 0/50 micrograms per day for pregnant women and lactating women; and 200 micrograms per day. The state stipulates that 20 micrograms of iodine should be added to each gram of salt. Universal consumption of iodized salt can prevent iodine deficiency disorders, which is a simple, safe, effective and economical iodine supplement measure.

Iodized salt is a mixture of potassium iodate and salt in a certain proportion. Because iodine is a lively and volatile element, iodized salt can lose 20%~25% during storage and 15%~50% due to improper cooking methods, so it is necessary to use iodized salt correctly.

1, can't be placed in high temperature and sunlight. 2. The storage container should be tightly covered. 3. Quick cover. 4. Salt should be added when the dish is out of the pot to prevent high-temperature volatilization from reducing iodine content and reducing the effect. Secondly, kelp, laver, Chinese cabbage, marine fish, shrimp, crab and shellfish are also rich in iodine, so you can eat more.

Third, infants eat iodized milk powder. Considering that the diet of infants is mainly dairy products, China also stipulates that iodine must be added to infant milk powder.

Edit this paragraph of fetal iodine deficiency 1. Abortion, stillbirth, congenital malformation, perinatal mortality and infant mortality; 2. Endemic cretinism. Neuromotor function development lags behind 4. Fetal hypothyroidism Neonatal hypothyroidism, childhood and adolescent neonatal goiter, adolescent hypothyroidism, subclinical cretinism, mental retardation, limb retardation, simple deaf-mute adult goiter and its complications, hypothyroidism, mental retardation, iodine-induced hyperthyroidism, etc. The recommended iodine intake for adults with physiological needs is150 ug/d; The maximum tolerable intake is1000 ug/d/d.

Excessive performance is long-term high iodine intake.

3. What are the basic common sense of thyroid nodules?

When the thyroid gland has a mass of unknown nature, we call it a "thyroid nodule".

Many fans talked to me about "thyroid nodules" and said that at present, the company hopes that half of people have "nodules" in their thyroid. What's going on here? Don't worry, today I will discuss with you the hot issues of 10 that patients encounter daily. 1. What is the most important content in the thyroid ultrasound examination report? Ultrasound reports generally include general items, descriptions and diagnostic opinions, with diagnostic opinions being the most important.

2. What is thyroid nodule? How big is the nodule that needs attention? When the thyroid gland has a mass that can be distinguished from the surrounding tissues, it can be called "thyroid nodule", which can be neoplastic or non-neoplastic; If it is a tumor, it may be malignant or benign. The "occupying space" in physical examination refers to those nodules that squeeze the tissues around the thyroid gland.

Although thyroid nodules are mostly benign, thyroid cancer only accounts for about 5- 15%. If the early nodules are not treated, they will further evolve into thyroid cancer. Therefore, after the diagnosis of benign nodules, most patients should not be careless, so we must find and treat them early.

3. Is the "calcification" in the ultrasound report cancer? ? Calcification of thyroid nodules is considered to be the deposition of calcium in nodules, which has different manifestations: some are micro-calcification with tiny spots (≤ 1mm); Some have large (> 1mm) coarse calcification; Others can be annular calcification. ? Calcification of thyroid nodules is not necessarily cancer, and the malignant probability of each calcification type is different. Generally speaking, its malignant degree may be microcalcification >: coarse calcification > annular calcification.

But in order to avoid canceration and calcification, we must go to a regular hospital for professional treatment. IV. What is uneven thyroid echo? Ultrasonic imaging is to scan the human body with ultrasonic sound beam, and obtain the image of internal organs by receiving and processing the reflected signals.

The echo represents the intensity of the reflected signal, and the normal thyroid echo is uniform. When thyroid lesions occur, hypoechoic, isoechoic and hyperechoic manifestations may appear, which 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 cavity of follicles is filled with colloid.

Any factors affecting the synthesis and transport of thyroid follicular colloid may lead to thyroid colloid retention, including genetic and environmental factors. Glial retention is common in benign nodules. Typical ultrasonic manifestations are "comet tail" sign after strong echo in nodules, which is sometimes atypical and can be confused with calcification in nodules.

6. What is a cystic-solid nodule? Thyroid nodules can be cystic or solid. When there are cystic-solid components in a nodule, we call it cystic-solid nodule. Benign nodules are the most common cystic-solid nodules.

7. What are the ultrasonic features of typical malignant nodules? Typical malignant nodules are usually solid nodules with hypoechoic or extremely hypoechoic ultrasound, which may be accompanied by uneven edges, calcification (especially microcalcification) and vertical growth (especially in

When ultrasound shows moderate to high suspicious manifestations, such as: ① hypoechoic nodules above1cm; ② Nodules with the above malignant ultrasonic signs (low or extremely low echo, solid, uneven edge, calcification, vertical growth); ③ When accompanied by suspicious cervical lymph node metastasis; The following tests need to be done: such as thyroid function test (functional nodules need to be evaluated by thyroid radionuclide imaging); Fine needle aspiration cytology basically clarified the benign and malignant nodules; When the nodule is large, some patients need to do CT, PET-CT and other examinations to clarify the relationship between it and adjacent tissues (such as blood vessels and nerves). 9. What is ultrasound-guided thyroid puncture? Ultrasound-guided thyroid puncture is a technique of aspiration of cells and other components in thyroid lesions by fine needle puncture under ultrasound guidance.

The puncture needle is thin, safe and economical, which is the most reliable diagnostic method for differentiating benign from malignant thyroid nodules at present. 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 kind of concentrated destruction of tissues in the focus area with ablation equipment under the supervision of real-time ultrasound, and its histopathological manifestations are coagulation necrosis.

4. Common sense of goiter

Disease analysis: adenoidal hypertrophy is divided into three degrees: the degree I can't see but can touch; The swelling can be seen and felt, but the degree in sternocleidomastoid muscle is degree ⅱ; The degree beyond the outer edge of sternocleidomastoid muscle is ⅲ degree. The common diseases that cause goiter are as follows: 1. Hyperthyroidism and goiter are soft in texture, they may tremble when palpated, and they may hear "buzzing"-like vascular murmur, which is the result of increased blood vessels, thickening and increased blood flow. 2. Simple goiter is very prominent and can be diffuse or nodular, with no signs of hyperthyroidism. 3. Thyroid cancer palpation mass can be nodular, irregular and hard. Because of its slow development and sometimes small size, it is easily confused with thyroid adenoma and anterior cervical lymph node enlargement. 4. Chronic lymphocytic thyroiditis (Hashimoto's thyroiditis) is diffuse or nodular, which is easily confused with thyroid cancer. Because swollen inflammatory glands can push the common carotid artery backward, the common carotid artery pulse can be felt at the posterior edge of the gland, while thyroid cancer often wraps the common carotid artery in the cancer tissue, and the common carotid artery pulse can not be felt during palpation, which can be used for differentiation. 5. Parathyroid adenoma The parathyroid gland is located behind the thyroid. When adenoma occurs, the thyroid gland can protrude and move with swallowing during examination. It needs to be differentiated according to the clinical manifestations of hyperparathyroidism.

5. What are the basic common sense of thyroid nodules?

When the thyroid gland has a mass of unknown nature, we call it a "thyroid nodule". Many fans talked to me about "thyroid nodules" and said that at present, the company hopes that half of people have "nodules" in their thyroid. What's going on here? Don't worry, today I will discuss with you the hot issues of 10 that patients encounter daily.

1. What is the most important content in the thyroid ultrasound examination report?

Ultrasound reports generally include general items, descriptions and diagnostic opinions, with diagnostic opinions being the most important.

2. What is thyroid nodule? How big is the nodule that needs attention?

When the thyroid gland has a mass that can be distinguished from the surrounding tissues, it can be called "thyroid nodule", which can be neoplastic or non-neoplastic; If it is a tumor, it may be malignant or benign. The "occupying space" in physical examination refers to those nodules that squeeze the tissues around the thyroid gland.

Although thyroid nodules are mostly benign, thyroid cancer only accounts for about 5- 15%. If the early nodules are not treated, they will further evolve into thyroid cancer. Therefore, after the diagnosis of benign nodules, most patients should not be careless, so we must find and treat them early.

3. Is the "calcification" in the ultrasound report cancer?

Calcification of thyroid nodules is considered to be the deposition of calcium in nodules, which has different manifestations: some are micro-calcification with tiny spots (≤ 1mm); Some have large (> 1mm) coarse calcification; Others can be annular calcification.

Calcification of thyroid nodules is not necessarily cancer, and the malignant probability of each calcification type is different. Generally speaking, its malignancy may be microcalcification. Coarse calcification >; Annular calcification However, in order to avoid canceration and calcification, we must go to a regular hospital for professional treatment.

IV. What is uneven thyroid echo?

Ultrasonic imaging is to scan the human body with ultrasonic sound beam, and obtain the image of internal organs by receiving and processing the reflected signals. The echo represents the intensity of the reflected signal, and the normal thyroid echo is uniform. When thyroid lesions occur, hypoechoic, isoechoic and hyperechoic manifestations may appear, which 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 cavity of follicles is filled with colloid. Any factors affecting the synthesis and transport of thyroid follicular colloid may lead to thyroid colloid retention, including genetic and environmental factors.

Glial retention is common in benign nodules. Typical ultrasonic manifestations are "comet tail" sign after strong echo in nodules, which is sometimes atypical and can be confused with calcification in nodules.

6. What is a cystic-solid nodule?

Thyroid nodules can be cystic or solid. When there are cystic-solid components in a nodule, we call it cystic-solid nodule. Benign nodules are the most common cystic-solid nodules.

7. What are the ultrasonic features of typical malignant nodules?

Typical malignant nodules are usually solid nodules with hypoechoic or extremely hypoechoic ultrasound, which may be accompanied by uneven edges, calcification (especially microcalcification) and vertical growth (especially in

8. How to diagnose thyroid tumor? Ultrasound Report: When should further examination be done?

Generally speaking, thyroid nodules can be roughly inferred from ultrasonic features, and diagnosis requires fine needle aspiration cytology, coarse needle aspiration or surgical and pathological results. When ultrasound shows moderate to highly suspicious performance, such as:

① hypoechoic nodules above1cm;

② Nodules with the above malignant ultrasonic signs (low or extremely low echo, solid, uneven edge, calcification, vertical growth);

③ When accompanied by suspicious cervical lymph node metastasis;

The following checks are required:

For example, thyroid function measurement (functional nodules require additional thyroid radionuclide imaging); Fine needle aspiration cytology basically clarified the benign and malignant nodules; When the nodule is large, some patients need to do CT, PET-CT and other examinations to clarify the relationship between it and adjacent tissues (such as blood vessels and nerves).

9. What is ultrasound-guided thyroid puncture?

Ultrasound-guided thyroid puncture is a technique of aspiration of cells and other components in thyroid lesions by fine needle puncture under ultrasound guidance. The puncture needle is thin, safe and economical, which is the most reliable diagnostic method for differentiating benign from malignant thyroid nodules at present. 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 kind of concentrated destruction of tissues in the focus area with ablation equipment under the supervision of real-time ultrasound, and its histopathological manifestations are coagulation necrosis.