Kodi muli ndi chithokomiro chofutukuka? Ngati dokotala wapeza kuti muli ndi matenda a chithokomiro, khungu la chithokomiro, kapena kutulutsa chithokomiro chomwe chimadziwika kuti goiter-mudzafuna kudziwa zambiri za zizindikiro, zizindikiro, mayesero, ndi chithandizo cha mankhwalawa.
Kodi Cholinga Chotani?
Mawu akuti goiter akunena pazochitika zilizonse pamene chithokomiro chanu chasintha kwambiri.
Matenda a chithokomiro achibadwa amatha kulemera pafupifupi ounce ndipo sawoneka kunja. Koma ndi goiter, chithokomiro chimakula mokwanira kotero kuti kusintha kukuwoneka ndi ultrasound kapena x ray, ndipo nthawi zina, khosi lanu likhoza kusonyeza mtanda kapena bulge.
Goiter ikhoza kuchitika pazinthu zingapo:
- pamene mankhwala anu a chithokomiro akupanga hormone yambiri ya chithokomiro (hyperthyroidism)
- pamene chithokomiro chanu sichikutulutsa mahomoni otchedwa thyroid (hypothyroidism)
- pamene muli ndi matenda a chithokomiro - Matenda a Graves kapena matenda a Hashimoto -omwe amachititsa kutupa m'matenda anu
- pamene muli ndi mitsempha imodzi kapena yambiri ya chithokomiro
- pamene muli ndi khansa ya chithokomiro
- pamene muli osowa ayodini
Zizindikiro Zowonetsera ndi Zizindikiro za Otsogolera
Zizindikiro za goiter zikuphatikizapo:
- kutambasula kwa pakhosi
- chotupa chooneka kapena kutupa m'kati mwa khosi
Tawonani, kuti zina zochitika za goiter zingakhale zosaoneka kunja, ndipo zimangodziwika ndi mayesero.
Zizindikiro za goiter zikuphatikizapo:
- kukoma mtima kukhudza
- kumverera kwodzaza mu khosi
- kumverera kwachisokonezo pa mphepo yanu kapena mphuno yanu
- kuvutika kukumeza, kapena kumverera kuti chakudya chimakhala pakhosi pako
- kupuma pang'ono kapena kupuma kovuta, makamaka usiku
- kutsokomola
- zosasangalatsa
- osagwirizana ndi ziphuphu, zomangira, ndi zofiira
Nthawi zina, mukhoza kukhala ndi hypothyroidism kapena zizindikiro za hyperthyroidism zomwe zikugwirizana ndi goiter.
Nthawi zina, goiter sangayambitse zizindikiro.
Mayesero & Ndondomeko Zowunikira Goiter
Kuzindikira kwa goiter nthawi zambiri kumawonekera kapena mwachangu pa kafukufuku wamakono ndi dokotala wanu. Nthawi zina, goiter ikhoza kupezeka pazithunzi zojambula.
Pamene goiter ikudziwika, sitepe yotsatira ndiyo kufufuza zomwe zimayambitsa ndikudziwitsani kuti chithokomiro chosawonongeka chasintha bwanji. Kuwunika kumeneku kumaphatikizapo mayesero a chithokomiro, kuphatikizapo TSH, Free T4, Free T3, ndi mayesero a tizilombo toyambitsa matenda kuti ayang'ane Hashimoto (chithokomiro cha peroxidase antibodies / TPO) ndi matenda a Graves (chithokomiro chomwe chimayambitsa ma immunoglobulins / TSI). Mankhwala a ayodini angayesedwe kuti ayang'ane kusowa kwa ayodini.
Dokotala wanu akhoza kuitanitsa zojambula zojambula monga ultrasound, MRI, CT scan, kapena njira yowonongeka ya chithokomiro, kuti muwone momwe mungapangidwire, kuti muwone ngati mukupuma kapena mumeza, ndipo mudziwe ngati muli ndi mitsempha.
Zopereka Zogwira Ntchito
Chithandizo cha goiter chimadalira chifukwa ndi zizindikiro.
- Ngati muli ndi goiter yaing'ono popanda zizindikiro kapena matenda ena a chithokomiro, dokotala wanu angapangitse kuti nthawi zonse ayang'ane popanda chithandizo.
- Ngati goiter yako ikusowa chifukwa cha kusowa kwa ayodini, udzapatsidwa ayodini supplementation. Izi kawirikawiri zimachedwetsa kapena kuleka kukula, ndipo zingachepetse kukula kwa goiter, koma nthawi zambiri sizingatheke.
- Ngati goiter yako ikugwirizanitsidwa ndi hypothyroidism, mankhwala ochizira ndi mankhwala otsekemera amatha kuchepetsa kapena kuchepetsa kukula kwa mankhwala. Zingatheke, komabe, ziwongolerani goiter yanu.
- Ngati mankhwala anu akugwiritsidwa ntchito ndi hyperthyroidism chifukwa cha matenda a Manda, chithandizo-kuphatikizapo iodin radioactive, kapena mankhwala osokoneza bongo-amatha kuchepetsa kapena kuimitsa kukongola kwa gland, ndipo akhoza kuchepetsa goiter.
- Ngati goiter yanu ikupitirizabe kukula pamene mukudwala chithandizo cha chithokomiro, zizindikiro zowonongeka, kapena goiter ndizosawonongeka, madokotala anu angakulimbikitseni opaleshoni, yotchedwa thyroidectomy.
Kodi Mankhwala a Chithokomiro Ndi Chiyani?
Chithokomiro chimagwedeza ndi zowonongeka kapena zozizira mu chithokomiro chanu. Mankhwala amatha kukhala olimba, kapena mankhwala odzaza madzi. Mankhwala otentha a chithokomiro amavuta kwambiri, ndipo akuti pafupifupi hafu ya anthu ali ndi nodule umodzi, ngakhale ambiri sadziwa. Mankhwala a chithokomiro amakhalanso ochuluka kwambiri pamene mukukalamba, ndipo akuti anthu a zaka makumi asanu ndi awiri ndi makumi asanu ndi awiri (70) aliwonse oposa 70 peresenti amakhala ndi mitsempha imodzi ya chithokomiro.
Mankhwala amatha kupezeka pa zifukwa zingapo:
- Khansara ya chithokomiro. Izi ndizimene zimayambitsa matendawa a chithokomiro, ndipo pafupifupi 95 peresenti ya mitsempha yonse ya chithokomiro siidwala khansa.
- Zidzakhalanso ndi chithokomiro, monga Hashimoto's ndi Graves 'matenda, omwe amachititsa kutupa kwa gland ndikuyambitsa mitsempha.
- Kuwonjezeka kwa minofu yanu yachibadwa ya chithokomiro. Izi zimatchedwa adenoma ya chithokomiro, ndipo kawirikawiri si khansa kapena imakhala yovuta kupatula ngati chifuwa chimayambitsa zizindikiro chifukwa cha kukula kwake.
- Kutaya kwa ayodini. Izi zingayambitse chitukuko chamagulu, pamodzi ndi goiter.
- Goiter yamitundu yonse, yomwe imadziwikanso ndi adenoma ya poizoni, kumene muli ndi mitsempha yambiri. Kawirikawiri, timadzi timene timatulutsa timadzi timene timatulutsa kachilombo ndipo timatha kukhala ndi hyperthyroidism.
Zizindikiro Zowoneka ndi Zizindikiro za Mankhwala a Chithokomiro
Nthawi zina, ngati muli ndi nkhono yaikulu kwambiri, kapena ili pafupi ndi khungu lanu, ikhoza kuwonetsedwa kunja kapena kumveka ndi kuunika kwa buku lanu. Mitsempha yambiri, koma, siyiwoneka kapena yowoneka bwino, ndipo imatha kudziwika ndi mayesero ojambula.
Nthawi zambiri, mitsempha imayambitsa zizindikiro zosadziwika. Koma pamene chithokomiro chimagwedeza zimayambitsa zizindikiro, zina mwazinthu zikuphatikizapo:
- palpitation
- kusowa tulo
- kupweteka kapena kulemera
- nkhawa
- kunjenjemera
- kutopa
- kudandaula
- mphamvu mu khosi
- zovuta kumeza
- kumverera kwa chidzalo kapena chikondi mu khosi
- zosasangalatsa
Mayesero ndi Ndondomeko Zowunikira Matenda a Chithokomiro
Pamene nthenda ya chithokomiro imapezeka, dokotala wanu akuyesa mafunso angapo ofunika kwambiri:
- Kodi mankhwalawa amachititsa kuti mahomoni ambiri azitentha komanso aziwopsa kwambiri?
- Kodi nthendayi ikuwononga mphamvu ya chithokomiro kuti ikhale ndi mahomoni okwanira a chithokomiro ndikuyambitsa hypothyroidism?
- Kodi khansa yako ndi khansa?
- Kodi mimba yanu imakhudza kupuma kwanu kapena kumeza?
Gawo loyamba poyesa ndilo gawo la kuyesedwa kwa magazi, kuphatikizapo TSH, Free T4, Free T3, ndi mayesero a antibodies kwa matenda a Hashimoto ndi Graves. Izi zingathandize kudziwa ngati nodule ikuyambitsa hyperthyroidism kapena hypothyroidism.
Gawo lotsatira ndizoyeso zojambula za chithokomiro , zomwe zingaphatikizepo ultrasound, MRI, CT scan, kapena scan radiod i-scan. Kawiri kaŵirikaŵiri amachitidwa kuti aone kukula ndi zizindikiro za nodule, ndi kuzindikira zizindikiro zomwe zimakayikira kuti zifufuze kufufuza. Zina mwa zizindikiro zoyesera zojambula zomwe zimaonedwa kuti ndizoyikira ndizo:
- dothi lokhalokha (motsutsana ndi mitsempha yambiri)
- Kukhalapo kwa microcalcification mu noduli
- kukula kwakukulu kuposa 2 cm
- zolemba zolimba
- Malo "ozizira" pamayeso oyesa, kutanthauza kuti nodule sichimwa ayodini kapena imatulutsa mahomoni a chithokomiro
- kukula kwa nodule
Ngati nthendayi ikuwoneka kuti ikukayikira, sitepe yotsatirayi ndi yachilendo chabwino cha singano (FNA) biopsy . Pachiyeso ichi, singano imalowetsedwa mu nodula-kawirikawiri imatsogoleredwa ndi ultrasound-kuchotsa chitsanzo pofuna kupenda matenda. Chitsanzo chimodzi kapena zingapo zingayesedwe kuti muyesedwe bwinobwino. Kawirikawiri, ma FNA amachitika ndi akatswiri a zachipatala, a cytopathologists, kapena opaleshoni. Maselo amawerengedwa ndikuyesedwa ndi cytopathologist. Ma FNA ambiri amachitidwa ku ofesi ya dokotala, ngakhale kuti ena angachitidwe ngati mankhwala ochiritsira kuchipatala kapena kuchipatala.
Ndikofunika kuti dokotala yemwe amachita FNA wanu adziwe zambiri, kuti atsimikizire kuti njirayi imapanga zitsanzo zabwino kwambiri. Chiwerengero cha zotsatira za FNA zosokoneza chimaonedwa kuti sichidziwitso, kutanthauza kuti sichikhoza kugwiritsidwa ntchito konse, ndipo chiyenera kuyambiranso; Zotsatira zake zikhoza kuchitika ngati akatswiri osadziŵa zambiri akupanga sampuli. Kuopsa kwa chithokomiro cha FNA kumatulutsa magazi kapena kutaya magazi. Koma ndi katswiri wodziŵa zambiri, chiopsezo chimenecho n'chochepa, ndipo chithokomiro cha FNA chimawoneka kuti n'chosungika, pafupifupi osayambitsa mavuto alionse.
Chinthu chimodzi chovuta kwambiri ndi pamene zotsatira za FNA zimabwereranso ngati "zosakwanira" kapena "zosakwanira." Pachifukwa ichi, kufufuza kwa matenda sikuthetsa khansara. Gawo lotsatira lachidziwitso ndi chithokomiro-chithandizo chochotsa chithokomiro , chomwe chimayesedwa kuti chizindikiritse mosamalitsa kapena kulamula khansara ya chithokomiro.
Ngati palibe khansa ya chithokomiro itapezeka, zomwe zimachitika nthawi zambiri, wodwala ayenera kukhala ndi moyo wonse wa hypothyroid, pambuyo pa chithokomiro chosafunikira.
Zikuoneka kuti ma F2 pafupifupi mamiliyoni makumi asanu ndi awiri amapangidwa ku United States chaka chilichonse, ndipo 30 peresenti ya iwo amabwerera monga osadziwika, kapena osadziwika. Zaka 20 mpaka 30 peresenti ya zovuta zowonongeka zimapezeka kuti zili zoipa.
Choncho muyenera kudziŵa mayeso otchedwa Afirma Thyroid FNA Analysis , omwe ngati atayesedwa panthawi yoyamba ya biopsy amathetsa pafupifupi zonse zomwe zimachitika ndi FNA. Dziwani kuti muyenera kutsimikizira kuti dokotala akugwiritsa ntchito dongosolo lino musanayambe kukonzekera FNA yanu, kapena mupeze dotolo yemwe amagwira ntchito ndi kuyesedwa komweku.
Matenda a Chithokomiro
Ngati nthendayi imapezeka kuti ili ndi khansa, sitepe yotsatira ndiyo kuchotsa opaleshoni ndi mankhwala otsatira pogwiritsa ntchito mtundu ndi siteji ya khansa yomwe imapezeka.
Ngati muli ndi mitsempha yomwe simukuyang'ana bwino, kapena imafooketsa mphamvu yanu yokumeza kapena kupuma, opaleshoni nthawi zambiri amalimbikitsidwa.
Ngati nthendayi yokhayokha siimaphatikizidwa ndi hyperthyroidism kapena hypothyroidism, nthawi zambiri idzayang'aniridwa ndi ultrasound ndi kuyesedwa ndi dokotala wanu.
Kawirikawiri, chifukwa cha mankhwala osokoneza bongo omwe amachititsa kuti hypothyroidism, mankhwalawa azipereka mankhwala a chithokomiro. Izi zingathandize kuchepetsa vutoli, kapena kuteteza kukula kwake. Ngati nodule ikupitirira kukulirakulira, dokotala wanu akhoza kubwezeretsanso kachilomboka, kupatseni kuchotsa opaleshoni, kapena kupatsirana chithandizo monga jekeseni wothira mafuta m'thupi (PEI) mu dothi, zomwe zingathandize kuchepetsa ululu.
Ngati mankhwala oopsa a adenoma ali ndi hyperthyroidism, mankhwalawa ndi mankhwala a antithyroid, kapena nthawi zina, kupatsirana kwa mankhwala a iodin kapena opaleshoni, malinga ndi kuchuluka kwa hyperthyroidism, yankho lanu kwa mankhwala, ndi zina zomwe zimatsimikiziridwa ndi dokotala wanu .
Mawu Ochokera
Kumbukirani kuti ngakhale chiopsezo cha khansa ya chithokomiro ndi chaching'ono kwambiri, mitsempha yonse iyenera kuyesedwa ndi dokotala, kuti asatenge kachilombo kochepa kuti ali ndi khansa.
> Zotsatira:
> Braverman L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Haugen B. et. al. "2015 American American Thyroid Association Management Guide kwa Odwala Achikulire Odwala Matenda a Chithokomiro ndi Matenda a Chithokomiro Osiyana-siyana / American Therapy Thyroid Guidelines Task Force pa Matenda a Chithokomiro ndi Kusiyanitsa Khansa ya Chithokomiro." Chithokomiro . Vesi 26, Nambala 1, 2016. DOI: 10.1089 / thy.2015.0020