How many ways to Phoenix from the central hospital

On the third degree simple goiter
Article 16 the third degree simple goiter is unqualified. Article 16.1 explains that simple goiter is more common in women, and its main characteristics are goiter and no toxic symptoms of hyperthyroidism. Iodine deficiency is the main cause of endemic goiter. Due to living in iodine deficiency environment for a long time, the body absorbs less iodine from food and water, and the concentration of thyroxine in blood decreases, which increases the secretion of thyroid stimulating hormone (TSH) in the body and causes compensatory enlargement of thyroid gland. Sporadic simple goiter is a compensatory enlargement of the thyroid caused by the relative increase of the body's need for thyroxine, or some drugs, congenital factors and other factors that hinder the synthesis of thyroxine. 16.1.1 endemic goiter, also known as iodine deficiency or non-toxic goiter, can be divided into diffuse goiter and nolar goiter according to its pathological changes. These two types are actually two different stages in the course of the disease. The latter is mostly evolved from the former, that is, the initial thyroid gland is diffuse enlargement, and many noles can be graally formed with the development of the disease, some of which can be secondary to hyperthyroidism or canceration. 16.1.2 sporadic goiter is sporadic and not endemic. There are three main causes: 1. The physiological demand for thyroxine increases ring puberty, pregnancy or lactation, which leads to the relative deficiency of thyroxine, resulting in compensatory enlargement of thyroid gland, mostly mild diffuse enlargement, which can be reced by itself in the future; ② Some drugs can block the synthesis of thyroid hormone. Taking these drugs for a long time will rece the synthesis of thyroid hormone, increase the secretion of TSH and stimulate thyroid hypertrophy. ③ Congenital thyroid hormone proction disorders lead to thyroid compensatory hyperplasia. If simple goiter has evolved into third degree goiter, especially nolar goiter and retrosternal goiter, it indicates that the disease period is longer and serious histopathological changes have appeared in thyroid. The enlarged thyroid gland can oppress the surrounding tissues and organs, cause dysphagia and symptoms of jugular vein, superior vena cava and nerve compression, and has the possibility of secondary hyperthyroidism or canceration. Therefore, surgical treatment should be carried out as soon as possible, so the third degree simple goiter is not qualified. 16.2 key points of diagnosis 16.2.1 key points of history inquiry: whether the disease is prevalent in long-term residential area, whether it is in pregnancy or lactation, age and gender characteristics of onset, whether there are systemic toxic symptoms of hyperthyroidism except for goiter, and whether there is a past history of hoarseness, dysphagia, goiter or noles. 16.2.2 physical examination points should pay attention to the characteristics of goiter, such as whether the thyroid gland is homogeneous, whether the left and right lobes are symmetrical, whether the texture is soft and hard, whether the surface is smooth or nolar, nolar goiter can touch one or more noles of different sizes in one or both sides of the thyroid gland; Whether there was local compression, such as hoarseness caused by compression of recurrent laryngeal nerve; Goiter or nole activity with swallowing (good activity is helpful to differentiate from thyroid cancer); Local vascular murmur and tremor (no vascular murmur and tremor is helpful to differentiate from hyperthyroidism). See section 1.3.5 "thyroid examination" in Chapter 2 for the judgment of goiter degree. 16.2.3 auxiliary examination points according to the characteristics of goiter, it is generally not difficult to make a diagnosis. As a physical examination, when it can not be differentiated from other thyroid diseases, related auxiliary examination can be done to further clarify the diagnosis. Thyroid B ultrasound: diffuse goiter showed diffuse, symmetrical enlargement of the gland, smooth surface without noles; Nolar goiter can be seen on both sides of the lobe is asymmetric enlargement, see multiple noles of different sizes, no obvious capsule, nole echo intensity is different, cystic change and calcification. Thyroid function: the serum T3 and T4 levels of patients with simple goiter are mostly in the normal range, and TSH can be increased. Thyroid autoantibody: negative. This examination is helpful to differentiate from chronic lymphocytic thyroiditis. 16.3 precautions the following thyroid diseases are unqualified in physical examination, so they must be differentiated from simple goiter. 1) Hyperthyroidism: in addition to diffuse goiter, local palpable tremor and vascular murmur can be heard. In addition, it also involves multi system manifestations, such as finger tremor, tachycardia, increased pulse pressure, exophthalmos, etc. serum T3 and T4 levels are increased. 2) Secondary hyperthyroidism of goiter: no matter how the degree of goiter is, secondary hyperthyroidism does not belong to "simple goiter". 3) Chronic lymphocytic thyroiditis: also known as Hashimoto's thyroiditis, is an autoimmune disease, which can be accompanied by Sjogren's syndrome, systemic lupus erythematosus, rheumatoid arthritis and other autoimmune diseases. The following points can be used for differentiation: the disease is more common in the elderly, rare in young people; The thyroid gland was diffusely enlarged, symmetrical, tough and smooth; Mild hypothyroidism may be accompanied; The recurrent laryngeal nerve was not compressed and there was no hoarseness; The results of TGA and MCA were positive. 4) Thyroid cancer: mostly single thyroid nole, hard, unsmooth, relatively fixed, not with swallowing activities, may be accompanied by cervical lymph node enlargement, especially the compression of recurrent laryngeal nerve, hoarseness symptoms, should be highly suspected of this disease, can further do thyroid B ultrasound, isotope scanning or surgical biopsy, in order to make a clear diagnosis. 5) High functional thyroid adenoma: General thyroid adenoma should be regarded as qualified physical examination, but if secondary hyperthyroidism (high functional adenoma) or canceration, it is unqualified physical examination

Zhengzhou 962 bus, can be in Zhengzhou bus terminal, Zhengzhou navigation road Xiangyun road two bus stops, complete the change, to Zhengzhou Phoenix

bus line: no.962 → No.35, the whole journey is about 9.2km

1. Walk about 30m from Zhengzhou bus terminal to bus terminal

2. Take no.962, pass 9 stops, and reach the East Street Station of Zijingshan road

3. Walk about 180m to the first people's Hospital Station

4. Take No.35, pass 4 stops, To reach the commodity world station

5, walk about 630 meters, to reach Zhengzhou Phoenix

bus line: 962 → 85, the whole journey is about 10.6 kilometers

1, walk about 370 meters from Zhengzhou Haidian Road Xiangyun Road, to Haidian Road Biyun Road Station

2, take 962 Road, after 10 stops, to Shilipu station of Shang road

3, walk about 90 meters, Arrive at Shilipu station on Shang road

4, take bus 85, pass 2 stops, arrive at Yingxie Road Station on Zhengbian road

5, walk about 770 meters, and arrive at Phoenix City in Zhengzhou