Ukuxilongwa kwe-Hypothyroidism, i-Thyroid Cancer kunye neNinzi
Ukongeza kwi -klinikhi ethile yokuhlola , iimeko ze-thyroid zifuna iimvavanyo ezithile kunye neenkqubo zokuqinisekisa ukuxilongwa. Inqaku elilandelayo liphonononga imigaqo eyahlukileyo yokuxilongwa.
Hypothyroidism
Ukukunceda ukuxilonga okanye ukulawula ngaphandle kwe-hypothyroidism, oogqirha baya kuqalisa ngokuhlolwa kwegazi okwenza i-hormone ye-thyroid-stimulating (TSH).
Ngomhla ka-2003, ii-laboratories ezininzi zaseMelika zineziqhelo eziqhelekileyo ukusuka kwi-0.5 ukuya ku-5.5. Nangona kunjalo, i- American Association of Clinical Endocrinologists iye yasandula ukuba icebo eliqhelekileyo lihlaziywe libe ngu-0.3 ukuya ku-3.0. Ngama-5.5 njengesiphelo esiphambili soluhlu oluqhelekileyo , i-TSH ngasentla kwinqanaba libhekwa njenge-hypothyroid. Ngaphantsi kwesikhokelo esitsha, kunjalo, i-TSH ngaphezu kwe-3.0 ingafunyanwa njenge-hypothyroid.
Qaphela: Abanye abaphengululi bakholelwa ukuba amazinga e-TSH kufuneka agcinwe kumazinga aphantsi ngexesha lokukhulelwa. (Jonga Ziziphi iiRang Ranges eziqhelekileyo Ngethuba leZithathu zokukhulelwa? )
Ezinye iimvavanyo zegazi ezinokwenziwa ukunceda ukufumanisa i-hypothyroidism ziquka:
- Ingqikithi yeT4 (i-Thyroxine iyonke) - ixabiso eliphantsi elipheleleyo leT4 kunye ne-TSH ephakamileyo ingabonisa i-hypothyroidism.
- I-T4 yamahhala (i-Thyroxine yamahhala) -nqanaba eliphantsi le-T4 kunye ne-TSH ephakamileyo ingabonisa i-hypothyroidism.
- Iyonke i-T3 (i- Total Triiodothyronine ) -Izinga eliphantsi elipheleleyo leT3 kunye ne-TSH ephakamileyo ingabonisa i-hypothyroidism.
- I-T3 yamahhala (i-Free Triiodothyronine) -nqanaba eliphantsi le-T3 kunye ne- TSH ephakamileyo ingabonisa i-hypothyroidism.
Izifo zikaHashimoto
I-Hashimoto's thyroiditis yinto yesifo esisodwa esona sizathu esiqhelekileyo se-hypothyroidism. Isigulane sikaHashimoto's thyroiditis sinobuchule obuphezulu be-TSH kunye ne-T3 ephantsi kunye ne-T4 (okanye i-Free T3 ne-Free T4).
Uxinzelelo oluphezulu lwe-autoantibodies - i-anti-TPO yamanqwelwana ngokuthe ngqo-nayo iyimpawu zesifo sikaHashimoto.
Izifo zeMangcwaba kunye neHyperthyroidism
Ukuchonga i-hyperthyroidism kudinga ukuhlolwa kwekliniki ngokupheleleyo, ngexesha apho ugqirha ahlola isigulane kunye ne-thyroid. I-Hyperthyroidism inokuqinisekiswa ngokusetyenziswa kweTSH, T4 (okanye i- Free T4 ), iT3 (okanye i-Free T3) kunye novavanyo lwe-Radioactive Iodine (RAI-U). Uvavanyo lwe-Iodine Update (RAI-U), olubonisa i-thyroid kunye nokukwazi ukufumana iodod, lisetyenziselwa ukuxilonga i-hyperthyroidism, kwaye uncede ubone ukuba i-hyperthyroidism ibangelwa zizifo ze-Graves. Ukuchonga izifo ze-Graves kwakhona kubandakanya ubungqina be-Antibodies ephezulu ye-Thyroid Receptor (TRAb) / I-Immunoglobulins ye-Thyroid-stimulating (TSI).
Ukujonga ngokubanzi indlela izifo ze-Graves kunye ne-hyperthyroidism efunyaniswa ngayo kule nkcazo: Ukuxilongwa kwezifo ze-Graves / Hyperthyroidism .
Goiter
Amanyathelo athile anokubandakanyeka ekuhloleni i-goiter:
- Ukuhlolisisa nokuqwalasela intanyeni yakho
- Ukuhlolwa kwegazi ukujonga ukuba i-thyroid yakho ivelisa ubuninzi be-hormone ye-thyroid
- Ukuhlolwa kwee-antibodies , ukuqinisekisa ukuba isifo esisisigxina esingaba sisisombululo sakho
- Uvavanyo lwe-ultrasound ukuvavanya ubuninzi bokwandiswa
- I-isotope ye-thyroid ihlola ukuba ivelise umfanekiso we-thyroid kwaye inikezele ngolwazi olubonakalayo malunga nohlobo lokukhulisa i-thyroid (inqaku: ngenxa yokonakala komntwana we-thyroid, oku akwenziwanga ngexesha lokukhulelwa okanye ukuncelisa)
Nodules
Iimodyuli zivame ukuhlolwa ngeendlela ezilandelayo:
- Ukuvavanywa kwegazi, ukujonga ukuba iifolothi zakho zivelisa i-hormone ye-thyroid
- I-iodine Uptake ye-radioactive (RAI-U)
- I-ultrasound yakho ye-thyroid, ukuchonga ukuba i-nodule isomekile okanye igcwalise amanzi
- I-needle-good aspiration okanye inaliti ye-biopsy yamagqabi akho, ukuvavanya ukuba i-nodule (s) ingaba nomhlaza
Ukususela ngo-2011, kuye kwafumaneka inkqubo ekhethekileyo ye- sindle yokufunwa kwenaliti , eyayiqhelisa iziphumo ze-FNA biopsy ezingapheliyo. Olu vavanyo lubizwa ngokuba yi- Veracyte Afirma Thyroid Analysis .
Cancer Cancer
Ukuxilongwa komhlaza we-Thyroid kunokubandakanya inani leenkqubo kunye neemvavanyo, kubandakanya ukuhlolwa ngokomzimba, i-biopsy, iimvavanyo zokucinga , kunye nokuhlolwa kwegazi. Eli nqaku linika umxholo wenkqubo yokuxilongwa.
Ngokubanzi, nangona kunjalo, kuwo wonke umntu ngaphandle kwezigulana ezikhulelweyo, i-RAI-U yenziwe ukwenzela ukukunceda ukuba i-nodules iyabanda, oko kuthetha ukuba banakho amathuba amakhulu okuba nomhlaza.
Ukuba i-nodule ikhunjulwa ngokuba ngumdlavuza, i- biopsy i- aspiration (FNA) ye-biopsy iqhutywe. I-Fluid kunye neeseli zisuswe kwiindawo ezahlukileyo zeengqungquthela, kwaye ezi sampulu zivandlakanywa ngumathambo. Iipesenti ezingama-60 no-80 zeemvavanyo ze-FNA zibonisa ukuba i-nodule iyingozi. Kuphela malunga nee-20 ze-FNA iimvavanyo zibonisa umdlavuza. Intsalela yamatyala ichazwa ngokuthi "uyakrokraza." Ngokuqhelekileyo, iigununu ezisolisayo zisuswe ngokugqithiseleyo kwi-biopsy, ukulawula okanye ukuxilonga umhlaza.
Umthombo
Braverman, MD, Lewis E., noRobert D. Utiger, MD. UWerner no-Ingbar I-Thyroid: Isicatshulwa esibalulekileyo kunye neZiklinikhi. 9th. , Philadelphia: Lippincott Williams & Wilkins (LWW), 2005.