Zachidule Zokhudza Mankhwala a Chithokomiro
Chithandizo cha matenda anu a chithokomiro chimadalira mtundu wa vuto la chithokomiro komanso ngati chithokomiro chanu chimakhala chopitirira muyeso, chopanda mphamvu, chokulitsa, kapena chikudwala khansa. Nazi mwachidule za mankhwala osiyana omwe amaperekedwa chifukwa cha chithokomiro.
Matenda a Hyperthyroidism / Graves '
Pamene chithokomiro chanu chimakhala chopweteka kwambiri kapena chimakhala chopitirira muyeso-chikhalidwe chodziwika kuti hyperthyroidism- mukupanga mahomoni ambiri a chithokomiro.
Nthawi zambiri mankhwalawa amayamba chifukwa cha matenda a Graves , kapena nthawi zina chifukwa cha mitsempha ya chithokomiro yomwe imatulutsa mahomoni ambiri otchedwa thyroiditis kapena thyroiditis.
Hyperthyroidism imatetezedwa ndi kuteteza kuti chithokomiro chikhale ndi mahomoni ambiri, kuchepetsa mphamvu ya chithokomiro yotulutsa mahomoni, kapena kuchotsa opaleshoni. Makamaka, mankhwalawa ndi awa:
- Mankhwala a Antithyroid , kuphatikizapo methimazole (Tapazole), propylthiouracil (PTU), ndi carbimazole (Neo-Mercazole). Chifukwa chakuti PTU nthawi zina imayanjanitsidwa ndi zotsatira zina zoopsa, methimazole imatengedwa kuti ndi mankhwala osokoneza bongo a antithyroid ku US (PTU), komabe, akuyenera kuchiritsidwa panthawi yoyamba yoyamba ya mimba chifukwa cha chiopsezo chochepa cha zolepheretsa kubadwa zomwe zimagwirizana ndi methimazole.)
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Hyperothyroidism Kawirikawiri Yosakhululukidwa ndi Levothyroxine ndi Yachizolowezi TSH
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Kuteteza Banja Lanu Pambuyo Kuchiza Mankhwala Othandiza Odwala
- Chithandizo cha mankhwala a iodin (RAI) , omwe amadziwikanso kuti amathandizira radioiodine. Mankhwalawa akuphatikizapo kutenga mlingo wa ayodini wothandizira mavitamini, omwe amatenga chithokomiro ndipo amawononga-kapena amawononga-zonse kapena mbali imodzi ya mphamvu ya gland yopangira hormone ya chithokomiro.
- Kutsegula kuchotsa zonse kapena mbali imodzi ya chithokomiro, yotchedwa thyroidectomy.
- Nthawi zina, zizindikiro za hyperthyroidism zofooketsa monga kufulumira kwa mtima, kupopera, kapena kuthamanga kwa magazi amathandizidwanso ndi mankhwala otchedwa beta blockers.
Kawirikawiri, njira yomwe imagwiritsidwa ntchito pa chithandizo imadalira kukula kwa matenda anu, ngati mungathe kulekerera mankhwala osokoneza bongo, komanso ngati muli ndi pakati kapena mukukonzekera kutenga mimba mwamsanga.
Geography ndi chinthu chimodzi, chifukwa mumatha kupezeka RAI ku United States-poyerekeza ndi opaleshoni kapena mankhwala osokoneza bongo. Ku US, opaleshoni siyikuchitika kawirikawiri kwa hyperthyroidism, pokhapokha mutakhala ndi pakati ndipo simungathe kulekerera mankhwala osokoneza bongo. Kunja kwa US, mankhwala othandizira mankhwala osokoneza bongo amatha kukhala chithandizo choyamba cha mankhwala, ndipo opaleshoni imagwiritsidwa ntchito kwambiri, makamaka kwa ana ndi akazi a msinkhu wobereka.
Njira zina zothandizira anthu odwala matendawa ndi mankhwala ochepetsera / ochizira (BRT), kuphatikizapo mankhwala osokoneza bongo otchedwa hormone komanso mankhwala osokoneza bongo.
Odwala ambiri a chithokomiro omwe amalandira chithandizo cha RAI kapena opaleshoni amatha kutulutsa hypothyroid, ndipo amachiza mankhwala osokoneza bongo .
Othandizira ena amalimbikitsa kuchepetsa kupanikizika ndi njira zoyendetsera ntchito monga kusinkhasinkha, kusamalitsa zakudya zamagetsi komanso kusintha kwa zakudya, mankhwala achi China, ndi njira zina zonse zomwe zingathandize chithokomiro chowonjezera.
Zopereka Zogwira Ntchito
Goiter amatanthauza chithokomiro chofutukuka , chomwe chingapangidwe mu hypothyroidism ndi hyperthyroidism.
Malingana ndi kukula ndi malo, ngati muli ndi goiter, zingayambitse kumverera kwanu, kupweteka, komanso kawirikawiri, zingakhale zovuta kuzimeza kapena kupuma.
Ngati muli ndi goiter yaing'ono yomwe siili chizindikiro ndipo siyimakhala ndi zovuta zomwe mumakhala mu chithokomiro chanu, dokotala wanu angasankhe kuyang'anira-osasamalira-wanu goiter.
Kwa kachilombo kakang'ono, kosautsa, madokotala amakuchititsani mankhwala osokoneza bongo . Nthawi zina, mankhwalawa amatha kuchepetsa kapena kuchepetsa kukula kwa goiter koma sangathe kuwongolera.
Ngati goiter yanu ndi yayikulu, ikupitirizabe kukula ngakhale kuti ili ndi mahomoni a chithokomiro, amakuvutitsani kwambiri, kapena akutsutsana ndi kumeza kapena kupuma, dokotala wanu angalimbikitse kuti ayodini yothandizira mavitamini (RAI) kuchepetsa chithokomiro chanu, kapena opaleshoni kuchotsa zonse kapena gawo lanu chithokomiro gland.
Pankhani ya goiter yomwe imachokera ku kusowa kwa ayodini, dokotala wanu angakonzekere ntchito ya ayodini yowonjezeretsa.
Matenda a Chithokomiro
Matenda ambiri a chithokomiro ali abwino. Kwazing'ono, zovuta kwambiri zomwe zimapangitsa kuti asakhale ndi zizindikiro, akatswiri ambiri amasankha kufufuza odwala. Chiŵerengero chachikulu cha anthu-akatswiri ena amasonyeza anthu ambiri-ali ndi mitsempha yotereyi, ndipo sakufuna mankhwala ena.
Kwa mavotolo oyipa omwe amachititsa kuti matendawa akhale oopsa, kawirikawiri njira yopangira chithandizo cha mankhwala a chithokomiro ndi mankhwala otchedwa levothyroxine , omwe nthawi zina amawombera minofu, amachititsa kuti mitsempha isapitirire kukula, komanso kuthandizira kupewa mitsempha yambiri. Chifukwa chakuti mankhwalawa ndi othandiza kwambiri kwa ochepa chabe odwala, levothyroxine mankhwalawa amavomereza kuti ndi ovuta.
Nthaŵi zina, ngati nodules ikuphatikiza ndi hyperthyroidism, iodine radioactive (RAI) ntchito, kuchepetsa nodule ndi chithokomiro gland. Ngati benign nodule ndi yaikulu komanso yosamvetsera mankhwala kapena RAI, opaleshoni nthawi zambiri amalimbikitsa.
Njira ina yogwiritsira ntchito mitsempha ndi jekeseni wothira mafuta m'thupi (PEI) , kumene mimba imathamanga ndi jekeseni.
Njira ina yowonjezera yopanda opaleshoni yopanga majekeseni ndi teknoloji yapamwamba kwambiri ya ultrasound .
Ngati nthendayi kapena majekeseni ambiri atsimikiza kuti ali ndi khansa, chithokomiro chanu nthawi zambiri chimachotsedwa onse kapena mbali. Pankhani ya matendawa , njira zothandizira khansa ya chithokomiro zimatsatiridwa pogwiritsa ntchito mtundu wa khansara.
M'mbuyomu, chithokomiro chinachitidwa patatha nsonga zabwino za singano (FNA) zomwe zimasonyeza kuti sizingatheke, koma kachilombo ka Veracyte Afirma Thyroid Analysis kachepetsa kwambiri zotsatirazi ndipo zimapangitsa opaleshoni yosafunikira .
Zotsatira zowonjezereka za chithandizo cha mitsempha zimayikidwa mu American Association of Clinical Endocrinologists ' Medical Guidelines for Clinical Practice kwa Kuzindikira ndi Kusamalira Mankhwala a Chithokomiro.
Chithandizo cha Thyroiditis
Chithokomiro chimatanthauzira kutupa kwa chithokomiro chanu. Ngakhale kuti Hashimoto's thyroiditis ndi yofala kwambiri, pali mitundu ina ya chithokomiro, kuphatikizapo post-partum thyroiditis, De Quervain's (yomwe imatchedwanso subacute kapena granulomatous) thyroiditis, ndi tizilombo toyambitsa matenda, pakati pa ena.
Monga taonera, nthawi zina, Hashimoto's thyroiditis amachizidwa ndi mankhwala a chithokomiro . Matenda a thyroiditis omwe ali opweteka, madokotala amawalimbikitsa kupweteketsa ndi mankhwala osapsa, monga aspirin, ibuprofen (Advil / Motrin), kapena naproxen (Aleve).
Ngati chithokomiro chimakhala chovuta kwambiri, madokotala nthaŵi zina amalimbikitsa mankhwala osokoneza bongo kuti asachepetse kutupa, komanso mankhwala osokoneza bongo otchedwa hormone m'malo mwake, kuti atenge chithokomiro kuti apumule kuntchito yake yopanga mahomoni.
Pamalo opatsirana zakudya, palinso umboni wina woti kupatsirana ndi mchere wa selenium kungathandize chithokomiro.
Nazi zambiri zokhudza mitundu yambiri ya thyroiditis :
- Riedel's thyroiditis
- subacute granulomatous thyroiditis
- tizilombo toyambitsa matenda
- thyroiditis yopweteka
- postpartum thyroiditis
Chithandizo cha khansa ya chithokomiro
Pali mitundu inayi yosiyanasiyana ya khansara ya chithokomiro: papillary, follicular, medullary, ndi amaplastic . Mankhwala a kansa ya chithokomiro amachokera ku mtundu wa khansara, ndipo nthawi zina, kupititsa patsogolo-momwe khansara yathawira ku mbali zina za thupi-komanso ngati khansara yatsopano kapena khansara yowonongeka.
Mankhwala a kansa ya chithokomiro ndi awa:
- Opaleshoni kuchotsa khansa, yotchedwa thyroidectomy . Odwala ena amalandira lobectomy, yomwe imachotsa mbali imodzi ya chithokomiro. Chithokomiro chokwanira chapafupi chimachotsa pafupifupi mtundu wonsewo. Chithokomiro chonsecho chichotsedwa mu chithokomiro chonse. Nthawi zina amachititsa opaleshoni ya chithokomiro, kuti ayese kufalikira kwa khansa ya chithokomiro.
- Mankhwala othandiza mazira kuti aphe khansa. Kwa khansa ya chithokomiro, mankhwalawa amapezeka makamaka mu madzi kapena mapiritsi omwe ali ndi ayodini yotulutsa radioactive (RAI). Chithokomiro chimayambitsa ayodini, ndipo mawonekedwe a ayodini amawotchera m'matumbo a chithokomiro ndipo amapha maselo a khansa. Nthaŵi zina, mankhwalawa amachokera kunja kwa thupi, makamaka pa chithokomiro, ndipo amadziwika kuti ndizomwe zimatuluka kunja.
- Mankhwala opanga mahomoni, pogwiritsira ntchito mankhwala osokoneza bongo . Pambuyo pa opaleshoni ya chithokomiro kapena RAI, mumatha kukhala hypothyroid, ndipo mumakhala mankhwala osokoneza bongo omwe mumakhala ndi mankhwala osokoneza bongo. Nthaŵi zina, madokotala amalimbikitsa mlingo womwe udzateteze TSH yanu kapena yosaoneka, kuti iteteze khansara ya chithokomiro kuti isabwererenso.
- Mankhwala othandizidwa, kuphatikizapo mankhwala osiyanasiyana osiyanasiyana a kansa ya chithokomiro, kuphatikizapo omwe sagwirizana ndi mankhwala opatsirana a iodine.
- Chemotherapy si yachilendo, koma ingagwiritsidwe ntchito nthawi zina, makamaka pofuna kuthetsa zizindikiro.
Matenda a Hyperothyroid / Matenda a Hashimoto
Hypyothyroidism ndi matenda omwe chithokomiro sichimawonongeka, chiwonongeko chamagetsi, kapena kuchotsedwa opaleshoni, choncho sichikhoza kutulutsa mahomoni otentha a chithokomiro. Ife tazisiya izo potsiriza chifukwa, mochuluka, mankhwala ambiri a chithokomiro-chifukwa amachititsa kuti radioactively ablating kapena opaleshoni kuchotsa chithokomiro-nthawi zambiri amatha kukhala hypothyroid.
Hypothyroidism imachiritsidwa m'malo mwa mahomoni omwe akusowa, mahomoni omwe ali ofunikira ku ntchito zazikulu za thupi. Izi zimachitidwa mwa kutenga mankhwala otentha a hormone m'malo mwa madokotala.
Mankhwala osokoneza mavitamini a chithokomiro m'malo mwa mahomoni otchedwa thyroid m'thupi lanu. Zina mwa izi ndi izi:
- Mankhwala omwe amachititsa kuti mankhwala a chithokomiro asamalowe m'malo ena amadziwika kuti levothyroxine, omwe amachititsa kuti utomoni wa thyroid wotchedwa Thyroxine (T4) ukhale wotani. Maina omwe amadziwikanso ndi Synthroid, Levoxyl, Unithroid, ndi Tirosint.
- Palinso mawonekedwe a mtundu wa T3, wotchedwa liothyronine, omwe nthawi zina amauzidwa ndi levothyroxine kwa T4 / T3 mankhwala othandizira. Dzina lachidziwitso ku US ndi Cytomel.
- Komanso pali mankhwala ena otchedwa hormone omwe amatchulidwa kuti amatulutsa chithokomiro, nthawi zina amamasuliridwa kuti NDT kapena amatchedwa "chithokomiro cha chithokomiro." Ngakhale kuti zakhala zikupezeka kwa zaka zopitirira zana ndipo zikugwiritsidwanso ntchito lero, NDT imalingaliridwa ndi kutsutsana ndi gulu lachipatala, koma limaperekedwa mobwerezabwereza ndi madokotala onse ogwira ntchito. Mayina omwe amagwiritsidwa ntchito amodzi amakhala monga mafilimu, chida chankhondo, ndi WP chithokomiro.
Kuchiza kwa matenda a Hashimoto, chikhalidwe chomwe chimayambitsa nthawi zambiri chimayambitsa hypothyroidism, ndizovuta kwambiri. Akatswiri ambiri amakhulupirira kuti Hashimoto sasowa chithandizo chamankhwala, ndipo amachiza mankhwala osokoneza bongo omwe amachititsa kuti Hashimoto apangidwe ndi hypothyroidism. (Phunzirani zambiri za kusiyana kwake: Hashimoto vs. Hypothyroidism: Kodi Kusiyana Ndi Chiyani?)
Akatswiri ena amakhulupirira kuti matenda a Hashimoto, omwe angatsimikizidwe ndi kuyesa tizilombo toyambitsa chithokomiro , amavomereza chithandizo kwa odwala ena omwe ali ndi zizindikiro, ngakhale ngati chithokomiro china ndi chachilendo. Palinso umboni wina wotsimikizira kuti matenda a Hashimoto ndi mankhwala a chithokomiro m'malo mwa chithokomiro choyambitsa timadzimadzi (TSH) chikhoza kuchepetsa zizindikiro zina. Kafukufuku wina akuwonetsanso kuti kuchitira munthu wina ndi Hashimoto omwe ali ndi mayeso oyenera a magazi, kuphatikizapo chiwerengero cha TSH , kumathandiza kuchepetsa kukula kwa TSH ndi kukula kwa hypothyroidism. Komabe, kupereka mankhwala a Hashimoto pamene TSH ndi yachilendo kumatsutsana.
Malo awiri atsopano ochiritsidwa ndi chithandizo cha Hashimoto: kugwiritsa ntchito mlingo wa mankhwala osokoneza bongo naltrexone (LDN) ndi autologous stem cell transplants. Zotsatira zonsezi zingathandize kuchepetsa mphamvu zowonjezera ma antibade ndikupulumutsira odwala ena.
Pa mankhwala ophatikizira patsogolo, akatswiri ena amachititsa kuti ayodine supplementation , zakudya zina zowonjezera zakudya, kusintha kwa zakudya, ma yoga ena, mankhwala a thupi, ndi njira zina zothandizira chithokomiro.
Njira zina zothandizira mankhwala ndi:
- Supplementation ndi selenium pofuna kuchepetsa tizilombo toyambitsa matenda
- Kutchula kusamvetseka kwa adrenal komwe kungakhale kovuta kwambiri chithandizo cha chithokomiro
- Kusintha kwa zakudya kumachepetsa kutupa
- Kuthetsa gluten ku zakudya chifukwa cha kugwirizana pakati pa gluten ndi kudziletsa
- Kusokonezeka maganizo ndi kusamalira
Mawu Ochokera
Pankhani yosankha chithandizo cha chithokomiro, muyenera kudziwa zambiri. Choyamba choyambira chiri pano, ndi zathu zonse zokhudza mavuto onse a chithokomiro .
Muyeneranso kupeza dokotala wabwino kwambiri wa chithokomiro nokha , ndikuyanjana naye. Ndipo kumbukirani: Musazengereze kupeza lingaliro lachiwiri pa chisamaliro chanu cha chithokomiro ngati muli ndi mafunso okhudza chithandizo chanu.
Zotsatira:
Bahn R, Burch H, Cooper D, et al. Hyperthyroidism ndi Zina Zimayambitsa Thyrotoxicosis: Malangizo Otsogolera a American Thyroid Association ndi American Association of Clinical Endocrinologists . Chitetezo cha Endocrine . Vol 17 No. 3 May / June 2011.
> Garber J, Cobin R, Gharib H, et al. Malangizo Othandizira Amagulu a Hypothyroidism Aakuluakulu: Olembedwa ndi a American Association of Clinical Endocrinologists ndi American Thyroid Association . Chitetezo cha Endocrine . Mph. 18 No. 6 Novemba / December 2012.
Smallridge R, Ain K, Asa S, et al. Maphunziro a Chithokomiro cha American Thyroid Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Chithokomiro . Vesi 22, Nambala 11, 2012: 10.1089 / wanu.2012.0302
A stagnaro-Green A, Abalovich M, Alexander E. et al. Malangizo a Association of American Thyroid Association ya Kuzindikira ndi Kusamalira Matenda a Chithokomiro Pakati pa Mimba ndi Postpartum. Chithokomiro . Volume 21, Number 10, 2011: 10.1089 / thy.2011.0087
Wells S, Asa S, Dralle H, et al. Buku la American Revised American Thyroid Association (Guidelines for Management of Medullary Thyroid Carcinoma). Chithokomiro . Vesi 25, Nambala 6, 2015. do: 10.1089 / thy.2014.0335