Kuzindikira za Hyspothyroidism, Khansa ya Chithokomiro ndi Zambiri
Kuwonjezera pa chithandizo cha chithokomiro, matenda a chithokomiro amafunika kuyesedwa ndi njira zoyenera kuti athe kutsimikizira. Nkhani yotsatirayi ikufotokoza njira zosiyanasiyana zochizira matenda.
Hypothyroidism
Pofuna kuthandizira kudziwa kapena kutulutsa mankhwala a hypothyroidism, madokotala amayamba ndi kuyesa magazi komwe kumayambitsa mahomoni otulutsa kanseri (TSH).
Kuyambira mu 2003, ma laboratories ambiri a ku America anali osiyana kwambiri kuyambira pafupifupi 0.5 mpaka 5.5. Komabe, bungwe la American Association of Clinical Endocrinologists posachedwapa linalimbikitsa kuti zofananazo zikhale zowonongeka mpaka 0,3 mpaka 3.0. Ndi 5.5 ngati mapeto akumwamba, TSH pamwambapayo imatengedwa ngati hypothyroid. Pansi pa malangizo atsopano, komabe TSH pamwambapa 3.0 ingapezedwe ngati hypothyroid.
Zindikirani: Olemba ena amaganiza kuti magulu a TSH ayenera kusungidwa pamunsi pa nthawi yomwe ali ndi mimba. (Onani Zomwe Zili Zowirikiza TSH Pa Nthawi Zonse za Mimba? )
Mayeso ena a magazi amene angapangidwe kuti athandizidwe ndi matenda a hypothyroidism ndi awa:
- Chiwerengero cha T4 (Total Thyroxine) - Pansi Padziko lonse T4 pamodzi ndi TSH yokwera ikhoza kusonyeza hypothyroidism.
- Free T4 (Free Thyroxine) - Pansi Free T4 mlingo pamodzi ndi TSH okwezeka angasonyeze hypothyroidism.
- Chiwerengero cha T3 ( Total Triiodothyronine ) - Pansi Padziko lonse T3 pamodzi ndi TSH yokwera ikhoza kusonyeza hypothyroidism.
- Free T3 (Free Triiodothyronine) - Pansi Free T3 mlingo pamodzi ndi okwera TSH angasonyeze hypothyroidism.
Matenda a Hashimoto
Hashimoto's thyroiditis ndi matenda omwe amachititsa kuti munthu azidwala matendawa . Wodwala wa Hashimoto wa chithokomiro amakhala ndi makhalidwe okwera a TSH komanso otsika T3 ndi T4 (kapena Free T3 ndi Free T4).
Matenda apamwamba a chithokomiro - Matenda a anti-TPO makamaka - amakhalanso ndi matenda a Hashimoto.
Matenda a Manda ndi Hyperthyroidism
Kuzindikira matenda a hyperthyroidism kumafuna kafukufuku wathunthu, pamene dokotala amayesa wodwalayo ndi chithokomiro. Hyperthyroidism kawirikawiri imatsimikiziridwa pogwiritsa ntchito TSH, T4 (kapena Free T4 ), T3 (kapena Free T3) ndi mayesero a Radioactive Iodine Update (RAI-U). Mayeso a Mavitamini a Iodine Update (RAI-U), omwe amawonetsa chithokomiro komanso mphamvu yake yodziwira ayodini, amagwiritsidwanso ntchito kuti azindikire hyperthyroidism, ndi kuthandiza kudziwa ngati hyperthyroidism inayambitsidwa ndi matenda a Graves. Kuzindikira Matenda a Manda kumaphatikizaponso umboni wa Matenda a Chithokomiro Chokwanira (TRAb) / Immunoglobulins (Zodzoladzola) Zokuthandizani Kutentha Kwambiri (TSI).
Kufotokozera mwachidule momwe matenda a Graves ndi hyperthyroidism amapezeka ndizofotokozedwa m'nkhani ino: Kuzindikira Matenda a Manda / Hyperthyroidism .
Goiter
Pali njira zingapo zomwe zingagwiritsidwe ntchito pofufuza goiter:
- Kupenda ndikuwonetsa kukula kwa khosi lanu
- Kuyezetsa magazi kuti mudziwe ngati chithokomiro chanu chikupanga kutentha kwa hormone yachithokomiro
- Kuyezetsa magazi , kutsimikizira kuti matenda omwe amatha kukhala nawo omwe angayambitse matenda anu
- Mayeso a ultrasound kuti aone kukula kwa kukula kwake
- Kachilombo koyambitsa matenda a chithokomiro kumatulutsa chithunzi cha chithokomiro komanso kumapereka mauthenga owonetsa za kukula kwa chithokomiro (cholembedwa: chifukwa cha kuwonongeka kwa chithokomiro cha mwana, izi sizichitika panthawi yoyembekezera kapena kuyamwa)
Mankhwala
Mankhwala amodzi amayang'anitsidwa ndi njira zotsatirazi:
- Kuyezetsa magazi, kuti mudziwe ngati mitsempha yanu ikupanga hormone ya chithokomiro
- Uptake wa Iodine Wopanga Mavitamini (RAI-U)
- Chithokomiro chanu cha ultrasound, kuti mudziwe ngati nodule ndi yamphamvu kapena yodzazidwa ndi madzi
- Cholinga chabwino cha singano kapena singano ya singano ya mitsempha yanu, kuti mudziwe ngati nodule (s) ili ndi khansa
Kuchokera mu 2011, ndondomeko yabwino ya singano ya singano yakhala ikupezeka, yomwe imathetsa zotsatira za FNA zomwe sizingatheke. Mayesowa amatchedwa Veracyte Afirma Thyroid Analysis .
Kansa ya Chithokomiro
Kuyeza khansa ya chithokomiro kungaphatikizepo njira ndi mayesero angapo, kuphatikizapo kuunika kwa thupi, biopsy, test imaging , ndi mayeso a magazi. Nkhaniyi ikupereka ndondomeko yowonongeka.
Komabe, kwa aliyense kupatula odwala oyembekezera, RAI-U amachitidwa kuti athandize kudziwa ngati minofu imakhala yozizira, zomwe zikutanthauza kuti akhoza kukhala ndi khansa.
Ngati nthendayi ikuwoneka kuti ili ndi khansa, chidziwitso chabwino cha singano (FNA) biopsy chikuchitidwa. Madzi ndi maselo amachotsedwa ku mbali zosiyanasiyana za nodule, ndipo zitsanzo zimenezi zimayesedwa ndi katswiri wamagulu. Pakati pa 60 ndi 80 peresenti ya mayeso a FNA amasonyeza kuti chifuwacho ndi choipa. Pafupifupi 20 mwa mayeso a FNA amasonyeza khansa. Malamulo otsalawo akuwerengedwa ngati "akukayikira." Kawirikawiri, zokayikitsa zimagwiritsidwa ntchito opaleshoni kuti zichoke, kuti zichotse kapena zidziwe khansa.
Kuchokera
Braverman, MD, Lewis E., ndi Robert D. Utiger, MD. Werner ndi Ingbar's The Thyroid: Mawu Ofunika ndi Otsogolera. 9th ed. , Philadelphia: Lippincott Williams & Wilkins (LWW), 2005.