Indlela evamile yokuhlola i-nodule enomsoco we-thyroid
Indlela evamile kakhulu yokuhlolwa kwesigunci se-thyroid esolisayo noma inqwaba yindlela eyaziwa ngokuthi i-needle aspiration biopsy, efingqiwe njenge-FNA.
Ku-FNA, inaliti enhle kakhulu, encane ifakwe kwisifo sakho se-thyroid, ukuze i-aspirate (noma "i-suction out") amaseli kanye / noma uketshezi olusuka kumlenze wakho we-thyroid noma ubukhulu enaleni. Isampula etholakalayo singabuye sihlolwe ngokuba khona kwamangqamuzana anomdlavuza.
I-FNA Ihluke Kanjani Esikhathini Sokudinga I-Biopsy?
Esikhathini sensilinga ye-needle biopsy, inaliti enkulu, inaliti enkulu isetshenziselwa ukuthola isampula "eyisisekelo" sokuhlaziywa, nesampula enkulu ukuthi ingabuyekezwa ngamasampuli amancane angathunyelwa ukuhlaziywa okwengeziwe. I-needle biopsies ivame ukusetshenziswa ngokusebenzisa i-anesthesia yendawo, futhi lezi zinqubo zineengozi encane kakhulu yokuphuma kwegazi ezihambisana nazo, ngakho-ke zivame ukwenziwa udokotela ohlinzayo ohlinzekwa iziguli noma izikhungo zokuhlinzeka ngeziguli.
Uma i-HMO noma umphakathi ungenawo odokotela abanolwazi ekwenzeni i-FNA, noma awekho ama-cytopathologists atholakalayo ukwenza uhlobo oluhlukile lokuhumusha oludingekile kumiphumela ye-FNA, iziguli zinamathuba okuba ne-biopsy eyinhloko, njengale nqubo, ngenkathi iningi lingenayo iziguli, zidinga ikhono elingaphansi ukuthola isampula evumelekile, kanye nekhono elincane labahlengikazi lokufunda nokuhumusha.
Ngubani okufanele enze i-FNA?
Ngokuvamile, i-FNAs yenziwa yi-endocrinologists, i-cytopathologists, noma odokotela abahlinzayo.
Amaseli ahlolwa futhi ahlolwe yi-cytopathologist.
Qinisekisa ukuthi udokotela unolwazi olunzulu ekwenziweni okuhle kwenaliti. Buza ukuthi zingakanani izintshisekelo ozenzayo ngenyanga, bese ucela isilinganiso sabo "esinganelisi" noma "esingavumelani". Ungalokothi ucabange ukuthi i-endocrinologist inamandla kakhulu kule nqubo - angeke enze njalo le nqubo.
Isilinganiso sezingqikithi ezingekho zokuxilonga noma ezingenelisekile - amasampula angenakusetshenziselwa ukuhlolwa kwelabhutri, futhi kufanele abuyele kabusha - angaphakanyiswa ngabasebenzi abathile abangenalwazi. U-Yolanda Oertel, MD, isazi se-cytopathologist esivela esibhedlela saseWashington esibhedlela ekhuluma nge-FNA emhlanganweni we-Thyroid Survivor's Association (ThyCa) Conference eWashington, DC, ixwayisa iziguli ukuthi zithole isilinganiso esiteshini lapho isifiso sabo sithatha khona. Isilinganiso singagijima kusuka kumaphesenti angu-5 ukuya ku-15. UDkt. Oertel, omkhuba wakhe ogxile ezintweni eziphathelene ne-thyroid kanye nebele, futhi ubani ofuna ukubhekana nesifo se-thyroid ngenyanga ngayinye, unesilinganiso "sokungatholakali" singaphansi kwamaphesenti angu-0.5.
Qaphela: ukuhlolwa okukhethekile kuyatholakala kwi-FNA imiphumela ye-biopsy, ebizwa ngokuthi i- Afirma Thyroid Analysis , evela ku-Veracyte, eqeda iningi lemiphumela engeyona yokuhlolisisa, engenakulinganiswa, noma engavumelani ne-FNA. Ukuhlolwa kufanele kuhlelwe ukuthi kwenziwe njengengxenye yenqubo ye-biopsy.
Uphi i-FNA eyenziwe?
Ama-FNA amaningi akwenziwa ehhovisi likadokotela, nakuba amanye angenziwa njengokwelashwa okuphulukisiwe .
UDkt. Oertel, Nokho, uncoma ukuthi iziguli zingatholi i-FNA ngaphandle kwesibhedlela. Ngenkathi inqubo ngokuvamile iphephile, futhi izinto zivame ukungalungi, kunengozi encane kakhulu yokugaya igazi, kodwa lokho kungaphathwa ngokushesha esibhedlela.
Iyini i-FNA eqondiswa yi-Ultrasound?
Uma i-nodule ingenakulinganiswa - okusho ukuthi, ungazizwa ngesandla sakho - odokotela abaningi abadingi ukusebenzisa i-ultrasound ukuqondisa inqubo ye-FNA.
Amanye ama-nodules aphansi kakhulu-angamanga noma angazwa kuphela uma ugwinya, noma awukwazi ukuzwa kodwa uthathwe yi-ultrasound, ikati yokukhipha noma i-MRI. Kulezi zimo, udokotela angasebenzisa i-ultrasound ukuqinisekisa ukuthi i-FNA yenziwe ngokunembile.
Izingozi ezihlangene
I-FNA ye-Thyroid ngokuvamile ibhekwa njengokuphephile, futhi cishe ayiphumeli kunoma yiziphi izinkinga.
Ingabe Kuzolimaza?
Lokho kuxhomeke emakhono ochwepheshe, imibono yakho siqu yobuhlungu.
Abanye odokotela bazosebenzisa i-lidocaine, i-anesthetic yendawo, ukuze banqande indawo yokujola. Kodwa iziguli zikhononda ngokuthi lokhu kungalimaza ngaphezu kwenqubo yangempela ye-FNA. Abanye odokotela abasebenzisi izifo zokubulala umzimba. Esikhathini senkomfa yeToCa, uDkt. Oertel wachaza ukuthi akasebenzisi i-anesthetic, ukhetha ukusebenzisa iphakethe leqhwa ukuze anqande isikhumba. Isizathu sakhe: inaliti ye-anesthetic yenza inhlama nokuvuvukala eduze kwendawo yokujola engaphazamisa ikhono lokuthola isampula esinembile.
Ubuhlungu nokubuyiswa
Ungase uzwe ubuhlungu obuncane nokuvuvukala nokulimaza ezindaweni zokujova, futhi mhlawumbe ukukhathazeka okuncane ukugwinya. Buza udokotela wakho mayelana nezincomo mayelana nemithi yokuhlunguphazwa kwe-post-FNA - abaningi bancoma ukuthatha i-acetaminophen noma ibuprofen njengoba kuqondiswe ukunciphisa noma yikuphi ukuphumula okusalayo.
Ungabuyela Emsebenzini?
Iningi labantu likhululekile ngokwanele ukuthi libuyele emsebenzini ngosuku olufanayo noma olulandelayo ngemuva kokuba ne-FNA.
Kodwa kufanele ugweme umsebenzi omningi wemidlalo kanye nemidlalo cishe amahora angu-24 emva kwe-FNA.
Imiphumela okufanele ilindelwe
I-nodule ingase ibe nomdlavuza uma inezici ezithile eziyingozi:
- Ama-nodules amakhulu: ngaphezu kwamamentimitha angama-4 kunamathuba amaningi okuba nomdlavuza kunamaqhuzu angaphansi kwama-4 cm
- Amagundane emadodeni angase abe nomdlavuza kunama-nodules wesifazane, kodwa, ama-nodules kwabesifazane abakhulelwe banamathuba amaningi okuba nomdlavuza kunama-nodules owesifazane ongakhulelwe
- I-nodule yodwa ingase ibe nomdlavuza kunama-nodules atholakala ku-"multinodular" ye-thyroid
- Ama-noodle kumuntu oneminyaka engaphansi kuka-20 noma ngaphezulu kuka-70
- Umlando we-neck irradiation wangaphandle ngesikhathi seyingane
- Ukubaluleka kwama-cold "nge-ultrasound, okusho ukuthi i-nodule ayifuni i-iodine noma yenza i-hormone ye-thyroid
Ekugcineni, cishe amaphesenti angu-5 kuwo wonke ama-nodules we-thyroid ayenomdlavuza.
Kuthiwani Uma Kuyi-Benign?
Uma une-nodule enesibindi, udokotela wakho cishe uzophatha lesi sikhwama. Ukuze uthole ulwazi oluthe xaxa, funda ngamagundane we-thyroid, amacu kanye nama-goiters njengendawo yakho yokuqala.
Kuthiwani Uma Kuyi-Malignant / Cancerous?
Uma kutholakala ukuthi unomdlavuza we- thyroid , ukuma kwakho kokuqala kufanele kube yi-athikili elandelayo, isingeniso kumdlavuza we -roid , okuyisisekelo esihle sokuthola ulwazi ngomdlavuza wegciwane, kuhlanganise ne-papillary , follicular, medullary, kanye nomdlavuza we-aplastic , kuhlanganise namaqembu asekela futhi ukulandelwa kwe-up-up. Isinyathelo sakho esilandelayo kufanele sijoyine i-Thyroid Cancer Survivor's Association, futhi sisebenzise insizakalo yabo eminingi yokusekela isiguli.
Kuthiwani Uma Kungenakuqhathaniswa Noma Ukunqunyelwe?
Uma i-nodule ingavumelani, esikhathini esidlule, odokotela baye batusa ukuhlinzwa ukuze basuse konke noma ingxenye ye-thyroid. Amaphesenti angama-20 kuya kwangu-30 kuphela angama-nodules angenasici noma angenakunqamuzana angumdlavuza. Lokhu kubangela ukuhlinzeka okuningi okungadingekile, kanye ne-hypothyroidism yonke impilo yonke yalezi ziguli emva kokuhlinzwa. Ukuhlolwa okukhishwe ngo-2011, inqubo ye-Afirma Thyroid FNA Analysis, eyakhiwe yiVeracyte, ivimbela imiphumela engavumelani / engenakunqunywa yamagundane, ngaleyo ndlela inikeza imiphumela ecacile ye-FNA, nokuvimbela isidingo sokuhlinzeka ngamaphesenti angaba ngu-70 kuya kwangu-80 weziguli ezingenakulinganiswa / ama-nodules angapheli, kodwa akukho mdlavuza.
Ungaba Nokuthola Inkohliso Yangamanga?
Imiphumela engamanga, njengezinkolelo ezingamanga ezibonisa imiphumela yakho ye-FNA iyinhlonipho uma empeleni ingumdlavuza, noma amaphutha amanga abonisa ukuthi i-nodule enobungozi iyingozi, ivame kakhulu kunalokho ucabanga. Abanye ochwepheshe balinganisela ukuthi isilinganiso samaphesenti angu-2 kuya kwangu-4 kuwo wonke ama-FNA angase abe imiphumela yamanga.
Izwi elivela
Futhi uma unokuthola okungaqondile noma okungafinyeleleki futhi ungazange uhlolwe i-FNA usebenzisa inqubo ye-Afirma Thyroid FNA Analysis, ungase ufune ukuba novivinyo olwenziwe ukuze uhlolisise i-nodule ngokuqondile ngaphambi kokuba uqale ukuhlinzwa.
Uma unomphumela omubi kodwa unomthelela obungozi noma umlando womndeni wesifo somdlavuza we-thyroid, ikakhulukazi, kufanele ucabange ukuthola umbono wesibili ku-FNA yakho. Futhi, uma unomphumela omuhle obonisa umdlavuza, umbono wesibili ubalulekile.
Ungase uzizwe ungakhululekile ngokukhuluma ngalokhu kudokotela wakho, noma uzizwe ukuthi uzobonwa kabi ngudokotela wakho, kodwa, njengoba uDkt. Oertel esho enkulumweni yakhe enkomfeni yeToCa, "Thola umbono wesibili. I-ego yami izosinda, kodwa ungase ungabi njalo! "
> Umthombo:
> UDkt. Yolanda Oertel, Ingqungquthela ye-Thyroid Survivor's Association Conference.