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March 11, 2020

如何診斷甲狀腺功能減退疾病?

一、視診：觀察甲狀腺的大小和對稱性，正常人甲狀腺外觀不突出，女性在青春發育期可略增大。檢查時囑被檢查者做吞咽動作，可見甲狀腺隨吞咽動作而向上移動，如不易辨認時，再囑被檢查者兩手放於枕後，頭向後仰，再進行觀察即較明顯。

來自香港康柏耳鼻喉專科中心的醫生建議，當出現頸淋巴痛的時候就應該引起重視，及早進行甲狀腺檢查，可以先做頸淋巴腺組織化驗，找到發病的原因，再做甲狀腺手術，把腫塊的部位切除掉就可以了。

二、觸診： 1、甲狀腺峽部：甲狀腺峽部位於環狀軟骨下方第二至第四氣管環前面.站於受檢者前面用拇指或站於受檢者後面用示指從胸骨上切跡向上觸膜，醫|學教育網搜集整理可感到氣管前軟組織，判斷有無增厚，請受檢者吞咽，可感到此軟組織在手指下滑動，判斷有無長大和腫塊。前面觸診：一手拇指施壓於一側甲狀軟骨，將氣管推向對側，另一手示、中指在對側胸鎖乳突肌後緣向前推擠甲狀腺側葉，拇指在胸鎖乳突肌前緣觸診，配合吞咽動作，重複檢查，可觸及被推擠的甲狀腺。

三、聽診隨著疾病的逐漸加重，甲狀腺越來越大，通過用鍾型聽診器直接放在腫大的甲狀腺上，如聽到低調的連續性靜脈嗡鳴音，對診斷甲狀腺功能亢進很有幫助。此外，甲亢彌漫性甲狀腺腫也能聽到動脈收縮期雜音。

四、甲狀腺腫大可分三度：不能看出腫大但能觸及者為Ⅰ度;能看到腫大又能觸及，但在胸鎖乳突肌以內者為Ⅱ度;超過胸鎖乳突肌外緣者為Ⅲ度。

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