I-Nodules ye-Thyroid iyakwazi ngakumbi ukunyuka kobuninzi ngexesha lokukhulelwa
Ukukhulelwa kunokuchaphazela iinqununu ze-thyroid , ezivuyiweyo okanye izibilini kwi-thyroid gland, kwaye ingaba ubunzima obuqinileyo, okanye i-cyst egcwele amanzi. Uninzi lweengqungquthela ze-thyroid ziyingozi, kodwa ipesenti ezincinci zinomdlavuza.
ZeNyroid Nodules
Ngokutsho kwe-2011 "Izikhokelo ze-American Thyroid Association ye-Diagnosis kunye noLawulo lweZifo ze-Thyroid ngexesha lokukhulelwa kunye ne-Postpartum," iigununu ziqhelekile emva kokuba ukhulelwe, kwaye iigulane ze-thyroid ziyakwazi ukwandisa ubungakanani ngexesha lokukhulelwa .
Xa iinqununu zifunyanwe ngexesha lokukhulelwa, kucetyiswa ukuba loo ntokazi ibuzwe malunga nembali yakhe yentsapho yokugula okanye isifo se-thyroid esibi kunye neengxaki ze-endocrine, isifo esidlulileyo okanye unyango olubandakanya entanyeni (ngokukodwa, nayiphina imithi yokwelapha entloko okanye entanyeni ebuntwaneni ), kunye nokuba i-nodule ifunyenwe, kwaye ikhula ngokukhawuleza.
Izikhokelo zincoma ukuba bonke abafazi abaneengqungquthela ze-thyroid babe ne- TSH kunye ne-Free T4 . Ukuba umfazi unembali yentsapho ye-medullary thyroid carcinoma okanye i-endocrine neoplasia (i-MEN) 2, amazinga e-calcitonin kufuneka alinganiswe.
Ngokutsho kweZikhokelo, i-ultrasound inconywa ukucacisa iimpawu ze-nodule, kwaye ilandele ukukhula kwazo. Ukuba i-nodule ingaphantsi kwe-10mm ngosayizi, i -aspiration-aspiration aspiration (FNA) ye-biopsy ye-thyroid ayifuni ngaphandle kokuba kukho izikhankaso.
Ukuba i-nodule ikhula, okanye ukuba kukho ukukhwehlela okuqhubekayo okanye iingxaki zezwi, okanye nayiphi na isalathisi esikhankanya imbali, izikhokelo zincoma ukuba kwenziwe i-FNA.
I-FNA ithathwa njengekhuselekile ngexesha lokukhulelwa.
Ukusetyenziswa kwe-radionuclide ukuskena kwe-nodule-eyinto eqhelekileyo yeengqungquthela ezinokukrokra ngaphandle kokukhulelwa-iyachithwa ngexesha lokukhulelwa, ngenxa yokukhathazeka ngokubhekiselele kwimibala emzimbeni. Ngokutsho kweZikhokelo, uphando oluthile lweengxelo lubonise, nangona kunjalo, ukusetyenziswa kakubi kwe-RAI phambi kweeveki ezili-12 zesigxina akuzange kubonakale kubonakalisa i-thyroid fetal.
Ngeengqungquthela ze-thyroid ezinobungozi, izikhokelo zibonisa ukuba akukho unyango. Ukuba iigunyuli zibonisa ukukhula ngokukhawuleza, utshintsho olukrokrezayo lomhlaza, kufuneka kuqhutywe iFNA. Ukuba iigununu zinyanzelisa i-trachea okanye i-esophagus, utyando lwe-thyroid lunokuqwalaselwa .
Cancer Cancer
Ukuba umhlaza we-thyroid ufunyenwe, uhlobo lomhlaza we-thyroid lubangela unyango. Ukuze umhlaza we-thyroid ufumaneke ngexesha lokukhulelwa, izikhokelo zibonisa ukuba utyando lugqithiselwa ngokubanzi emva kokuhanjiswa.
Ukuxilongwa komhlaza we-thyroid, unyango luyanconywa ngexesha lokukhulelwa xa kukho i-tumor enkulu enkulu, okanye isasazeka ngokubanzi kwi-lymph nodes.
Igalelo le-thyroidectomy ngexesha lokukhulelwa liye lafundiswa, kwaye ngokuqhelekileyo, ukuba utyando lwe-thyroid lwenziwa ngelixa lesibini le-trimester, alinakunxulumene nomngcipheko wokubeleka komntwana okanye umntwana.
Izikhokelo zincoma ukuba ukuba utyando lomhlaza wesifo se-thyroid uhlehliswa kude kube emva kokuhambisa, i-ultrasound kufuneka yenziwe ngekota nganye ukujonga ukukhula kancinci ngokukhawuleza. Xa kukho ukukhula okukhawulezileyo, okanye kusasazeka kwi-lymph nodes, utyando luyacetyiswa.
Ngomfazi onomdlavuza we-thyroid ohlukileyo ochaza unyango kuze kube emva kokuhambisa, unyango lwe-levothyroxine lunokusetyenziswa, ngenjongo yokukhupha izinga le-TSH ukuya kwi-0.1-1.5mIU / L.
Ukunyanga i-Hypothyroidism kwiNtsholongwane yeChrown Cancer
Ngokutsho kwezi Khokelo, kubasetyhini abanomdlavuza we-thyroid, i-TSH ingagcinwa ngaphantsi kwe-0.1 mIU / L ngexesha lokukhulelwa. Kubasetyhini abangenasifo somdlavuza we-thyroid kodwa abanomdla wengozi ephezulu ngexesha elidlulileyo, ukunyanzelwa kufuneka kugcinwe kumazinga eTSH phakathi kwe-0.1 mIU / L kunye ne-0.5 mIU / L. Kwizigulane ezingekho phantsi kweengozi ezingenazo iimpawu zomhlaza we-thyroid, i-TSH ingagcinwa kwisithuba esiphantsi soluhlu oluqhelekileyo (0.3-1.5 mU / L).
Ngokuqhelekileyo, abasetyhini abakhulelweyo abasebenzisa i -hormone ye-thyroid emva kwesifo somhlaza we-thyroid bafuna ukwanda kwenani le-dose xa kuthelekiswa nabasetyhini abane-hypothyroid ngenxa yezinye iingxaki.
Izikhokelo zincoma ukuba kula mabhinqa, i-TSH iya kujongwa rhoqo emva kweeveki ezi-4 ngexesha lokukhulelwa, ukuya kwiiveki ezingama-16 ukuya kwe-20 zesigxina, kwaye kwakhona ubuncinane kanye phakathi kweeyure ezingama-26 ne-32 zesigxina.
I-RAI unyango lweCarcer kunye nefuthe ekukhulelweni okulandelayo
Abaphandi abafumananga ukwanda kwintsholongwane, ukukhulelwa kwesisu, ukuzalwa komntwana, ukufa komntwana, ukuzalwa komntwana, ukuzalwa kwangaphantsi, ukuzala okuphantsi, okanye ukufa ngonyaka wokuqala wokuphila emva kokunyanga kwe-iodine (RAI) yomhlaza we-thyroid . Noko ke, kukho umngcipheko wokukhulelwa kwesisu kwiinyanga ezilandelayo i-RAI ezinokubangelwa ukulawula okwaneleyo amahomoni e-thyroid . Izikhokelo zincoma ukulinda ubuncinane iinyanga ezintandathu emva kwe-RAI ukuqinisekisa ukulawulwa kwe-thyroid eyiyo ngaphambi kokuba ukhulelwe.
Ukukhulelwa akubonakali kwandisa umngcipheko wokuphindaphinda umdlavuza we-thyroid kubasetyhini abangenayo isifo ngaphambi kokuba bekhulelwe. Kubasetyhini abanalo naliphi na umhlala-mdlavuza we-thyroid, mhlawumbi ngokwemibala ebonakalayo ye-thyroid, okanye kwizinga eliphezulu le-thyroglobulin (Tg), ukukhulelwa kungakhuthaza ukukhula komdlavuza we-thyroid.
Ukuba ibhinqa inomdlavuza we-thyroid oye waphathwa ngaphambili, kunye namazinga e-thyroglobulin (Tg) angabonakaliyo, akukho kuhlola okukhethekileyo ngexesha lokukhulelwa. Nangona kunjalo, izikhokelo zincoma i-ultrasound ngexesha lekota nganye kwintombazana eyayiphathwe ngaphambili ngenxa yomdlavuza we-thyroid eyahlukeneyo enezinga eliphezulu le-Tg okanye naluphi na ubungqina besifo esiqhubekayo.
> Umthombo:
> Stagnaro-Green, Alex, kunye. al. "Izikhokelo ze-American Thyroid Association ye-Diagnosis kunye nokuLawula izifo ze-Thyroid ngexesha lokukhulelwa kunye ne-Postpartum." Thyroid . Umqulu 21, iNombolo 10, 2011 (i-Intanethi)