What items should be checked in a routine physical examination?

There is no nationally unified fixed list for routine physical examinations. The core is "basic required items + personalized additional items that can be adjusted as needed." Ordinary people do not need to blindly pursue luxury packages worth tens of thousands of yuan, nor should they try to save trouble and only make basic items worth 180 yuan.

I have worked as a counselor in the physical examination center of a public tertiary hospital for 6 years. I have seen too many people come up and shout, "Give me the most expensive all-inclusive package."

In fact, the basic must-check items, to put it bluntly, are required regardless of your age or whether you have underlying diseases. They are what everyone often calls the "entry-level" items: Needless to say, height, weight, and blood pressure. The few tubes of blood drawn generally cover blood routine, liver and kidney function, blood lipids, Fasting blood glucose, plus urine and stool routines, as well as abdominal ultrasound (to see the liver, spleen, gallbladder, pancreas and kidneys), thyroid ultrasound, breast and gynecological ultrasound for women, prostate ultrasound for men, chest X-ray or low-dose chest CT are now basically standard features of the basic model. Many people think that surgeons and surgeons are just going through the motions by touching and listening. In fact, this is not the case. Last year, I met a 32-year-old Internet practitioner. His ultrasound did not report thyroid abnormalities. The surgeon palpated and felt small indurations on his thyroid gland, and suggested that he undergo a puncture. Finally, he was diagnosed with early-stage papillary cancer. After early detection, he underwent minimally invasive surgery. Now he has nothing to do, and he does not even need to take medicine for a long time.

As for whether or not to add items and what items to add, this is the most controversial part on the Internet right now. Some people say that all the additional items are made by the physical examination center to earn IQ tax, and it is in vain. Some people say that the more complete the items, the better. It is best to arrange all tumor markers and PET-CT. In fact, both of these statements are too extreme, and the additional items vary from person to person: for example, if you have been smoking for 20 or 30 years, then a basic chest X-ray is definitely not enough, and you need to add a low-dose chest CT to screen for lung cancer. ； If your parents are diabetic, and you love sweets and are overweight, don’t just check your fasting blood sugar. Add glycated hemoglobin to see your average blood sugar level in the past three months. Last month, there was a 41-year-old man whose fasting blood sugar was completely normal. His glycated hemoglobin had reached 6.2%, which is pre-diabetes. If you don’t check this and still drink milk tea and late-night snacks every day, you will most likely have to take anti-diabetic drugs in a year or two. There is also the tumor marker that everyone is most concerned about. There is really no need to prescribe more than a dozen of them at the beginning. If young people in their 20s and 30s do not have high-risk factors and are not uncomfortable, they don’t even need to add them specifically. Otherwise, if a certain one is found to be slightly elevated, it will scare them so much that they can’t sleep for half a month. In the final reexamination, there is nothing wrong, but other problems will appear in vain.

If you really don’t know what items you should add, think in advance about whether you have any discomfort, whether you have any genetic history in your family, and whether you have the habit of smoking, drinking, or staying up late. Go to the physical examination department and chat with the doctor for three to five minutes, and let the doctor help you adjust it. It is much more reliable than blindly choosing the Internet celebrity package.