Unayo i-thyroid ekhulisiwe? Uma udokotela wakho ekutholile ukuthi unezinyosi ze-thyroid, isifo se-thyroid, noma ukwandiswa kwe-thyroid-eyaziwa njenge-goiter-uzodinga ukufunda okwengeziwe ngezibonakaliso, izimpawu, izivivinyo, kanye nokwelashwa kwezimo ze -roid.
Iyini i-Goiter?
Igama elithi goiter libhekisela kunoma yisiphi isimo lapho igciwane lakho le-thyroid seliye lakhula ngendlela engavamile.
Ingubo evamile yegciwane le-thyroid igxila cishe i-ounce futhi ayibonakali ngaphandle. Kodwa nge-goiter, i-thyroid ikwandisa ngokwanele ukuze ushintsho lubonwe yi-ultrasound noma i-x ray, futhi kwezinye izimo, intamo yakho ingabonisa inqwaba ebonakalayo noma i-bulge.
I-Goiter ingenzeka ezimweni eziningi:
- lapho igciwane lakho le-thyroid likhiqiza i-hormone ye-thyroid kakhulu (i-hyperthyroidism)
- lapho i-thyroid yakho ingakhiqiza i-hormone ye-thyroid eyanele (hypothyroidism)
- uma une-auto-immune disease-Isifo sika- Graves noma isifo sikaHashimoto- esibangela ukusabela okuvuvukala ku-thyroid yakho
- uma unama-nodules amaningi we-thyroid noma amaningi
- uma unomdlavuza we -roid ongaphansi
- uma unesifo se-iodine
Izimpawu ezijwayelekile nezibonakaliso ze-Goiter
Izimpawu ze-goiter zifaka:
- ukukhuliswa kwentamo
- ukukhanya okubonakalayo noma ukuvuvukala endaweni yentamo
Kodwa-ke, phawula ukuthi ezinye izimo ze-goiter kungenzeka zingabonakali ngaphandle, futhi zitholakale kuphela ngokuhlola izithombe.
Izimpawu ze-goiter zifaka:
- ububele kuya othintekayo
- umuzwa wokugcwala entanyeni
- umzwelo wokucindezela emphepheni yakho yomoya noma isifo sakho
- kunzima ukugwinya, noma ukuzwa ukuthi ukudla kuqhuma emqaleni
- ukuphefumula noma ukuphefumula, ikakhulukazi ebusuku
- ukukhwehlela
- ukukhathazeka
- ukungaboni kahle ngama-turtlenecks, izibopho, nezinhlamvu
Kwezinye izimo, ungase ube ne- hypothyroidism noma izimpawu ze-hyperthyroidism ezihambisana ne-goiter.
Kwezinye izimo, i-goiter ingabangela izimpawu.
Izivivinyo & Izinqubo Zokuthola I-Goiter
Ukutholwa kwe-goiter kuvamise ukwenziwa ngeso lengqondo noma ngesandla ngenkathi kuhlolwe ngomtholampilo udokotela wakho. Kwezinye izimo, i-goiter ingatholakala ngesikhathi sokuhlolwa kwe-imaging.
Lapho kutholakala i-goiter, isinyathelo esilandelayo ukuhlola imbangela futhi unqume ukuthi yisiphi isimo esingavamile se-goroid esabangela ukukhuliswa. Lokhu kuhlolwa kuzokufaka izivivinyo ezibalulekile ze -roid, kufaka phakathi i-TSH, i-Free T4, i-Free T3, ne-test antibodies test ukuhlola amaHashimoto's (anti-peroxidase antibodies / TPO) nesifo se-Graves (i-thyroid evuselela i-immunoglobulins / TSI). Amazinga e-iodine angabuye ahlolwe ukuze ahlole ukuntuleka kwe-iodine.
Udokotela wakho angase futhi ahlele ukucabangela ukuhlola okufana ne-ultrasound, i-MRI, i-CT scan, noma iskena yokubheka i-thyroid, ukuze uhlole izinga le-goiter, ukuze ubone ukuthi kuthinta ukuphefumula noma ukugwinya, futhi unqume uma unama-nodules.
Imithi yokwelapha
Ukwelashwa kwe-goiter kuxhomeke esibangweni nasezimpawu.
- Uma une-goiter encane engenampawu futhi kungekho esinye isifo se-thyroid esingaphansi, udokotela wakho angase ancoma ukuqapha okwesikhashana ngaphandle kokwelashwa.
- Uma i-goiter yakho ingenxa yokuntuleka kwe-iodine, uzonikezwa i-iodine supplementation. Lokhu kuzovama ukuhamba kancane noma ukuyeka ukukhula, futhi kunganciphisa ubukhulu be-goiter ngandlela-thile, kodwa ngokuvamile hhayi ngokuphelele.
- Uma i-goiter yakho ihlotshaniswa ne-hypothyroidism, ukwelashwa ngezidakamizwa ze- hormone esikhundleni somzimba kungancipha noma kumise ukukhula kwegciwane. Kungenzeka ukuthi, noma kunjalo, kwehlisa i-goiter yakho.
- Uma i-goiter yakho ihlotshaniswa ne-hyperthyroidism ngenxa yesifo se-Graves, ukwelashwa-kuhlanganise i-radiooday i-radioactive, noma izidakamizwa ze-antithyroid-kunganciphisa noma kumise ukukhuliswa kwegundane, futhi kunganciphisa i-goiter.
- Uma i-goiter yakho iqhubeka ikhula ngenkathi iselashwa, izimpawu ziyancipha, noma i-goiter ingaboni kahle, odokotela bakho bangase batusa ukuhlinzwa, okuthiwa i-thyroidectomy.
Ziyini Ama-Nodules We-Thyroid?
Ama-nodules we-thyroid yi-swellings noma ama-lumps ekhanda lakho le-thyroid. Ama-noodle angaqina, noma ama-cysts agcwele amanzi. Ama-nodules we-thyroid ajwayelekile kakhulu, futhi kulinganiselwa ukuthi isigamu sabantu sinesibhamu esisodwa, nakuba iningi lalazi lutho. Izindebe ze-thyroid nazo zivame kakhulu uma uneminyaka yobudala, futhi kulinganiselwa ukuthi uma uneminyaka engama-70 abantu abangamaphesenti angu-70 kunenani elilodwa le-thyroid.
Amakhodi angenziwa ngezizathu eziningana:
- Umdlavuza we-Thyroid. Lesi yisizathu esivamile kunazo zonke zezinyosi ze-thyroid, kanti cishe amaphesenti angu-95 azo zonke izinqamuzana ze-thyroid azange zibe nomdlavuza.
- Izimo ze-autoimmune ezizenzakalelayo, njenge-Hashimoto's and Graves's, ezibangelwa ukuvuvukala kwesiginci futhi zenze ama-nodule.
- Ukwehluleka kwezicubu zakho ezivamile ze-thyroid. Lokhu kwaziwa ngokuthi i-adenoma ye-thyroid, futhi kaningi akuyona umdlavuza noma kubhekwa njengento engathí sina ngaphandle uma ingqungquthela ibangela izimpawu ngenxa yobukhulu bayo.
- Ukuntuleka kwe-iodine. Lokhu kungabangela ukuthuthukiswa kwama-nodule, kanye ne-goiter.
- I-goiter eningi, eyaziwa nangokuthi i-adenoma enobuthi, lapho unama-nodules amaningi. Ngokujwayelekile, lezi zinhlayiya zikhiqiza i-hormone yegciwane futhi zingabangela i-hyperthyroidism.
Izimpawu Ezivamile Nezibonakaliso Zama-Nodules We-Thyroid
Kwezinye izimo, uma une-nodule enkulu kakhulu, noma iseduze nesikhumba sakho, ingase ibonakale ngaphandle noma ikwazi ukuzwa ngokuhlolwa komqulu wakho. Ama-nodule amaningi, noma kunjalo, ayabonakali noma angenakwenzeka, futhi angatholakala kuphela ngokuhlola izithombe.
Ezimweni eziningi, ama-nodules abangela izimpawu ezicacile. Kodwa uma izigulane ze-thyroid zibangelwa izimpawu, ezinye ezivamile zihlanganisa:
- i-palpitations
- ukulala
- ukulahlekelwa isisindo noma ukutholakala kwesisindo
- ukukhathazeka
- ukuthuthumela
- ukukhathala
- ukucindezeleka
- ukuzwela entanyeni
- ubunzima bokugwinya
- umuzwa wokugcwele noma ububele entanyeni
- ukukhathazeka
Ukuhlolwa Nezinqubo Zokuthola I-Nodules Ye-Thyroid
Uma i-nodule ye-thyroid itholakele, udokotela wakho uzohlola imibuzo eminingana eyinhloko:
- Ingabe i-nodule yenza i-hormone enkulu yegciwane futhi ibangele i-hyperthyroidism?
- Ingabe i-nodule iyaphazamisa ikhono le-thyroid lokukhiqiza i-hormone ye-thyroid eyanele futhi ibangele i-hypothyroidism?
- Ingabe i-nodule yakho isifo somdlavuza?
- Ingabe i-nodule yakho ithinta ukuphefumula noma ukugwinya?
Isinyathelo sokuqala ekuhloleni ngokuvamile siyi-panel yokuhlolwa kwegazi, kufaka phakathi i-TSH, i-Free T4, i-Free T3, nezivivinyo ze-antibodies ze-Hashimoto's and Graves's disease. Lokhu kungasiza ekunqumeni ukuthi i-nodule ibangela hyperthyroidism noma hypothyroidism.
Isinyathelo esilandelayo ngokuvamile ukuhlolwa kwe-imaging ye-thyroid , okungase kuhlanganise i-ultrasound, i-MRI, i-CT scan, noma iskena lokusungula iodine. Zivame ukuqhutshwa ukuze zihlolwe ubukhulu nezici ze-nodule, futhi zikhomba izici ezisolisayo ezizofuna ukuqhubeka uphenyo. Ezinye zezici zokuhlolwa ze-imaging ezibhekwa njengokusola zifaka:
- i-nodule yodwa (ngokuhambisana nama-nodules amaningi)
- ukutholakala kwe-microcalcification ku-nodule
- isayizi enkulu kuna 2 cm
- ukwakheka okuqinile kwe-nodule
- Izakhiwo "ezibandayo" ekuhlolweni kokuhlolwa, okusho ukuthi i-nodule ayifuni i-iodine noma iveza i-hormone ye-thyroid
- ukukhula okusheshayo kwe-nodule
Uma i-nodule ithathwa njengokusola, isinyathelo esilandelayo ngokuvamile isifiso esihle senaliti (FNA) biopsy . Kulesi sivivinyo, inaliti ifakwa ku-nodule-evame ukuqondiswa yi-ultrasound-ukuhoxisa isampula yokuhlaziywa kwamathambo. Isampula esisodwa noma ngaphezulu kungadingeka ukuze kuvivinywe ngokuphelele. Ngokuvamile, i-FNAs yenziwa yi-endocrinologists, i-cytopathologists, noma odokotela abahlinzayo. Amaseli ahlolwa futhi ahlolwe yi-cytopathologist. Ama-FNA amaningi akwenziwa ehhovisi likadokotela, nakuba amanye angenziwa njengendlela yokwelashwa esibhedlela noma esikhungweni sokuhlinzwa.
Kubalulekile ukuthi udokotela owenza i-FNA yakho unolwazi olubanzi, ukuze aqiniseke ukuthi inqubo ikhiqiza amasampula angcono kakhulu. Iphesenti lemiphumela ye-FNA biopsy ibhekwa njengokungabonakali, okusho ukuthi ngeke isetshenziswe nhlobo, futhi kufanele ivuselelwe; umphumela okungenzeka ukwenzeke lapho odokotela abancane abanolwazi benza isampuli. Ingozi eyinhloko ye-FNA yegciwane iphuma noma isisu. Kodwa ngomsebenzi onolwazi, leyo ngozi iyinto encane, futhi i-FNA ye-thyroid ngokuvamile ibhekwa sengathi iphephile, cishe ingabe ingabangela noma yiziphi izinkinga.
Enye yezinselelo ezikhungathekisa kakhulu lapho imiphumela ye-FNA ibuyele "njengengacacile" noma "engagcwaliseki." Kulesi simo, ukuhlolwa kwegazi akukwazi ukulawula umdlavuza. Isinyathelo esilandelayo esilandelayo salesi simo yi- thyroidectomy-ukuhlinzwa ukukhipha i-thyroid , ehlolisiswa ukuze ihlolwe ngokucacile noma ilawule umdlavuza we -roid.
Uma kungatholakali umdlavuza we-thyroid, okwenzeka ezimweni eziningi, isiguli sidinga ukuhlala ne-hypothyroid yonke impilo, ngemuva kwe-thyroidectomy engadingekile.
Kucatshangwa ukuthi cishe ama-bizinesi e-FNA ayizigidi ezinhlanu eqhutshwa e-United States unyaka ngamunye, futhi amaphesenti angaba ngu-30 alabo abuyele njengezingakapheli, noma ezingavumelani. Amaphesenti angama-20 kuya ku-30 kuphela ama-nodules angenakutholakala atholakalayo abe yingozi.
Ngakho-ke kufanele uqaphele ukuhlolwa okubizwa nge- Afirma Thyroid FNA Analysis , okuyinto uma eqhutshwa ngesikhathi sokuqala kwe-biopsy inqamule cishe yonke imiphumela engapheli kanye ne-FNA engenakunqunywa. Qaphela ukuthi kuzodingeka uqinisekise ukuthi udokotela wakho usebenzisa lolu hlelo ngaphambi kokuthi i-FNA yakho ihlelwe, noma uthole udokotela osebenza nalokhu kuhlolwa okuthile.
Ukwelashwa kwe-Nodule ye-Thyroid
Uma i-nodule itholakale inomdlavuza, isinyathelo esilandelayo yisuswe ukuhlinzwa nokulandela ukwelashwa okusekelwe kuhlobo nesigaba somdlavuza otholakala.
Uma unama-nodules awubukeki ngokweqile, noma aphazamise ikhono lakho lokugwinya noma ukuphefumula, ukuhlinzwa kuvame ukuphakanyiswa.
Uma i-nodule enobungozi ayihambisani nanoma yimaphi ama-hyperthyroidism noma i-hypothyroidism, ngokuvamile iyohlolwa njalo nge-ultrasound nokuhlolwa ngudokotela wakho.
Ngokujwayelekile, ukuze uthole i-nodule enobungozi ebangela i-hypothyroidism, ukwelashwa ukuhlinzekela imithi ye-hormone esikhundleni somuthi. Lokhu kungasiza ukunciphisa u-nodule ngandlela-thile, noma ukuvimbela ukuthi ingakhulumi. Uma i-nodule iqhubeka ikhula, udokotela wakho angase abuyele futhi, ancoma ukususwa okuhlinzekwayo, noma uncoma ukwelashwa okunjengomjovo we-ethanol owodwa (PEI) engxenyeni ye-nodule, engasiza ekunciphiseni i-nodule.
Uma i-nodule enobungozi noma i-adenoma enobuthi ihambisana ne-hyperthyroidism, ukwelashwa ngokuvamile kuyimithi ye-antithyroid, noma kwezinye izimo, ukukhishwa kwemithi ye-iodine noma ukuhlinzwa, ngokuya ngesilinganiso se-hyperthyroidism, impendulo yakho emithini yemithi, nezinye izici ezinqunywa udokotela wakho .
Izwi elivela
Khumbula ukuthi nakuba ingozi yomdlavuza we-thyroid imincane kakhulu, zonke izigulane kufanele zihlolwe udokotela, ukuze zikhishwe ingozi encane yokuthi inomdlavuza.
> Imithombo:
> Braverman L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. I-WLL / Wolters Kluwer; 2012.
> Haugen B. et. al. "Izinkombandlela Zokulawulwa Kwamaqembu E-American American Thyroid Management Guidelines for Iziguli Ezikhulile Zama-Nodules We-Thyroid kanye ne-Cancer Yezifo Zomdlavuza We-Thyroid / I-American Thyroid Association Guidelines Task Force kwi-Nodules Ye-Thyroid kanye ne-Cancer Ehlukile Ngokomzimba Wegazi." I-Thyroid . Umqulu 26, Inombolo 1, 2016. DOI: 10.1089 / thy.2015.0020