Ama-Nodules we-Thyroid Kungenzeka Kakhulu Ukwandisa Okukhulu Phakathi Nokukhulelwa
Ukukhulelwa kungathinta ama-nodules e-thyroid , okuyi-swellings noma ama-lumps ku-gland yegciwane, futhi ingaba isisindo esiqinile, noma i-cyst egcwala amanzi. Iningi lezinyosi ze-thyroid ziyingozi, kodwa amaphesenti amancane angaba nomdlavuza.
Amakhodi we-Thyroid
Ngokweziqondiso zika -2011 ze-American Thyroid Association yokuHlola nokuPhathwa kwezifo ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum, " ama-nodules ajwayelekile kakhulu ngemva kokukhulelwa okuningi, futhi ama-nodules we-thyroid angase akhulise usayizi ngesikhathi sokukhulelwa .
Uma kutholakala ama-nodules ngesikhathi sokukhulelwa, kunconywa ukuthi lo wesifazane abuzwe ngomlando wakhe womndeni wesifo esibuhlungu noma esibi se-thyroid kanye nezifo ze-endocrine, isifo sangaphambilini noma ukwelashwa okubandakanya intamo (ikakhulukazi, noma iyiphi imithi yokwelashwa ekhanda noma entanyeni ngesikhathi seyingane ), kanye nalapho i-nodule itholakele khona, nokuthi ikhula kanjani ngokushesha.
Imihlahlandlela iphakamisa ukuthi bonke abesifazane abane-nodule ye-thyroid babe ne-TSH ne-Free T4 elinganiselwe. Uma owesifazane enomlando womndeni we-medullary carcinoma ye-thyroid noma i-endocrine neoplasia (i-MEN) 2, amazinga e-calcitonin kufanele alinganiswe.
Ngokwemihlahlandlela, i-ultrasound inconywa ukucacisa izici ze-nodule, futhi iqaphe ukukhula kwayo. Uma i-nodule ingaphansi kuka-10mm ngosayizi, isifiso esihle senaliti (FNA) biopsy of theroid ayikho isidingo ngaphandle uma kunezici ezisolisayo.
Uma i-nodule ikhula, noma uma kukhona ukukhwehlela okuqhubekayo noma izinkinga zezwi, noma ezinye izinkomba ezisolisayo zomlando, Imihlahlandlela iphakamisa ukuthi i-FNA yenziwe.
I-FNA ibhekwa njengokuphephile ngesikhathi sokukhulelwa.
Ukusetshenziswa kwe-radionuclide ukuskena kwe-nodule - okuyisimiso se-nodules esolisayo ngaphandle kokukhulelwa - kuyaphikisana ngesikhathi sokukhulelwa, ngenxa yokukhathazeka mayelana nokuvezwa kwemisebe kumntwana. Ngokwezinkombandlela, ucwaningo oluthile luye lwabonisa, noma kunjalo, ukuthi ukusetshenziswa okungavumelekile kwe-RAI ngaphambi kwamasonto angu-12 wokubeletha akubonakali ukulimaza i-thyroid fetal.
Ukuze uthole ama-nodules we-thyroid abonakalayo, iziqondiso zikhomba ukuthi akukho ukwelashwa. Uma ama-nodules abonisa ukukhula okusheshayo, izinguquko ezisolisayo ngomdlavuza, kufanele kwenziwe i- FNA ephindaphindiwe . Uma ama-nodules ecindezela i-trachea noma i-oophagus, ukuhlinzwa kwe-thyroid kungacatshangwa.
I-Cancer Cancer
Uma umdlavuza we-thyroid utholakala, uhlobo lomdlavuza we -roid lwenza ukwelashwa. Ukuze umdlavuza we-thyroid uhlukaniswe kahle ngesikhathi sokukhulelwa, imihlahlandlela iphakamisa ukuthi ukuhlinzekwa kungahle kuhanjiswe kuze kube sekupheleni kokubeletha.
Ukuze umdlavuza we-medullary we-medullary, ukuhlinzwa kunconywa ngesikhathi sokukhulelwa uma kune-tumor enkulu enkulu, noma ukusabalala okubanzi kuma-lymph nodes.
Umthelela we-thyroidectomy ngesikhathi ukhulelwe uye wahlolisiswa, futhi ngokuvamile, uma ukuhlinzwa kwe - thyroid kwenziwa ngesikhathi sesibili sesibili, akuzange kuhlotshaniswe nengozi enkulu yomama noma yomntwana.
Imikhombandlela iphakamisa ukuthi uma ukuhlinzekwa komdlavuza we-thyroid ohlukaniswe kahle kuhanjiswa kuze kube sekupheleni kokubeletha, i-ultrasound kufanele yenziwe ngesikhathi sesigamu ngasinye sokubheka ukukhula kwe-tumor ngokushesha. Uma kukhona ukukhula okusheshayo, noma kusakazeka kuma-lymph nodes, ukuhlinzwa kunconywa.
Kuwesifazane onomdlavuza we-thyroid ohlukaniswe kahle ophikisayo ukuhlinzwa kuze kube ngemva kokubeletha, ukwelashwa kwe-levothyroxine kungasetshenziswa, ngenhloso yokucindezela izinga le-TSH ukuya ku-0.1-1.5mIU / L.
Ukwelapha i-Hypothyroidism Emsindeni We-Cancer Okhulelwe
Ngokwemihlahlandlela, kwabesifazane abanomdlavuza we-thyroid oqhubekayo, i-TSH ingagcinwa ngaphansi kwe-0.1 mIU / L ngesikhathi sokukhulelwa. Kulabo besifazane abangenaso umdlavuza we-thyroid kodwa ababenomdlavuza omkhulu esikhathini esidlule, ukucindezelwa kumele kugcinwe emazingeni ka- TSH phakathi kuka-0.1 mIU / L no-0.5 mIU / L. Ezigulini ezingekho ngaphansi kwengozi ezingenayo izibonakaliso zomdlavuza we-thyroid, i-TSH ingagcinwa ekugcineni okuphansi kwebanga elijwayelekile (0.3-1.5 mU / L).
Ngokuvamile, abesifazane abakhulelwe abasebenzisa i- hormone ye-thyroid esikhundleni somdlavuza wegciwane badinga ukwanda kwamanani okulingana uma kuqhathaniswa nabesifazane abanesifo se-hypothyroid ngenxa yezinye izifo.
Imikhombandlela iphakamisa ukuthi kulaba besifazane, i-TSH ihlolwe njalo ngemva kwamasonto amane ngesikhathi sokukhulelwa, kuze kufike amasonto angama-16 kuya kwangu-20 okubeletha, futhi futhi okungenani kanye phakathi kwamaviki angu-26 no-32 wokubeletha.
I-RAI Ukwelashwa Kwe-Cancer kanye Nomthelela Wokukhulelwa Okulandelayo
Abacwaningi abatholanga ukwanda kokungabi nabantwana, ukukhulelwa kwesisu, ukubeletha, ukushona kwezingane, ukuzalwa kokuzalwa kwangaphambi kokubeletha, ukuzala okuphansi, noma ukufa phakathi nonyaka wokuqala wokuphila ngemuva kokwelashwa kwe- iodine (RAI) yomdlavuza we-thyroid . Kodwa-ke, kukhona ingozi eyengeziwe yokukhulelwa kwesisu ezinyangeni ezilandela i-RAI ezingabangelwa ukulawulwa okwanele kwamahomoni wegciwane . Lezi ziqondiso zincoma ukulinda okungenani izinyanga eziyisithupha emva kwe-RAI ukuqinisekisa ukuphathwa kahle kwe-thyroid ngaphambi kokuba ukhulelwe.
Ukukhulelwa kubonakala kungakhulisa ingozi yokuphindaphinda umdlavuza wegciwane kulabo abangenaso isifo ngaphambi kokukhulelwa. Kulabo besifazane abanomdlavuza wesibeletho we-thyroid, noma ngokwezicubu ezibonakalayo ze-thyroid, noma amazinga we-thyroglobulin (Tg) aphakeme, ukukhulelwa kungabangela ukukhula komdlavuza we-thyroid.
Uma owesifazane uye waba nomdlavuza we-thyroid owehlukile ngaphambili ophuthwe, futhi amazinga we-thyroglobulin (Tg) angaqondakali, akukho ukuqapha okukhethekile okudingekayo ngesikhathi sokukhulelwa. Kodwa-ke, lezi zikhombandlela zincoma i-ultrasound ngesikhathi sesigamu ngasinye kumuntu wesifazane oye waphathwa ngaphambilini ngomdlavuza we-thyroid ohlukanisiwe ophethe amazinga aphezulu we-Tg nanoma yibuphi ubufakazi bezifo eziphikisanayo.
> Umthombo:
> Stagnaro-Green, Alex, futhi. al. "Imihlahlandlela ye-American Thyroid Association ye-Diagnosis kanye nokuphathwa kwezifo ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum." I-Thyroid . Umqulu 21, Inombolo 10, 2011 (ku-intanethi)