Ukujonga i-Antithyroid izidakamizwa, i-iodine ye-radioactive kunye ne-Surgery
Unyango olungcono kakhulu lwe- hyperthyroidism yakho incike kwizinto ezininzi, ngenxa yezizathu zokukhupha kwakho kwixesha lakho, ubunzima bebhodi lakho kwimpilo yakho yonke. Ngelixa izidakamizwa ze-antithyroid (u-Tapazole, umzekelo) zingasetyenziselwa ukunceda umsebenzi we-thyroid ngokuqhelekileyo, ezinye iindlela zonyango-ezifana ne-beta-blockers-zinokucingwa ukuphucula iimpawu ze-hyperthyroid.
Izinketho ezinjenge-ablation ye-thyroid kunye ne-iodine ye-radioactive okanye ukuhlinzwa ukuze ususe i-gland (thyroidectomy) inokuqwalaselwa kwakhona.
Nangona zonke iindlela ezintathu zisebenzayo, zineendleko ezihlukahlukileyo kunye neziphumo ezinobungozi. Yingakho ingxoxo enononophelekileyo kunye noogqirha yakho iyalungelelaniswa ngaphambi kokuceba isicwangciso sonyango.
Imigaqo
Imishanguzo yesigqirha ngokuqhelekileyo yonyango oluphambili lwe-hyperthyroidism. Unokumiselwa nezinye iziyobisi ukukunceda ukulawula iimpawu ezihambelanayo.
Ngonyango lweAntithyroid
Injongo yezilwanyana ze-antithyroid kukufezekisa umsebenzi oqhelekileyo we-thyroid ngaphakathi kwinyanga okanye ezimbini zokuqala unyango. Emva koko umntu unokuqhubeka nokukhetha okulandelayo:
- Ukufumana unyango oluchanekileyo nge-iodine ye-radioactive okanye ukuhlinzwa
- Qhubeka nokusetyenziswa kwesicatshulwa se-antithyroid omnye unyaka okanye ezimbini, nethemba lokufumana ukuxolelwa (okunokwenzeka kakhulu kubantu abane-hyperthyroidism emninzi kunye nabancinci kubantu abano-goiter enkulu kunye nabashunayo)
- Thatha i-antithyroid yexesha elide
Nangona ukhathalelo lwezonyango olude lwe-antithyroid lukhangeleka (unethuba lokuxolelwa, unyango luya kuguqulwa, kwaye unokuphephela ingozi kunye neendleko ezihlobene notyando), ukuphazamiseka kukuba abaphandi baqikelela ukuba kuma-70 ekhulwini abantu baya kuphinda baphinde babuye unyango lweziyobisi lwe-antithyroid luyekile.
Izidakamizwa ezimbini ze-antithyroid ezifumaneka e-United States ziTapazole (methimazole, okanye i-MMI) kunye nepropylthiouracil (PTU). Ngenxa yokuba i-MMI ineempembelelo ezimbalwa kwaye ibuyisela i-hyperthyroidism ngokukhawuleza ngakumbi kune-PTU, i-MMI iyona khetho olukhethiweyo.
Oko kwathiwa, i-PTU isetyenziselwa ukuphatha i-hyperthyroidism ngethuba lokuqala lokukhulelwa kunye nabantu abafumana isiphepho se-thyroid . Kwakhona kunokuba kunikwe abantu abaye basabela kwi-methimazole kwaye abangafuni ukungena kwi-iodine okanye kwi-optics.
Ezinye iziphumo ezincinci ezinobungozi ezinxulumene nokuthatha i-MMI okanye i-PTU ziquka:
- Ukutshiza
- Rash
- Intlungu kunye nokuvuvukala
- I sizathu
- Fever
- Utshintsho kwintle
Okubaluleke kakhulu, ukulimala kwesibindi kunye nokuba yi-MMI okanye i-PTU (eqhelekileyo ngokugqithiseleyo) kungenzeka. Iimpawu zokulimala kwesibindi ziquka intlungu yesisu, i-jaundice, umchamo omnyama, okanye izibonda ezinobumba. Ngelixa lingaqhelekanga, imeko enokuthi isongela ubomi ebizwa ngokuba yi-agranulocytosis (ukwehla kwamaseli esifo-ntsholongwane emzimbeni wakho) inokwenzeka nge-MMI okanye i-PTU. Kubalulekile ukuba abantu bathathe la mayeza ukuba baxelele ugqirha wabo ngokukhawuleza ukuba bavelise iimpawu zentsholongwane njengomkhuhlane okanye umqala.
Beta I-Blocker Therapy
Nangona ingekho unyango lwe-hyperthyroidism, abantu abaninzi abane-hyperthyroidism baqeshwe nge-beta-adrenergic antptistist (eyaziwa ngokuqhelekileyo njengowokuthi ibheta-blocker).
I-beta-blocker isebenza emzimbeni ukunciphisa imiphumo ye-hormone ye-thyroid kwi-intliziyo kunye nokujikeleza, ngokukodwa ukukhawuleza kwenhliziyo, uxinzelelo lwegazi, ukunyanzeliswa, ukugubha, kunye neziqhelo ezingaqhelekanga. I-Beta blockers iyanciphisa izinga lokuphefumula, ukunciphisa ukujuluka okugqithiseleyo nokunyamezela ukushisa, kwaye ngokubanzi ukunciphisa iimvakalelo zokukhathazeka kunye nokuxhalabisa.
Iidakamizwa ze-Thyroiditis
Iifom ze-hyperthyroidism (ngokomzekelo, i-subacute thyroiditis okanye i- postpartum thyroiditis ), i-focus focal in therapy of therapy. Ukunciphisa ubuhlungu kunokuba kunikwe ubuhlungu be-thyroid nokuvuvukala, okanye i-beta blockers inokumiselwa iimpawu ezinxulumene nentliziyo.
Ngamanye amaxesha, isicatshulwa se-antithyroid simiselwe ixesha elifutshane.
Ablation
Iodine ye-radioactive (RAI) isetyenziselwa ukutshabalalisa izicubu ze-thyroid gland, eyaziwa ngokuba yi-ablation. Isetyenziselwa ukuphatha uninzi lwabantu abaxilongwa ngesifo se-Graves e-United States, kodwa asikwazi ukusetyenziswa kwabasetyhini abakhulelweyo okanye abancancisayo, okanye abantu abanomdlavuza we-thyroid ngaphezu kwe-hyperthyroidism yabo.
Ngethuba lonyango lwe-RAI, iodody i-radioods inikezwa njengomthamo owodwa, kwi-capsule okanye ngesisombululo somlomo. Emva kokuba umntu ephethe i-RAI, iithagethi ze-iodine aze angene kwi-thyroid, apho ikhanya khona iiseli ze-thyroid, ibonakalise kwaye ibulala. Ngenxa yoko, i-thyroid gland iyancipha kwaye umsebenzi we-thyroid uyancipha, uguqula umntu ophethe i - hyperthyroidism .
Oku kufuthi kubakho kwiiveki ezintandathu ukuya kwezi-18 emva kokungenisa iodine ye-radioactive, nangona abanye abantu bafuna unyango lwesibili lwe-RAI.
Kubantu abadala, abanesimo sempilo esinjengesifo senhliziyo, okanye abaneempawu ezibalulekileyo ze-hyperthyroidism, i-antithyroid (i-methimazole, ngokuqhelekileyo) isetyenziselwa ukulungelelanisa umsebenzi we -roid ngaphambi kokuba uphumelele kwi-RAI unyango. I-Methimazole inikwa kwakhona malunga neentsuku ezisixhenxe ukuya kwi sixhenxe emva kokuba unyango lwe-RAI kulaba bantu, kwaye ngokuthe ngcembe lugqithise njengoko umsebenzi wabo we-thyroid uhlala uqhele.
Iimpembelelo eziPhakathi kunye neengxaki
I-RAI ingaba nemiphumo emibi, kuquka i-nasusea, isisu somqala, kunye nokuvuvukala kweengqungquthela ze-saliva, kodwa ezi ziqhelekileyo zisesigxina. Ipesenti encinci yezigulane zisengozini yokutshatyalaliswa kwesifo se-thyroid emva kokuba i-RAI.
Ngaphezu koko, kukho ubungqina benzululwazi obonisa ukuba unyango lwe-RAI lunokubangela ukuphuhliswa okanye ukugqithisa kwezilwanyana zesifo se-Graves (i-orbitopathy). Nangona le nkqubela idla ngokukhawuleza kwaye imfutshane, izikhokelo ze-American Thyroid Association azicebisi ukunika unyango lwe-RAI kubantu abanesifo esifana nesifo esibi.
Ukuba unayo i-RAI, ugqirha wakho uya kuxoxa ngezinga leemitha kunye naluphi na amanyathelo okumele uyenze ukuthatha ukukhusela intsapho yakho okanye uluntu. Oko kwathiwa, qiniseka ukuba inani lemirhumo elisetyenziswa kwiyeza le-RAI lincinci kwaye alubanga umhlaza, ukungabikho komntwana okanye ukukhubazeka kokuzalwa.
Ngokuqhelekileyo, nangona kunjalo, kwiiyure ezingama-24 zokuqala emva kwe-RAI, thintela ukudibana kunye nokubanga. Kwiintsuku ezintlanu zokuqala okanye emva kwe-RAI, ukunciphisa ukuvezwa kwabantwana abancinci kunye nabasetyhini abakhulelweyo, kwaye, ngokukodwa, gweba ukuthwala abantwana ngendlela abaza kubonakala ngayo kwindawo yakho ye-thyroid.
Ukuhlinzwa
Utyando lwe-thyroid (olubizwa ngokuba yi-thyroidectomy) ngokuqhelekileyo lukhetho lokugqibela lokunyanga i-thyroid gland. Nangona ukususa i-thyroid gland kuyasebenza kakhulu ekuphatheni i-hyperthyroidism, unyango luyingozi, lubiza kwaye luyingozi.
Ngokubanzi, uphando lucetyiswa kwezi zilandelayo:
- Ukuba iziyobisi ze-antithyroid kunye / okanye i-RAI abazange bakwazi ukulawula imeko
- Ukuba umntu unobungozi kwiziyobisi ze-antithyroid kwaye akafuni unyango lwe-RAI
- Ukuba umntu unokrokrela, mhlawumbi unomdlavuza we-thyroid
- Ukuba umntu unendoda enkulu kakhulu (ikakhulukazi ukuba uyayinqanda indlela yokuhamba okanye yenza kube nzima ukugwinya), iimpawu ezinzima, okanye isifo seJerse
Xa unyango lwe-thyroid lugqirha, ugqirha wakho uya kugqiba isigqibo sokuba ingawususa i-thyroid ingqungquthela (ebizwa ngokuba yi-thyroidectomy yakho yonke) okanye inxalenye ye-gland (ebizwa ngokuba yi-thyroidectomy). Esi sigqibo asikho ngaso sonke isikhathi esilula kwaye sifuna ingxoxo nengqiqo.
Ngokuqhelekileyo, uhlobo oluthile lotyando olwenziwa ngalo luxhomekeke kwisizathu sakho se-hyperthyroidism. Ngokomzekelo, i-hormone enye ye-thyroid i-hormone ye-thyroid ehlala kwicala lasekhohlo ye-thyroid gland ingaphathwa nge-thyroidectomy encinane (kwicala lasekhohlo le-thyroid gland lisuswe). Ngakolunye uhlangothi, i-goiter enkulu ethatha amahlangothi omabini we-thyroid ingaphathwa nge-thyroidectomy yakho yonke.
Ulawulo lokuPhepha-uphando kunye neengozi
Ukuba ufumana i-thyroidectomy yakho yonke, i-hormone ye-thyroid iyimfuneko. Ngakolunye uhlangothi, nge-thyroidectomy ekhethekileyo, kukho ithuba elihle lokuba awuyi kufuna imithi ye-thyroid engapheliyo, nje ngokuba kukho i-gland eyaneleyo yokushiya ukuvelisa inani elaneleyo le-hormone ye-thyroid.
Njengoko naluphi na utyando, kubalulekile ukuphonononga ingozi ebunokuba nogqirha wakho. Ukuhlinzwa okwe-thyroid, ingozi inokuquka ukuphuma kwegazi, kunye nomonakalo kwimbilini yamanzi ephindaphindiweyo (kubangela ukuphazamiseka) kunye / okanye ingxaki ye-parathyroid (elawula ukulinganisela kwe-calcium emzimbeni). Nangona ugqirha we-thyroid owaziwayo, nangona kunjalo, le mngcipheko uncinci.
Ngexesha lokukhulelwa
Ngokuqhelekileyo ikwacetyiswa ukuba ukuba ibhinqa li-hyperthyroid kwaye iminqweno yokukhulelwa kungekudala iqwalasela unyango lwe-RAI okanye utyando lweenyanga ezintandathu ngaphambi kokukhulelwa.
Abafazi abakhulelwe abaneempawu kunye / okanye i-hyperthyroidism enomlinganiselo oyimfuneko kufuna unyango. Uphuhliso olucetywayo luyiyobisi ye-antithyroid, ukuqala nge-PTU kwi-trimester yokuqala kwaye ishintshela kwi-methimazole kwi-trimesters yesibini neyesithathu (okanye uhlala kwi-PTU).
Nangona la mayeza ayena mngcipheko kubasetyhini abakhulelweyo, umgudu wakho ugqirha ukuwusebenzisa njengendlela encinci ukulawula i-hyperthyroidism nokunciphisa ingozi ebangela ukuba wena kunye nosana lwakho.
Ngokuqhelekileyo, oogqirha bancomela umthamo omncinci omncinci oya kulawula imeko. Ekubeni zonke izidakamizwa ze-antithyroid ziyawela i-placenta, nangona kunjalo kubaluleke ngokukodwa ukulandela imiyalelo yesigqirha kwaye uqhubeke kunye ne-check-ups ezicetywayo (ezenzeka rhoqo kwiiveki ezimbini ukuya kwezine).
Ekutyelelweni kwezempilo, ngaphezu kokuvavanywa kwe-thyroid, i-pulse yakho, inzuzo yesisindo , kunye nobukhulu be-thyroid ziya kuhlolwa. I-Pulse kufuneka ihlale phantsi kwe-100 beats ngomzuzu. Kufuneka ujonge ukugcina ubunzima bakho kwiindawo eziqhelekileyo zokukhulelwa, ngoko uthetha nogqirha wakho malunga nokutya okufanelekileyo kwaye yiziphi iintlobo zomsebenzi osebenzayo ezifanelekileyo kwiimeko zakho zangoku. Ukukhula kwe-Fetal kunye ne-pulse kufuneka kwakhona kuhlolwe rhoqo ngenyanga.
Kwa bantwana
Njengabantu abadala, i-hyperthyroidism kubantwana inokuphathwa nge-antithyroid yonyango lonyango, i-iodine ye-radioactive okanye i-thyroidectomy.
Unyango olukhethiweyo kubantwana abane-hyperthyroidism yi-antityroid drug MMI, njengoko ithwala ubuncipheko obuncinci xa kuthelekiswa ne-RAI okanye ukuhlinzwa, kwaye kunemiphumo emibini efana ne-PTU. Ngethuba i-RAI okanye utyando okanye ezinye iindlela zokwakheka, i-RAI igwenywa kwabantwana abangaphantsi kweminyaka emi-5.
I-Medicine Complementary (CAM)
NgaseTshayina nakwamanye amazwe, amayeza aseTshayina ngamanye amaxesha asetyenziswa ukuphatha i-hyperthyroidism, mhlawumbi yedwa okanye kunye neziyobisi ze-antithyroid. Nangona indlela echanekileyo ingacacile, abanye bakholelwa ukuba izityalo zisebenza ngokuthintela ukuguqulwa kwe-thyroxine (T4) ukuya kwi-triiodothyronine (T3) nangokunciphisa iziphumo ze-T4 emzimbeni.
Kuhlolisiso olukhulu lokuphonononga, oluye lwavavanya izilingo ezilishumi elinesithathu zabantu abangaphezu kwe-1700 abane-hyperthyroidism, ukunyuka kwamayeza aseTshayina kwizidakamizwa ze-antithyroid kwaphumelela ekuphuculeni iimpawu kunye nokunciphisa imiphumo emibi yezidakamizwa ze-antithyroid kunye nokuphindaphinda kwamazinga (oku kuthetha ukuphindaphinda kwe-hyperthyroidism) kwabanye abantu. Kodwa abalobi besifundo, kodwa, baqaphele ukuba zonke ezi zilingo azizange zenziwe kakuhle. Ngenxa yobungakanani babo, abalobi babonisa ukuba akukho ubungqina obuqinileyo bokuxhasa ukuphumeza amayeza aseShayina emachiza ekunyanga kwe-hyperthyroidism.
Ekubeni amayeza aseTshayina (okanye ezinye iindlela zokwelapha) zingathintela amayeza akho kunye namazinga e-thyroid ngokungalunganga, kubalulekile ukuba uwathathe kuphela phantsi kokhokelo lwe-endocrinologist yakho.
Ngaphandle kwemifuno yaseTshayina, i- vitamin D iye yafumana ingqwalasela eninzi kwiindawo ze-thyroid. Ngoxa ikhonkco sele ifunyenwe phakathi kwe-vitamin D kunye nesifo se-thyroid esisodwa (isisifo se-Graves kunye nesifo sikaHashimoto), kusengacacanga ukuba oku kuthetha ukuthini, kuquka ukuba ukungabi nantlungu kwe-vitamin D kukubangelwa yinto yokukhubazeka kwe-thyroid.
Siyazi ukuba i-hyperthyroidism inokubangela ukuba ithambo linciphise (i-osteoporosis), ngoko ukuqinisekisa ukuba i-vitamin D efanelekileyo kunye nokudla kwe-calcium kubaluleke kakhulu. Iziko lezeMpilo lincoma ama-unit angama-600 ngamazwe (ii-IUs) ze-vitamin D ngosuku kubantu abadala abaneminyaka engama-19 ukuya kuma-70 no-800 ii-IU kubantu abadala abangaphezu kweminyaka engama-70. Oku kusithi, kusengumzekelo omuhle ukuqinisekisa i-dose yakho ye-vitamin D kunye nogqirha wakho. Unokuthi uncome ukuhlola izinga lakho levithamini D kunye nokuhlolwa kwegazi; Ukuba ungekhoyo, ungadinga ukuphakanyiswa kwamanani ngaphezu kwezi ziphakamiso zibonisa.
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