Matenda a Chithokomiro Angakhale Owonjezeka Kwambiri Pakati pa Mimba
Mimba ingakhudze mitsempha ya chithokomiro , yomwe imakhala yotupa kapena yotupa mu chithokomiro, ndipo imatha kukhala wolimba kwambiri, kapena tsamba lodzaza madzi. Mavitamini ambiri a chithokomiro ali abwino, koma peresenti yaing'ono imatha kukhala khansa.
Matenda a Chithokomiro
Malinga ndi "Malangizo a" American Thyroid Association "a 2011 kuti athetse matenda a chithokomiro pa nthawi ya mimba ndi Postpartum," mitsempha imakhala yowonjezereka pambuyo pobereka mimba zambiri, ndipo mitsempha ya chithokomiro imakhala ikuwonjezeka kwambiri pa nthawi ya mimba .
Ngati mitsempha imapezeka pa nthawi yomwe ali ndi mimba, zimalimbikitsidwa kuti mayiyo afunsidwe mbiri yokhudza banja lake la matenda oopsa a chithokomiro ndi matenda a endocrine, matenda ambuyomu kapena chithandizo cha khosi (makamaka, mankhwala amtundu uliwonse kumutu kapena khosi ali mwana ), komanso pamene phokosolo ladziwika, ndipo likukula mofulumira.
Malangizowo amavomereza kuti amayi onse omwe ali ndi thola la chithokomiro ali ndi TSH ndi Free T4 . Ngati mkazi ali ndi mbiri ya banja ya medullary thyroid carcinoma kapena multiple endocrine neoplasia (AMEN) 2, mawerengero a calcitonin ayenera kuyesedwa.
Malingana ndi Malangizo, ultrasound ikulimbikitsidwa kuti mudziwe mbali za nodule, ndi kuyang'anira kukula kwawo. Ngati nthendayi ilibefupi ndi 10mm muyeso, chitsimikizo chabwino cha singano (FNA) chithunzithunzi cha chithokomiro sichifunikira pokhapokha pali zifukwa zokayikira.
Ngati nkhono ikukula, kapena ngati kuli chifuwa chokhazikika kapena mavuto a mawu, kapena zizindikiro zina zokayikitsa za mbiriyakale, malangizowa amalimbikitsa kuti FNA ichitike.
FNA imaonedwa ngati yotetezeka panthawi yoyembekezera.
Kugwiritsira ntchito mpweya wotchedwa radionuclide wodula - womwe ndizoloŵera wa mitsempha yokayikira kunja kwa mimba - imatsutsana pa nthawi ya mimba, chifukwa cha nkhaŵa zokhudzana ndi kutentha kwa dzuwa kwa fetus. Malingana ndi Zowonjezera, kafukufuku wambiri wawonetsera, komabe, kuti kugwiritsa ntchito RAI mosagwiritsidwa ntchito masabata khumi ndi awiri asanakwane, sikunapangitse chithokomiro cha fetus.
Kuti majekesi a chithokomiro awonongeke, malangizowa amasonyeza kuti palibe mankhwala. Ngati mitsempha imasonyeza kukula mofulumira, kusintha kusakayikira kwa khansa, FNA ikubwerezanso . Ngati mitsempha ikupanikizika ndi trachea kapena eophagus, opaleshoni ya chithokomiro ikhoza kuganiziridwa.
Kansa ya Chithokomiro
Ngati khansa ya chithokomiro imapezeka, khansa ya chithokomiro imayambitsa chithandizo. Malinga ndi kansa yodziwika bwino yomwe imapezeka pa nthawi yomwe mayi ali ndi pakati, malangizowa akusonyeza kuti opaleshoni imatha kufotokozedwa mpaka atabereka.
Pofuna kugwiritsira ntchito khansa ya chithokomiro, opaleshoni imalimbikitsidwa panthawi yomwe mimba ili ndi chotupa chachikulu, kapena kufalikira kwa maselo am'mimba.
Zotsatira za chithokomiro pa nthawi ya mimba zakhala zikuwerengedwa, ndipo kawirikawiri, ngati opaleshoni ya chithokomiro ikuchitidwa pa 2 trimester yachiwiri, siinayanjane ndi chiopsezo cha amayi kapena fetus.
Malangizowo amavomereza kuti ngati opaleshoni ya khansara yosiyana kwambiri ya chithokomiro ikubwezeretsedwa kufikira mutatha kubereka, ultrasound iyenera kuchitika pa trimester iliyonse kuti iwonetsere kukula kwa chifuwa chachikulu. Ngati pali kukula kofulumira, kapena kufalikira kwa maselo am'mimba, opaleshoni imalimbikitsidwa.
Mayi amene ali ndi khansara yosiyana kwambiri ya chithokomiro yemwe amachititsa opaleshoni mpaka atatha kubereka, mankhwalawa angagwiritsidwe ntchito, ndi cholinga chochotsera TSH mlingo kufika 0.1-1.5mIU / L.
Kuchiza Hypothyroidism mu Odwala Khanda la Khanda la Khanda
Malingana ndi Malangizo, kwa amayi omwe ali ndi kansa ya chithokomiro, TSH ingasungidwe pansi pa 0.1 mIU / L panthawi yoyembekezera. Azimayi omwe alibe khansa ya chithokomiro koma omwe anali ndi chiwopsezo chachikulu m'mbuyomo, kuponderezedwa kuyenera kusungidwa pa ma TSH pakati pa 0.1 mIU / L ndi 0.5 mIU / L. Pakakhala pangozi odwala omwe alibe zizindikiro za khansa ya chithokomiro, TSH ikhoza kusungidwa pamapeto otsika (0.3-1.5 mU / L).
Kawirikawiri, amayi apakati omwe ali ndi chithokomiro chotchedwa kanseri m'malo mwa khansa ya chithokomiro amafunika kuchuluka kwa mlingo poyerekeza ndi amayi omwe ali hypothyroid chifukwa cha matenda ena.
Malangizowa amalimbikitsa kuti amayi awa, TSH aziziyang'aniridwa patatha milungu iwiri iliyonse panthawi yomwe ali ndi mimba, mpaka masabata 16 mpaka 20 atakwatirana, komanso kachiwiri kamodzi pakati pa milungu 26 ndi 32 yokhala ndi pakati.
Kachilombo ka RAI kwa Khansa ndi zotsatira za Mimba Yotsatira
Ochita kafukufuku sanapeze kuwonjezeka kwa kusabereka, kuperewera kwa amayi, kubereka, kufa kwa mwana, kubadwa kwa mwana, kubadwa, kuchepa kwa thupi, kapena kufa m'chaka choyamba cha moyo pambuyo pa chithandizo cha khansa ya iodin (RAI) ya khansa ya chithokomiro . Komabe, pali chiopsezo chowonjezereka chotha kupititsa padera m'miyezi ikutsatizana ndi RAI yomwe ikhoza kutha chifukwa cha kusakwanira kokwanira mahomoni a chithokomiro . Malangizowa amalimbikitsa kuyembekezera osachepera miyezi isanu ndi umodzi kuchokera pa RAI kuti athetse chithandizo chabwino cha chithokomiro musanakhale ndi pakati.
Zikuoneka kuti mimba saonjezera kuti chiwopsezo cha khansara chibwererenso kwa amayi omwe alibe matendawa asanakhale ndi mimba. Kwa amayi omwe ali ndi khansa yowonjezera yotsalira, kaya mwa maonekedwe a chithokomiro chowonekera, kapena m'mimba ya thyroglobulin (Tg) yomwe ili pamwamba, kutenga mimba kumayambitsa khansa ya chithokomiro.
Ngati mkazi wakhala akudwala kansa ya kansa yamtundu wina, ndipo sitingapezekanso tizilombo ta thyroglobulin (Tg). Komabe, Malangizi amalimbikitsa ultrasound pa trimester iliyonse mwa mayi amene anachitidwa kale kuti asamakhale ndi khansa yosiyana yomwe ali ndi Matenda apamwamba a Tg kapena umboni uliwonse wa matenda opitirira.
> Chitsime:
> Stagnaro-Green, Alex, ndi. al. "Malangizo a Association of American Thyroid Association kuti Apeze Matenda ndi Kusamalira Matenda a Chithokomiro Pakati pa Mimba ndi Postpartum." Chithokomiro . Vesi 21, Nambala 10, 2011 (Online)