Enlarged thyroid gland on the right side of the neck

For goiter, it is usually very important to strengthen psychological treatment on the basis of drug treatment. First of all, we should eliminate adverse stimuli, improve our mental state and bad living environment, maintain a good attitude, and insist on exercising to enhance our own immune function. Early treatment is more effective. When treating, you should go to the hospital to find out the cause of the disease, and then treat it symptomatically according to the different causes.

Treatment for an enlarged thyroid gland

1. Treatment indications

Treatment is needed for the following conditions:

(1) There are local symptoms, ranging from neck discomfort to severe compression symptoms.

(2) Affects the appearance.

(3) Goiter progresses rapidly.

(4) Retrosternal goiter.

(5) Nodular goiter cannot exclude malignant transformation.

(6) Patients with abnormal thyroid function (including clinical hyperthyroidism).

2. Treatment principles

The clinical manifestations of patients with simple goiter vary greatly in severity, so the treatment plan should be individualized. Because the thyroid function of simple goiter is normal, no treatment is required unless there is compression or even suspected tumor, in which case surgical treatment is taken.

3. No treatment, clinical follow-up

Many patients with simple goiter have slowly growing goiter, no local symptoms, and normal thyroid function. They do not need special treatment, but only close clinical follow-up, regular physical examinations, and B-ultrasound examinations. In addition, serum TSH levels should be tested regularly to detect subclinical hyperthyroidism or hypothyroidism early. If there are obvious goitrogenic factors present, they should be removed.

4. TSH suppression therapy

The pathogenesis of some simple goiters is related to the stimulation of TSH. The use of exogenous thyroid hormones can inhibit the secretion of endogenous TSH, thereby preventing and treating the growth of goiter. TSH suppression therapy has been widely used in the treatment of simple goiter.

Before TSH suppression therapy, the serum TSH level should be tested. If the serum TSH level is normal, TSH suppression therapy can be performed. If the serum TSH is <0.1mU/L, it indicates subclinical hyperthyroidism and TSH suppression therapy should not be performed. Serum TSH level or thyroid uptake rate (RAIU) should be tested during TSH suppression therapy. It is generally believed that serum TSH < 0.1mU/L or RAIU < 5% is complete suppression, and levels above this are partial suppression. It is generally believed that serum TSH levels can be suppressed to the lower limit of the normal range. The effectiveness of TSH suppression therapy is a controversial issue. During treatment, TSH needs to be suppressed to below normal values, and attention should be paid to the fact that long-term TSH suppression therapy may cause side effects on the heart and bones.

5. Radioactive iodine 131 therapy

Radioactive iodine 131 has been widely used in the treatment of toxic goiter, but has not yet been widely used in the treatment of non-toxic goiter. The situation has changed in recent years, and iodine-131 has received increasing attention in the treatment of simple goiter. In the past 10 years, many literature reports have shown that a one-time high-dose I treatment for simple goiter has achieved good results, reducing the thyroid volume by 40% to 60% in 80% to 100% of patients.

6. Surgery

Surgical treatment can quickly relieve local compression symptoms. Therefore, surgical treatment of simple goiter has irreplaceable advantages.

7. Puncture aspiration or injection of anhydrous alcohol

For cystic nodules, puncture aspiration or injection of anhydrous alcohol can be performed, which can cause the nodules to shrink.