Indlela eqhelekileyo yokuvavanya isigxina se-thyroid
Indlela eqhelekileyo yokuvandlakanyiswa kwesigxina se-thyroid okanye ubunzima bezinto ezibizwa ngokuba yi-good nucleus aspiration biopsy, ezifingqiweyo njenge-FNA.
Kwi-FNA, into enhle kakhulu, inaliti encomekileyo ifakwe kwisifo sakho se-thyroid, ukuba ufune (okanye "ukunyuka") kunye kunye / okanye umbane ovela kwi-nodule yakho ye-thyroid okanye ubunzima kwiinaliti. Isampuli efunyenweyo sinokuvavanywa ngenxa yobukho beeseli zomhlaza.
I-FNA ihluke njani kwi-Needle?
Kwi-nucleal core biopsy, isalathisi, inaliti enkulu isetyenziselwa ukufumana isampuli "yesisiseko" isampula yokuhlalutya, kunye nesampula enkulu ekwazi ukuphinda ibuyele kwiisampuli ezincinci ezingathunyelwa ukuhlalutya. I-needle biopsies iyenziwa ngokusetyenziswa kwe-anesthhesia yendawo, kwaye le nkqubo inomngcipheko omncinci wokuphuma kwegazi, ixakeke rhoqo ngugqirha ogqirha kwizithuba zokugulisa.
Ukuba i-HMO okanye uluntu alunabo abanezakhono zobuchule ekwenzeni i-FNA, okanye akukho i-cytopathologists ekhoyo ukwenza uhlobo oluyingqayizivele lokutolika olufunekayo kwiziphumo ze-FNA, izigulane zinamathuba okuba ne-biopsy enkulu, njengale nkqubo, ngelixa kuninzi izigulane, zidinga ubuncitshi obungaphantsi ukufumana isampula esivumelekileyo, kunye nekhono elingaphantsi kwezilwanyana zezilwanyana ukufunda nokutolika.
Ngubani omele enze i-FNA?
Ngokuqhelekileyo, ii-FNA zenziwe ngama-endocrinologists, i-cytopathologists, okanye oogqirha.
Iiseli zifundwa kwaye zihlolwe yi-cytopathologist.
Qinisekisa ukuba ugqirha unamava amaninzi ekwenzeni izilwanyana ezinomdla. Buza ukuba zingaphi iinjongo ezenziwa ngunyanga nganye ngenyanga, kwaye zibuze "ukunganeliseki" okanye "ukungabonakali" kweesampuli. Musa ukuhlala ucinga ukuba i-endocrinologist ingakumbi kwizakhono - ingenakuyenza rhoqo le nkqubo.
Izinga lokungaxilongo okanye ukungaqiniseki - iisampula ezingenakusetyenziswa kwi-laboratory yokuhlola, kwaye kufuneka zibuyiswe ngokutsha-zinokuphakanyiswa kwabasebenzi abathile abangaphantsi. I-Yolanda Oertel, MD, i-cytopathologist kwi-Centre Hospital yaseWashington eyathetha ngo-FNA kwiNgqungquthela ye-Thyroid Survivor's Association (ThyCa) eWashington, DC, iyalumkisa izigulane ukuba zifumane isantya kwiziko apho iinjongo zabo zenzeke khona. Umyinge unokugijima ukususela kuma-5 ukuya kuma-15 ekhulwini. UDkt. Oertel, owenza umgudu wakhe ugxile kwi-thyroid kunye nesifiso sesifuba, kwaye ngubani ofuna ukufumana i-thyroid nganye ngenyanga, une-"non-diagnostic" rate engaphantsi kwama-0.5 ekhulwini.
Qaphela: uvavanyo oluthile lufumaneka kwiziphumo ze-FNA biopsy, ebizwa ngokuba yi- Afirma Thyroid Analysis , esuka eVeracyte, ephelisa uninzi lwezinto ezingenalo ukuxilonga, iziphumo ezingapheliyo, okanye ezingenakulinganiswa neziphumo zeFNA. Uvavanyo kufuneka lulungiswe ukuba lwenziwa njengenxalenye yenkqubo ye-biopsy.
Uphi i-FNA eyenziwe?
Uninzi lwe-FNA lwenziwa kwiofisi yegqirha, nangona ezinye zingenziwa njengophenyo lwangaphandle .
UDkt. Oertel, ke, ucebisa ukuba izigulane zifumane i-FNA ngaphandle kwesibhedlele. Nangona le nkqubo ikhuselekile ngokuqhelekileyo, kwaye izinto zihlala zingalunganga, kunomngcipheko omncinci wokumisa isisu, kodwa oko kungathathwa ngokukhawuleza kwisibhedlele.
Yintoni i-FNA ekhokelwa yi-Ultrasound?
Xa isigxina sinokuthi sinokutshatyalaliswa-isichaza, unokuyiva ngesandla sakho - iingcali ezininzi azidingi ukusebenzisa i-ultrasound ukukhokela inkqubo ye-FNA.
Ezinye izigulane ziphantsi kakhulu okanye ziyakwazi ukuziva xa ugxininisa, okanye awukwazi ukuvalelwa kodwa zithathwa yi-ultrasound, i-cat scan okanye i-MRI. Kule meko, ugqirha unokusebenzisa i-ultrasound ukuqinisekisa ukuba i-FNA ichanekileyo.
Mngcipheko
I-Froid ye-Thybia ibhekwa ngokukhuselekileyo, kwaye ayifumaneki nayiphi na ingxaki.
Ngaba Kuya Kubuhlungu?
Oko kuxhomekeke kwizakhono zengcali, ingcinga yakho yentlungu.
Abanye oogqirha baya kusebenzisa i-lidocaine, i-anesthetic yasekuhlaleni, ukuze banqande isayithi elitsha. Kodwa izigulana zikhalazela ukuba oku kunokulimaza ngaphezu kwenkqubo ye FNA. Ezinye iingcali zisebenzisi i-anesthetic. KwiNgqungquthela yaseTyCa, uDkt. Oertel wachaza ukuba akayisebenzisi i-anesthetic, ukhetha ukusebenzisa ipakethe yeqhankqalazi ukuya kwincinci. Ingqiqo yakhe: inaliti ye-anesthetic idala isilonda kunye nokuvuvukala kwi-site injection engaphazamisa ukwazi ukufumana isampuli echanileyo.
Ubuhlungu kunye nokubuyiswa
Unokuba neentlungu ezincinane kunye nokuvuvukala kunye nokutyumla kwiindawo zokulinywa, kwaye mhlawumbi unzima ukugwinya. Buza ugqirha wakho malunga neengcebiso malunga neyeza zentlungu ye-FNA - abaninzi bancoma ukuthatha i-acetaminophen okanye ibuprofen njengoko ijoliswe ekunciphiseni nantoni na ihlazo.
Ungabuyela Emsebenzini?
Uninzi lwabantu lukhululekile ngokwaneleyo ukuba babuyele emsebenzini kumhla omnye okanye ngosuku olulandelayo emva kokuba ne-FNA.
Kodwa kufuneka ugweme umsebenzi omzimba kunye nemidlalo malunga namahora angama-24 emva kweFNA.
Iziphumo zokulindela
I-nodule iyakwazi ukuba nomhlaza xa inemingcipheko ethile:
- Izigulane ezinkulu: ngaphezu kwamangentimitha angama-4 banokuthi banomdlavuza kunamaqhuqhuva angaphantsi kwama-4 centimeters
- Iigunqa zamadoda ziyakwazi ukuba nomhlaza kuneentlobo zeentlobo zamabhinqa, nangona kunjalo, iinqununu kumabhinqa abakhulelweyo banokuthi banomdlavuza ngaphezu kweendundumanzi kumfazi ongakhulelweyo
- Isigulane esisodwa sisinomdlavuza ngaphezu kweendununu ezifumaneka kwi-"multinodular" ye-thyroid
- Iimododo kumntu ongaphantsi kwe-20 okanye ngaphezulu kwe-70
- Imbali yangaphandle yentamo ye-irradiation ebuntwaneni
- I-"cold" yokubonakalisa kwi-ultrasound, oku kuthetha ukuba i-nodule ayifuni iodode okanye yenza i-hormone ye-thyroid
Ekugqibeleni, ke, malunga neepesenti ezingama-5 zazo zonke iinqununu ze-thyroid zinomdlavuza.
Kuthiwani ukuba nguBenign?
Ukuba unogqirha obunobunzima, ugqirha wakho uya kuluphatha. Ukufumana ulwazi oluthe vetshe, funda ngee -nodules ze-thyroid, izilwanyana kunye nabahamba njengendawo yokuqala.
Kuthiwani Ukuba Kubuhlungu / Ngomhlaza?
Ukuba ufumene unomdlavuza we- thyroid , ukuyeka kwakho kuqala kufuneka kube yinqaku elilandelayo, isingeniso kumdlavuza we-thyroid , okuyiyona nto yokuqala yokufumana ulwazi malunga nomdlavuza we-thyroid, kuquka i-papillary , follicular, medullary, kunye nomhlaza we-aplastic , kuquka amaqela enkxaso kunye unyango olulandelayo. Isinyathelo sakho esilandelayo kufuneka ukuba ujoyine i-Thyroid Cancer Survivor's Association, kwaye usebenzise amathuba enkonzo yabo yokuxhasa isigulane.
Kuthiwani ukuba ayinakuqhelaniswa okanye ayinqunyiwe?
Ukuba i-nodule ayifanelekanga, ngexesha elidlulileyo, oogqirha baye batusa ukuhlinzwa ukuba basuse konke okanye inxalenye ye-thyroid. Kuphela i-20 ukuya ku-30% yeengqungquthela ezingavumelaniyo okanye ezingapheliyo ziqhenqa, nangona kunjalo. Oku kubangela ezininzi uphando olungenasidingo, kunye ne-hypothyroidism yonaphakade kwiintlobo zezi gulane emva kokuhlinzwa. Uvavanyo olukhululwe ngo-2011, inkqubo ye-Afirma Thyroid FNA Analysis, eyenziwa nguVeracyte, inqanda iziphumo ezingapheliyo / ezingapheliyo kwiigulane, ngokunjalo zinika iziphumo ezicacileyo ze-FNA, nokukhusela isidingo sokuhlinzwa kuma-70 ukuya kuma-80 ekhulwini kwezigulane ezingenazo / iinqununu ezingapheliyo, kodwa akukho mhlaza.
Ngaba Unako Ukuxilongwa Ngamanga?
Iziphumo ezingamanga, ezifana neziganeko ezingamanga zibonisa ukuba iziphumo zakho zeFNA ziyingozi xa ziba nomdlavuza, okanye iimpazamo ezibuxoki ezibonisa i-nodule enobungozi njengento engathandekiyo, iqhelekile kunokuba ucinge. Ezinye iingcali ziqikelela ukuba umyinge wama-2 ukuya kwe-4 ekhulwini kuwo onke amaFNA angaba yimiphumo yobuxoki.
ILizwi
Yaye ukuba unako ukufumana okungaqhelekanga okanye okungafumanekiyo kwaye ungenayo i-FNA ivavanywa usebenzisa inkqubo ye-Afirma Thyroid FNA Analysis, unokufuna ukuvavanywa ukuba uhlolisise i-nodule ngokuqinisekileyo ngaphambi kokuba uqhutywe ngophando.
Ukuba unemiphumo emibi kodwa unomngcipheko weengxaki zomdlavuza we-thyroid, ngokukodwa, kufuneka uqikelele ukufumana umbono wesibini kwi-FNA yakho. Kwaye, ukuba unemiphumo emihle ebonisa umdlavuza, imbono yesibini ibalulekile.
Unokuziva ungakhululekile ukuthetha oku ngogqirha wakho, okanye uzive ukuba kuya kuqondwa kakubi ngugqirha wakho, kodwa, njengoko uDkt. Oertel uthe kwintetho yakhe kwingqungquthela yaseTyCa, "Yiba nembono yesibini. mhlawumbi ungekho! "
> Umthombo:
> UDkt. Yolanda Oertel, iNkomfa ye-Thyroid Survivor's Association.