Ngaba unayo i-thyroid eyandisiweyo? Ukuba ugqirha wakho ufumene ukuba unesigxina se-thyroid, umlenze we-thyroid, okanye ukwandiswa kwe-thyroid-eyaziwa ngokuba yi-goiter-uya kufuna ukufunda ngakumbi ngempawu, iimpawu, iimvavanyo, kunye neyeza zonyango.
Yintoni iGoiteriter?
I-term goiter ibhekisela kunoma yintoni na imeko apho isifo sakho se-thyroid senziwe ngokugqithiseleyo.
I-thyroid ye-thyroid yegciwane igxinwa malunga ne-ounce kwaye ayibonakali ngaphandle. Kodwa nge-goiter, i-thyroid ikwandisa ngokwaneleyo ukwenzela ukuba utshintsho lufunyanwe yi-ultrasound okanye i-ray, kwaye kwezinye iimeko, intamo yakho ingabonisa intsimbi ebonakalayo okanye ibhokhwe.
I-Goiter ingenzeka kwiimeko ezininzi:
- xa isifo sakho se-thyroid siphumeza kakhulu i-hormone ye-thyroid (hyperthyroidism)
- xa i-thyroid yakho ingavelisi i-hormone ye-thyroid eyanele (hypothyroidism)
- xa unesifo se-thyroid esisodwa -Isifo se- Graves okanye isifo sikaHashimoto-esibangela ukuphendula okuvuthayo kwi-thyroid yakho
- xa unesigxina esisodwa okanye ezininzi
- xa unomdlavuza we-thyroid
- xa unesifo se-iodine
Iimpawu eziqhelekileyo kunye neempawu ze-Goiter
Iimpawu ze-goiter ziquka:
- kwandisa intamo
- ibhokhwe ebonakalayo okanye ukuvuvukala kwindawo yentamo
Kodwa ke, phawula ukuba ezinye iimeko ze-goiter zingabonakali kwangaphandle, kwaye zifunyenwe kuphela ngovavanyo lweemifanekiso.
Iimpawu zokuhamba ziquka:
- uvelwano kumgca
- ukuvakalelwa kwintliziyo
- ukuziva uxinzelelo kwi-windpipe yakho okanye isifo sakho
- ubunzima bokugwinya, okanye uvakalelwa kukuba ukutya kudibene emqaleni wakho
- ukuphefumla okufutshane okanye ukuphefumula, ngakumbi ebusuku
- ukukhwehlela
- ukuthobeka
- ukungahambi kakubi kunye neen-turtlenecks, izibophelelo kunye nezikhwama
Kwezinye iimeko, unokuba ne- hypothyroidism okanye iimpawu ze-hyperthyroidism ezihamba ne-goiter.
Kwezinye iimeko, i-goiter ingabangela ukuba kubekho iimpawu.
Uvavanyo kunye neNkqubo zoLwahlulo lwe-Goiter
Ukufumanisa i-goiter yisoloko iyenziwa ngokubonakalayo okanye ngesandla ngexesha loviwo lwekliniki ngudokotela wakho. Kwezinye iimeko, i-goiter ingafunyanwa ngexesha lovavanyo lweemifanekiso.
Xa i-goiter ifunyenwe, isinyathelo esilandelayo kukuba kuhlolwe imbangela kwaye ubone ukuba i-thyroid engavamile yenze ntoni ukukhulisa. Olu vavanyo luya kubandakanya iimvavanyo ze-thyroid eziphambili, kubandakanya i-TSH, i-Free T4, i-T3 yamahhala, kunye neemvavanyo ze-thyroid antibodies ukujonga i-Hashimoto (i-thyroid peroxidase antibodies / TPO) kunye nesifo se-Graves (i-thyroid eyenza i-immunoglobulins / i-TSI). Amanqanaba e-iodine angabuye ahlolwe ukuba ahlole ukusilela kwe-iodine.
Ugqirha wakho unokuhlaziya nokuhlola iimvavanyo ezifana ne-ultrasound, i-MRI, i-CT scan, okanye i-thyroid scanner scan, ukuvavanya ubungakanani be-goiter, ukuze ubone ukuba kuchaphazela ukuphefumla okanye ukugwinya, kwaye unqume ukuba unogxobhozo.
Iingcali zonyango
Unyango lwe-goiter kuxhomekeke kwisizathu kunye neempawu.
- Ukuba unayo i-goiter encinci kwaye ingekho esinye isifo se-thyroid, ugqirha wakho unokuncoma ukubeka iliso rhoqo ngaphandle kwonyango.
- Ukuba i-goiter yakho ingenxa yokuntuleka kwe-iodine, uya kunikwa i-iodine supplementation. Oku kuya kudla ngokukhawuleza okanye ukuyeka ukukhula, kwaye kunokunciphisa ubukhulu be-goiter ngokukodwa, kodwa ngokungaqhelekanga.
- Ukuba i-goiter yakho idibene ne-hypothyroidism, unyango ngeyeza le-hormone ye-substmatic substitution inganciphisa okanye luyeke ukukhula kwentsimbi. Kodwa ke, akunakunciphisa i-goiter yakho.
- Ukuba i-goiter yakho inxulumene ne-hyperthyroidism ngenxa yesifo se-Graves, unyango-kuquka i-iodine ye-radioactive, okanye i-antithyroid izidakamizwa-inganciphisa okanye imise ukukhuliswa kwe-gland, kwaye inganciphisa i-goiter.
- Ukuba i-goiter yakho iyaqhubeka ikhula ngelixa unyango lwe-thyroid, iimpawu ziyancipha, okanye i-goiter ingaboni kakuhle, oogqirha bakho baya kunconywa ukuhlinzwa, eyaziwa ngokuba yi-thyroidectomy.
Ziziphi iiNodules ze-Thyroid?
Izigulane ze-Thyroid zinyumba okanye izibilini kwi-thyroid gland. Iimodyuli zinokuthi zomelele, okanye i-cysts egcwele amanzi. Iinqununu ze-Thyroid ziqheleke kakhulu, kwaye ziqikelelwa ukuba isiqingatha sabemi sinomqolo omnye, nangona ininzi ayifumananga. Iinqununu ze-Thyroid nazo ziqheleke kakhulu xa uneminyaka ubudala, kwaye uqikelelwe ukuba abantu abangama-70 abangama-70 ekhulwini abantu banomyinge omnye we-thyroid.
Ama-Nodules angenzeka ngenxa yezizathu ezininzi:
- Umhlaza weTyroid. Le nto iyona nto ibangelwa yi-nodules ye-thyroid, kwaye malunga nama-95 ekhulwini kuwo onke ama-nodules ye-thyroid awayiyo umdlavuza.
- Izimo ze-thyroid ezenza ngokuzenzekelayo, ezifana ne-Hashimoto's and Graves's disease, ezibangelwa ukuvuvukala kwe-gland kwaye zenze iigununu.
- Ukugqithiswa kweethambo zakho eziqhelekileyo ze-thyroid. Oku kuyaziwa ngokuba yi-adenoma ye-thyroid, kwaye kaninzi ayinomdlavuza okanye ibonwa ngokungathí sina ngaphandle kokuba i-nodule ibangela iimpawu ngenxa yobukhulu bayo.
- Ukusilela kwe-iodine. Oku kunokubangela ukuphuhliswa kwamagqabi, kunye ne-goiter.
- I-goiter ye-Multinodular, eyaziwa ngokuba yi-adenoma enetyhefu, apho unayo iinqununu. Ngokuqhelekileyo, ezi ntsholongwane zivelisa i-hormone ye-thyroid kwaye ingakhokelela ekubeni i-hyperthyroidism.
Iimpawu eziqhelekileyo kunye neempawu zeNodules ze-Thyroid
Kwezinye iimeko, ukuba unesidumbu esikhulu, okanye sisondele kwesikhumba sakho, sinokubonakala ngaphandle okanye sikwazi ukuvavanywa ngongqinisiso lwencwadi. Nangona kunjalo, iigunyuli ezininzi azibonakali okanye zinyanzeliswa, kwaye ziyafumaneka kuphela ngovavanyo lweemifanekiso.
Kwiimeko ezininzi, iigunyuli azikho iimpawu ezibonakalayo. Kodwa xa i-thyroid igxininisa ibangela iimpawu, ezinye eziqhelekileyo ziquka:
- iipilpitations
- kulala
- ukulahleka kwesisindo okanye ukuzuza ubunzima
- uxhalaba
- ukuthuthumela
- ukukhathala
- ukuxinezeleka
- uvakalelo entanyeni
- ubunzima bokugwinya
- uvakalelo lokuzaliseka okanye ukunyameka entanyeni
- ukuthobeka
Uvavanyo kunye neNkqubo zoKuhlola i-Nodules ye-Thyroid
Xa i-nodule ye-thyroid ifunyenwe, ugqirha wakho uza kuhlola imibuzo emininzi ebalulekileyo:
- Ingaba i-nodule yenza i-hormone enkulu ye-thyroid kwaye ibangela i-hyperthyroidism?
- Ingaba i-nodule iphazamise ikhono le-thyroid ukuvelisa i-hormone ye-thyroid eyaneleyo kunye ne-hypothyroidism?
- Ingumhlaza wakho womhlaza?
- Ingaba i-nodule yakho ithintela ukuphefumla okanye ukugwinya?
Isinyathelo sokuqala kuhlolo luqhelekileyo kwiphaneli yeimvavanyo zegazi, kubandakanywa ne-TSH, i-Free T4, i-Free T3, kunye neemvavanyo zengqungquthela kwi-Hashimoto's and Graves's disease. Oku kunokukunceda ukuba i-nodule ibangela hyperthyroidism okanye hypothyroidism.
Isinyathelo esilandelayo ngokuqhelekileyo kuhlolwa kwe-thyroid , okungabandakanya i-ultrasound, i-MRI, i-CT scan, okanye i-iodine ye-iodine. Zihlala ziqhutyelwa ukuvavanya ubungakanani kunye neempawu zeengqungquthela, kwaye zichane iimpawu ezisolisayo eziya kuqinisekisa ukuba uphando. Ezinye zeempawu zokuvavanya okucatshulwa ezicatshangelwa ukusola ziquka:
- isigxina esisodwa (ngokubhekiselele kwiigununu ezininzi)
- ubukho be-microcalcification kwi-nodule
- ubukhulu obukhulu kune-2 cm
- ukwakheka okuqinileyo kwesigxina
- Iimpawu "ezibandayo" kwi-test, oko kuthetha ukuba i-nodule ayifuni iodode okanye ivelise i-hormone ye-thyroid
- ukukhula ngokukhawuleza kweengqungquthela
Ukuba i-nodule ithathwa njengesityholo, isinyathelo esilandelayo ngokuqhelekileyo sinesilwanyana esifuthekileyo (FNA) biopsy . Kulo vavanyo, inaliti ifakwa kwi-nodule-ngokuqhelekileyo ikhokelwa yi-ultrasound-ukurhoxisa isampula yokuhlalutya kwezilwanyana. Isampuli enye okanye ngaphezulu ingafuneka ukuba uvavanyo olunzulu. Ngokuqhelekileyo, ii-FNA zenziwe ngama-endocrinologists, i-cytopathologists, okanye oogqirha. Iiseli zifundwa kwaye zihlolwe yi-cytopathologist. Uninzi lwe-FNA lwenziwa kwiofisi yegqirha, nangona ezinye zinokuthi zenziwe njengenkqubo yokuphulukiswa kwesibhedlele kwisibhedlele okanye kwindawo yokuhlinzwa.
Kubalulekile ukuba ugqirha owenza i-FNA yakho unamava amaninzi, ukwenzela ukuba uqinisekise ukuba inkqubo iyavelisa iisampuli ezifanelekileyo kakhulu. Ipesenteji ze-FNA iziphumo ze-biopsy zibhekwa njengento engeyiyo yokuxilonga, oku kuthetha ukuba ayinakusetyenziswa kuyo yonke, kwaye kufuneka ibuyiswe kwakhona; isiphumo esinokuthi senzeke xa oogqirha abangaphantsi kwamava benza isampuli. Umngcipheko omkhulu we-thyroid ye-FNA uyaphala okanye isisu. Kodwa kunye neengcali ezinolwazi, loo mngcipheko uncinci, kwaye i-FNA ye-thyroid ibonwa ngokukhuselekileyo, phantse ingabikho naziphi na iingxaki.
Enye yemingeni ephazamisayo xa iFNA ibuyele "ingenakulinganiswa" okanye "ingagqibekanga." Kule meko, uvavanyo lwezilwanyana alukwazi ukulawula umhlaza. Isinyathelo esilandelayo esilandelayo kule meko i- thyroidectomy-utyando lokususa i-thyroid , ehlolisiswayo ukuba ihlolisise okanye ilawule umdlavuza we-thyroid.
Xa kungekho mdlavuza we-thyroid, owenzeka kwiimeko ezininzi, isigulane kufuneka siphile kunye ne-hypothyroid engapheliyo, emva kwe-thyroidectomy engeyomfuneko.
Kuqikelelwa ukuba malunga nezigidi eziqingatha yezigidi ze-FNA biopsies zenziwa eMelika ngamnye ngonyaka, kwaye ukuya kuma-30 ekhulwini abo babuya njengento engagqibekanga. Iipesenti ezingama-20 ukuya kuma-30 kuphela zeengqungquthela ezingagqibekanga zifunyanwe zibi.
Ngoko ke kufuneka uqaphele uvavanyo oluthiwa yi- Afirma Thyroid FNA Analysis , enokuthi xa iqhutywe ngexesha le-biopsy yokuqala iphelisa phantse zonke iziphumo ezingaphelelanga kunye neziphumo zeFNA. Qaphela ukuba kuya kufuneka uqinisekise ukuba ugqirha usebenzisa le nkqubo ngaphambi kokuba i-FNA yakho ilungiselelwe, okanye ufumane ugqirha osebenza nale vavanyo.
Unyango lweNyroid Nodule
Ukuba i-nodule itholakala ukuba isifo somhlaza, isinyathelo esilandelayo kukususwa kokukhutshwa kunye nonyango olulandelayo olusekelwe kumhlobo kunye nesigaba somhlaza ofunyenwe ngumhlaza.
Ukuba unamaqhuqhuva ongenakucaceka, okanye aphelisa amandla akho ukugwinya okanye ukuphefumla, utyando luvame ukucetyiswa.
Ukuba i-nodule enobunzima ayihambelani nayiphi na i-hyperthyroidism okanye i-hypothyroidism, ngokuqhelekileyo iya kujongwa rhoqo ngama-ultrasound kunye noviwo logqirha wakho.
Ngokuqhelekileyo, ngenxa yesigulane esinobungozi esibangela i-hypothyroidism, unyango lubonisa ukuba i-thyroid i-hormone ishintshe imithi. Oku kunokuncedisa ukunciphisa i-nodule ngandlela-thile, okanye ukuyikhusela ekukhuleni. Ukuba i-nodule iyaqhubeka ikhula, ugqirha wakho unokuyixubusha kwakhona, uncoma ukususwa ngokukhawuleza, okanye ucebise unyango olunjenge-ethanol injection (PEI) kwi-nodule, enokukunceda ukunciphisa i-nodule.
Ukuba i-nodule enobungozi okanye i-adenoma enetyhefu ihamba kunye ne-hyperthyroidism, unyango luyinkqubo ye-antithyroid, okanye kwezinye iimeko, ukuchithwa kwe-iodine ye-iodine okanye ukuhlinzwa, kuxhomekeke kumlinganiselo we-hyperthyroidism, impendulo yakho kumachiza, kunye nezinye izinto ezinqunywe ngugqirha wakho. .
ILizwi
Khumbula ukuba nangona umngcipheko womhlaza we-thyroid uncinci kakhulu, zonke iigulane kufuneka zihlolwe ngugqirha, ukulawula umngcipheko omncinci wokuba unomdlavuza.
> Imithombo:
> Braverman L, Cooper D. Werner & Ingbar's The Thyroid, Edition 10. WLL / Wolters Kluwer; 2012.
> Haugen B. et. al. "Izikhokelo zoLawulo lweMigodi yase-American American Thyroid Guidelines yezigulane zabantu abadala abaneeNodules ze-Thyroid kunye ne-Cancer Cancer / I-American American Thyroid Association Guidelines Task Force kwiiNodules ze-Thyroid kunye ne-Cancer Cancer eyahlukeneyo." Thyroid . Umqulu 26, iNombolo 1, 2016. INGA: 10.1089 / yakho.2015.0020