#1
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Äà, 20
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Ã.À. Ìåëüíè÷åíêî |
#2
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Öèòàòà:
Íî ÷òî åùå ëþáîïûòíåå - ïðè óçëîâîì çîáå âïîëíå ìá è Ò3 òèðîòîêñèêîç,è ñóáêëèíè÷åñêèé ò-òîêñèêîç
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Ã.À. Ìåëüíè÷åíêî |
#3
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Ñöèíòèãðàôèÿ ïî ãðàôèêó â èþëå, áèîïñèÿ ïîêàçàëà êîëëîèäíûé óçåë. Ïüþ òèðîçîë 20 ìã (ïîñëåäíþþ íåäåëþ ïüþ ïî 10 ìã, ò.ê. ÷àñòî çàáûâàþ), ò4 11.05.2015- 0,52 (0,80-2,10). Áèîïñèþ áðàëè â îáëîíêîäèñïàíñåðå, âðà÷-îíêîëîã ñêàçàë, ÷òî â ñöèíòèãðàôèè íà äàííûé ìîìåíò íåò ðåçêîé íåîáõîäèìîñòè....
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#4
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Öèòàòà:
Eur J Nucl Med Mol Imaging (2008) 35:1171–1172 Scintigraphy or fine-needle aspiration biopsy to exclude thyroid malignancy: what should be done first in iodine deficiency? C. Reiners "Fine-needle biopsy is recommended to be performed only in patients with cold nodules detected by scintigraphy, which reduces the percentage of nodules to be biopsied to approximately 30%." Áèîïñèÿ ïðîïóñêàåò 30% ðàêîâ ÙÆ. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Ann Surg. 2007 Nov; 246(5):714-20. Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review. |
#5
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 íåöèâèëèçîâàííûõ - òîæå è ïðè ÍÈÇÊÎÌ ÒÒà ( íèæå 2-õ ) ïðîâîäÿò ñöèíòèãðàôèþ äëÿ âûÿâëåíèÿ òåõ ñàìûõ ãîðÿ÷èõ óçëîâ , êîè è íå äóìàþò áûòü çëîêà÷åñâòåííûìè.
Áèîïñèÿ è íå äóìàò ïðîïóñêàòü 30 % ðàêîâ - îíà ÷åñòíî ãîâðèò , ÷òî çäåñü Áåòåñäà 3 èëè 4 ñëåäóþùèé øàã - îïåðàöèÿ êàê çàêëþ÷èòåëüíûé ýòàï äèàãíîñòèêè . Áèîïñèÿ îøèáàåòñÿ ïðè ìåäóëëÿðêå - ïî÷åìó è äåëàåì êàëüöèòîíèí
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Ã.À. Ìåëüíè÷åíêî |
#6
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Öèòàòà:
Öèòàòà:
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#7
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ÿñíî, áûëà íà ïðèåìå ó äðóãîãî î÷íîãî âðà÷à (ìîé ëå÷àùèé âðà÷ â îòïóñêå), ñòàâèò äåñòðóêòèâíûé òèðåîòîêñèêîç è ãîâîðèò, ÷òî íåò íåîáõîäèìîñòè ïèòü òèðîçîë. ìîæåò áûòü òàêîå? íà äàííûé ìîìåíò ïåðåøëà íà ïîääåðæèâàþùèå 5 ìã, äî ñöèíòèãðàôèè ïîïüþ 5 ìã, ò4 ñäàì íà ñëåä. íåäåëå. à êàê ïîäòâåðæäàåòñÿ èëè îïðîâåðãàåòñÿ äåñòðóêòèâíûé òèðåîòîêñèêîç? è ÷òî âîîáùå çà çâåðü òàêîé? à òî ÷åðåç ìåñÿö ïðåäñòîèò ëå÷åíèå (ôèçèîòåðàïèÿ ñ éîäèäîì êàëèÿ). ÿ êàê ñëûøó "Éîä" ñðàçó ñîìíåíèÿ. è ìîæíî ëè ïðîâîäèò ñöèíòèãðàôèþ ïîñëå ëå÷åíèÿ éîäèäîì-êàëèÿ?
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#8
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ïîÿâèëîñü óäóøåíèå â ãîðëå, áóäòî öåïüþ ñêîâàëî, íî÷àìè ñïàòü íå ìîãó.
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#9
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Ìåíåå âñåãî ñåé÷àñ óìåñòíî ðàññêàçûâàòü î äåñòðóêòèâíîì òèðîèäèòå - ïðè íàëè÷èè óçëà ñ òèðîòîêñèêîçîì . Åñëè áû Âû ïðîñòî ïîêàçàëè äîêòîðó çàî÷íûå êîíñóëüòàöèè, íå áûëî áû åùå îæíëé ñìóùàþùåé èäåè Ìû òàê äîëãî áåñåäóåì íà ðàçíûå òåìû, ÷òî ýòî çàìåíÿåò íàì ðåàëüíóþ ðàáîòó. Âðà÷ ïàëüïèðîâàë æåëåçó?
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Ã.À. Ìåëüíè÷åíêî |
#10
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äà, ïàëüïèðîâàë
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#11
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Ã.À. Ìåëüíè÷åíêî |
#12
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Íèêàêîé òèðåîòîêñèêîç íå ëå÷àò ôèçèîòåðàïèåé ñ éîäèäîì êàëèÿ.
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |
#13
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Ôèçèîòåðàïèÿ ñ éîäèäîì êàëèÿ áóäåò íà ìàòî÷íûå òðóáû, à òàêæå áóäóò ëå÷èòü ýíäîìåòðèîç. ïîñëå ÷åãî, òðè ìåñÿöà àêòèâíîãî çà÷àòèÿ...
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#14
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ÃÎñïîäè òâîÿ âîëÿ ....Âàøà äîêòîð ãäå-òî â íà÷àëå 20-ãî âåêà çàêàí÷èâàëà èíñòèòóò ?
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Ã.À. Ìåëüíè÷åíêî |
#15
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Öèòàòà:
Âî-âòîðûõ, ÷òî ëå÷èì ñåé÷àñ, åñòü äèàãíîç áåñïëîäèÿ (ïîïûòêè çà÷àòèÿ â òå÷åíèå ãîäà, íå ïðèâåäøèå ê óñïåõó)?
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Àííà, âðà÷-ýíäîêðèíîëîã Âîðîíåæ, êëèíèêà Íåïëàöåáî |