Hyperthyroidism – Classification, Indications & Surgical Treatment

Classification of hyperthyroidism, indications, Surgical operation indications and contraindications.

Hyperthyroidism symptoms

Hyperthyroidism symptoms

Classification

  • Primary hyperthyroidism
  • Secondary hyperthyroidism
  • Hyperfunctioning thyroid adenoma

Indications:

  1. Nodular hyperthyroidism, although drugs or iodine can eliminate or alleviate the symptoms of hyperthyroidism, but the nodules still exist, and may be secondary to hyperthyroidism or cancer.
  2. Diffuse hyperthyroidism, after systemic drug treatment, no significant improvement, or relapse after stopping the drug.
  3. Retrosternal goiter with hyperthyroidism, or compression symptoms caused by thyroid enlargement.
  4. Within 6 months of pregnancy, there is hyperthyroidism, which is adversely affects both situation mutually.
  5. Suspected of malignant. (primary condition has a localized nodule or a scanning find outs a cold nodule)
  6. Hyperfunctioning thyroid adenoma

Surgical operation indications:

  1. Secondary hyperthyroidism, hyperfunctioning thyroid adenoma
  2. Moderate or above primary hyperthyroidism
  3. Hyperthyroidism with thyroid compression symptoms or retrosternal goiter, or suspected cancer
  4. Medical treatment of side effects such as allergies or myelosuppression
  5. Long-term drug treatment relapse after drug withdrawal or relapse after 131I treatment
  6. Those with the above indications in the early and middle stages of pregnancy should also consider surgery

Contraindications:

  1. Teen hyperthyroidism
  2. Mild primary hyperthyroidism
  3. Exophthalmos is severe and hyperthyroidism is mild.
  4. The patient has severe organ dysfunction such as heart and lung, and the drug is not improved, and surgery is not allowed.

 

The role and usage of iodine as a preoperative preparation for hyperthyroidism.

  1. Inhibits proteolytic enzymes, thereby reducing the decomposition of thyroglobulin, which gradually inhibits the release of thyroxine, and does not cause sudden changes in the circulatory system after surgery.
  2. Iodine can reduce the blood flow of the thyroid and reduce the congestion of the gland, with the time glands get shrunken and harden.

Use of iodine: compound potassium iodide solution, 3 times a day, 3 drops per day on the first day, then add 1 drop each time to 16 drops each time, then maintain this dose.

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