1.How to detect thyroid disease early?
A: Thyroid diseases are broadly divided into two categories: one is symptomatic, such as hyperthyroidism, commonly known as hyperthyroidism; hypothyroidism, commonly known as hypothyroidism; this type of disease can produce symptoms such as panic, irritability, excessive sweating, hand trembling or slow heart rate, weakness, coldness, swelling, etc. Patients can be detected early through their own symptoms; the other is asymptomatic, such as nodular goiter, thyroid cancer, thyroid adenoma, etc. Thyroid adenoma, etc. These diseases do not have any symptoms in the early stage and are basically detected during physical examinations, so regular ultrasound examination of the thyroid gland is essential.
2.Can I have my thyroid checked anywhere?
A: Checking thyroid function, that is, taking blood to check thyroid series (T3, T4, TSH) can be done in many hospitals;
The ultrasound of the thyroid gland can vary greatly due to the level of ultrasound doctors. Therefore, it is highly recommended to go to a large tertiary hospital for ultrasound examination, as an experienced ultrasound doctor can significantly improve the ultrasound diagnosis rate. It is also recommended to have thyroid ultrasound at least in two or more hospitals to reduce the rate of misdiagnosis.
3.What kind of thyroid nodules require surgery?
A: Surgery is recommended for the following five conditions
A large thyroid nodule with a single nodule larger than 75px in diameter;
If the thyroid nodule is not treated in time, later surgery may involve open-heart surgery, which is risky;
Thyroid nodules are accompanied by symptoms of hyperthyroidism, i.e. irritability, irritability, fear of heat, excessive sweating, insomnia, hand tremors, excessive eating, and weight loss;
Thyroid nodules can cause compression symptoms such as hoarseness due to nerve compression, dyspnea or wheezing due to tracheal compression, and swallowing disorder due to esophageal compression;
Thyroid ultrasound indicates the possibility of thyroid cancer;
4.What are the cosmetic and minimally invasive methods of thyroid surgery?
A: There are three types of thyroid surgery: conventional open surgery, lumpectomy and minimally invasive radiofrequency ablation treatment.
Conventional open surgery is currently the most commonly chosen treatment method, with clear exposure of the surgical field, clear anatomical structure, little bleeding during surgery, and fast recovery of the patient after surgery. Although there is an incision on the neck, all of them are currently cosmetically sutured, and the scar is almost invisible after surgery. This surgery is the safest and, in a sense, minimally invasive. (Minimally invasive does not only mean a small incision, but more importantly, less damage to the patient and faster recovery for the patient to be called minimally invasive);
This is a good choice for patients who love beauty, but it is relatively invasive and not suitable for some relatively complex thyroid diseases, so it should be called cosmetic surgery;
Radiofrequency ablation, which is the use of radiofrequency ablation needles through the skin of the neck to tie to the thyroid nodules, which will be burned and dissolved, and then gradually absorbed. No abnormalities can be seen on the neck after the procedure. However, at present, radiofrequency ablation treatment is not suitable for patients with thyroid cancer and is more expensive. This technique is most suitable for the treatment of benign thyroid nodules with small number and small diameter when the patient’s financial status allows.
5. What are the manifestations of patients with hyperthyroidism?
A: Irritability, irritability, fear of heat, excessive sweating, insomnia, tremors, hyperphagia, lethargy, palpitations, rapid pulse, increased pulse pressure, menstrual disorders, etc.
6.Is elevated T3 and T4 in thyroid function test hyperthyroidism?
A: Not necessarily. A significant number of patients with thyroiditis will have elevated T3 and T4 in the early stages. Therefore, further ECT of the thyroid gland is required to identify hyperthyroidism or hypothyroidism. Because the treatment for hyperthyroidism and hypothyroidism are different.
7. What are the treatments for hyperthyroidism and is surgery necessary?
A: There are three types of hyperthyroidism: primary hyperthyroidism, secondary hyperthyroidism, and high-functioning adenoma. The latter two require surgery. Primary hyperthyroidism is usually treated with oral medication and iodine 131.
8.What is the effect of thyroid cancer treatment? Will it kill people?
A: In most cases of thyroid cancer, surgical treatment is very effective and patients can have no recurrence for a long time or even for a lifetime. However, for a few highly invasive thyroid cancers, it is still life-threatening, which can only be determined by relevant examination in hospital, so early treatment is highly recommended.
9.Do I need to pay attention to anything before thyroid surgery?
A: The main thing is to practice the posture, that is, lying flat on the bed with a pillow at the shoulder and the head in a backward position. Because the surgery is this posture, preoperative adaptation exercises, can greatly reduce the postoperative headache, dizziness, nausea, vomiting and other symptoms. Then there is to quit smoking and drinking before surgery, treat cough, no cold and fever and other symptoms of upper respiratory tract infection, women avoid menstruation, oral aspirin should stop for more than a week, patients with diabetes, hypertension, heart disease, cerebral infarction and other diseases can be operated under effective control.
10.When to remove the drainage tube and remove the stitches after thyroid surgery?
A: Postoperative medication change: normally 2-3 days postoperative medication change, whether the drainage tube is removed depends on the drainage flow, usually the drainage tube can be removed at the same time as the medication change; the sutures of the neck incision are all cosmetic sutures, in order to reduce the postoperative skin irritation of the incision by the intracutaneous sutures, we use non-absorbable sutures to close the incision, 7-10 days postoperative sutures will be withdrawn, the whole process is fast, safe, without any pain.
11.What are the symptoms and solutions for thyroid patients after surgery?
A: ① Postoperative headache, nausea, vomiting: may be due to inadequate exercise of the posterior neck position before surgery, longer pressure on the posterior neck during surgery, inadequate antiemetic drugs in postoperative anesthesia, postoperative hypertension, etc. It can be solved by appropriate massage of the posterior neck, giving appropriate antihypertensive drugs, and giving appropriate antiemetic drugs after surgery;
②Postoperative fever: the patient’s postoperative fever is within 38℃, usually due to postoperative blood absorption heat, which usually disappears within three days after surgery, and can be treated with oral Enzyme;
③Post-operative pain in the throat: due to long time stimulation of the throat by tracheal intubation during surgical anesthesia, post-operative patients have a swollen and painful throat and are afraid to swallow, similar to the performance of acute laryngitis, which usually disappears within 1 week after surgery. In order to relieve the symptoms, you can take Golden Voice Throat, Silver Yellow Tablet, etc;
④Postoperative cough: if you have a dry cough without sputum, you can give cough suppressants or licorice tablets; if you have a postoperative cough with yellow sputum, you may have bronchial inflammation, so you can take oral anti-inflammatory drugs and do nebulized inhalation;
⑤ Postoperative antibiotic application: under normal circumstances, thyroid surgery is a sterile surgery, no need to apply antibiotics; postoperative fever for a long time, or a significantly higher white blood cell count and other cases can follow medical advice to apply antibiotics;
(6) postoperative neck incision swelling and hardening: due to the separation of the neck flap during surgery, postoperative neck skin swelling will occur to varying degrees, some due to lymphatic exudate, some due to a small amount of blood leakage, usually keep the neck brake, 25% magnesium sulfate wet and hot compresses can significantly reduce swelling, in serious cases to find a doctor to deal with; skin hardening at the incision is a normal phenomenon, is the result of the scar formed after suturing, three months after surgery It will gradually soften three months after surgery.
(7) Occasional throbbing pain in the incision, tightening of the skin of the neck, and hoarseness in speech for a long period of time: this is a normal postoperative phenomenon that can gradually disappear after more than half a year, and it is not recommended to speak too much or speak loudly within one month after surgery;
12.How to prevent the formation of scar after surgery?
A: In addition to the use of the thinnest sutures that have the least impact on the human body during surgery, some patients may still experience scarring of the neck incision depending on their individual physique. In order to effectively prevent the incision scar, patients can move their head normally within 1 month after surgery, but try to reduce the movement of head lifting and head tilting. Local application of silicone, or spraying of epidermal growth factor, or application of isotope paste on the incision after surgery can appropriately reduce scar growth and make the incision grow more beautifully;
13.Thyroid surgery complications and related treatment?
A: Although thyroid surgery is not a large incision, it is definitely considered a medium-high risk surgery because it is performed in the throat of the neck. There are various problems that may occur after surgery, which are addressed below.
① 24 hours after surgery, pay attention to the presence of gradually increasing dyspnea and neck swelling: the most dangerous symptom after surgery is postoperative incision bleeding, so after the patient comes off the stage, nursing staff should pay close attention to the patient’s breathing, whether the neck is swollen, when the patient has obvious breathing difficulties to promptly notify the medical staff, quickly open the incision, discharge the blood accumulation in the neck can quickly relieve the patient’s breathing difficulties, and then go to the operating room The treatment is usually not life-threatening;
② Post-operative hoarseness: most post-operative patients have hoarseness due to surgical pulling of the recurrent laryngeal nerve or post-operative scar compression of the nerve, which can be recovered within 2-6 months in most cases, so there is no need to be afraid; if necessary, you can take oral Huang’s sound pills and B vitamins, while applying heat to the neck and practicing expiratory vocalization.
③ Post-operative choking cough: caused by intraoperative pulling or injury of the supraglottic nerve, which can be gradually recovered within 2 weeks after surgery, so that drinking water can be reduced and choking cough will not occur when eating some sticky food;
④ Postoperative hand and foot numbness and twitching: caused by postoperative parathyroid gland ischemia, usually need to take oral calcium D, 1 or 2 tablets once, three times a day for 2 weeks; serious cases need calcium gluconate static point, usually within 2 weeks can recover, no need to worry;
14.How long does it take to be hospitalized for thyroid surgery and how much does it cost?
A: In general, thyroid patients need 5 days from admission to discharge, 1-2 days for preoperative examination and 2 days for postoperative discharge. You can speak and move around on the same day after surgery.
15.How do I take medication after thyroid surgery? How long do I need to take it?
A: Since some or all of the thyroid gland was removed during surgery, it will inevitably lead to low thyroid function after surgery, so it is necessary to take oral levothyroxine sodium tablets (trade names: Euthyroxine, Retis, Gahon, Zenin) for a long time or for life to replace the thyroid function. The amount of oral eugenol should be adjusted or not.
16.What about the discharge checkout and reimbursement?
A: Usually you can’t settle the bill on the day of discharge, but you can settle the bill after 3 working days at the earliest, bring the deposit note and settle the bill on the first basement floor of Building 4; it doesn’t matter if you don’t settle the bill for the time being, all the charges will be closed automatically after discharge, you can bring the ID card of the patient and the representative to the case room on the first basement floor of Building 3 after 2 weeks of discharge, then go back to the nail and breast surgery department on the 15th floor of Building 2 to get a diagnosis letter from the attending doctor, which will be used as a reimbursement certificate after you go home. As a proof of reimbursement after going home. At the same time, you can handle the checkout;
17.What do I need to check after the operation?
A: Post-operative review includes blood collection and ultrasound examination. For benign diseases, thyroid series can be checked after surgery. 3 months after surgery, thyroid ultrasound can be checked, and every 3-6 months afterwards; for thyroid cancer patients, blood collection includes thyroid series, thyroid antibody and thyroglobulin; ultrasound includes thyroid ultrasound and cervical lymph node ultrasound, and every 3-6 months after surgery.
18.What kind of thyroid cancer patients need to take radioactive iodine 131?
A: Patients with thyroid cancer who have undergone total bilateral thyroidectomy and have high risk factors for thyroid cancer (large cancer foci, bilateral multiple cancers, obvious lymph node metastasis, strong invasiveness and metastasis of the cancer itself) may consider taking Iodine 131, which is radioactive and has certain toxicity, and requires isolation time, precautions and the number of doses.
19.What is hyperparathyroidism and do I need surgery?
A: Hyperparathyroidism, also known as hyperparathyroidism, is a serious disease caused by the hyperplasia of a small gland called the parathyroid gland behind the thyroid gland. The main symptoms are: high calcium and low phosphorus in the blood, patients with significant osteoporosis, serious fractures at any time, generalized bone and joint pain; digestive dysfunction, urinary stones, leading to severe uremia or renal failure. Conversely, uremic or renal failure dialysis patients are also prone to hyperparathyroidism. This disease seriously affects the quality of life of patients and must be treated surgically with a good postoperative recovery.