Ukungavezwa noma ukungaphathwa kabi kwe-hypothyroidism ngesikhathi sokukhulelwa kuye kwaboniswa ukwandisa ingozi yemiphumela ehlukahlukene emibi, kubandakanya ingozi eyengeziwe yokukhulelwa kwesisu, ukubeletha, ukuguqulwa komzimba ngaphambi kokusebenza kwesikhathi, nezinye izinkinga. I-overt hypothyroidism ngokuvamile ibhekisela esimweni lapho amazinga e-hormone e-stimulating (TSH) we-thyroid ahlanganisa ama-10 mIU / L nangaphezulu.
Manje, ucwaningo luye lwabonisa ukuthi ukuphatha abesifazane abano-hypothyroidism abanobucayi noma obuncane-okubizwa ngokuthi amazinga ka-TSH ngaphansi kuka-10.0 mIU ngesikhathi sokukhulelwa kunganciphisa ingozi yokubeletha ngaphambi kwesikhathi, izingxenye zokuqeda izikhathi zakuqala, nokuzalwa komntwana.
Imiphumela yokucwaninga yabika kwiNgqungquthela yonyaka we-Society for Endocrinology eBrighton ngoNovemba 2016, futhi yenziwa nguDkt Peter Taylor weYunivesithi yaseCardiff eWales.
Ucwaningo lwahlola abesifazane abangaphezu kuka-13 000 abaphakathi kwamasonto angu-12 kuya kwangu-16 abakhulelwe. Phakathi kwalelo qembu, u-518 wayene-hypothyroidism emnene, eyaziwa ngokuthi i- subclinical hypothyroidism . Phakathi kwalaba besifazane abachazwe ngokuthi banesifo se-thyroid esingavamile, isigamu sanikezwa ngezikhathi ezithile i- hormone ye-hormone esikhundleni somuthi we-drug levothyroxine , kanti enye ingxenye ayitholanga ukwelashwa. Abacwaningi bahlaziya izinga lokuzalwa kokubeletha, ukushona kokubeletha, ukungabi nesikhathi sokubeletha (ukulethwa kwamaviki angaphansi kwama-37), kanye nezigaba zokuqala zokuyeka.
Ucwaningo oluthola:
- Abesifazane abane-mild hypothyroidism abangaphenduliwe babengase babe nokubeletha kunabesifazane abanomsebenzi ovamile we-thyroid.
- Abesifazane abanezinkinga ze-thyroid abaphathwa nge-levothyroxine babe nomngciphezi ophansi wokukhula kweminyaka yokuthoma kanye nesisindo sokubeletha esincane ngesikhathi sokubeletha, kanye nezigaba zokuqala zokugcina.
Ekubikeni okutholakala kocwaningo, uDkt. Taylor wathi:
Umsebenzi wethu uphakamisa amathuba okunikeza izinzuzo zangempela ngokusebenzisa ukwelashwa okuphephile, ezishibhile nokwakhiwa kahle ngokusondeza kwinani labesifazane abakhulelwe esibaphathayo. Kufanele sicabangele ukuhlolwa kwe-thyroid emhlabeni wonke ekukhulelweni njengoba kuqhathanisa kahle ngokuphathelene nezindleko-ukusebenza nezinye izimo esizibonayo okwamanje.
UDkt. Taylor utshele i-website ethi Endocrine Namuhla :
"Siye sabonisa ukuthi kungase kube nezinzuzo zangempela ekuqondiseni umsebenzi we-thyroidline emisebenzini yabesifazane abakhulelwe besebenzisa isisindo esivame ukusetshenziselwa imali, i-levothyroxine. Lokhu kunemiphumela ebalulekile, kufaka phakathi ukunciphisa ukuzalwa kokubeletha nokuqeda isimo, nakuba izifundo eziningi zidinga. Iphinde iphakamise ukuthi kungenzeka ukuthi njengoba i-hypothyroidism nomsebenzi we-thyroid boundary zivamile, kunengxabano ephoqelekile yokuhlola i-thyroid yonkana ekukhulelwe. Ukugxila okwengeziwe kwesimo se -roid kuyadingeka kanye nokucubungula ukuhlolwa kwe-thyroid yonke. "
Lokhu kusho ukuthini lokhu
Kunemiphumela eminingi lokhu okutholakele kunabesifazane abaneminyaka yobudala kanye nodokotela ababaphathayo.
Gcina izinga elifanele ngaphambi kokukhulelwa
Uma u-hypothyroid omnene futhi uhlela ukukhulelwa, kufanele uqaphele iziqondiso ezisemthethweni mayelana namazinga akho aphezulu we-TSH ngaphambi kokukhulelwa.
Ngokusho "Imihlahlandlela ye-American Thyroid Association yokuHlola nokuPhathwa kwezifo ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum," umthamo wakho we-thyroid i-hormone substlacement mithi kufanele ulungiswe ukuze i-TSH yakho ingaphansi kwe-2.5 mIU / L ngaphambi kokukhulelwa.
Qinisekisa Ukukhulelwa Kwakho Njengasekuseni Kunokwenzeka
Qaphela ukuthi ochwepheshe futhi banxusa ukuthi uqinisekise ukukhulelwa kwakho ngokushesha, futhi ube nesandulela ngaphambi kokuthi ukwandise imithi yakho yemithi ngokushesha uma wazi ukuthi ukhulelwe. Ukukhulelwa masinyane kudala isidingo esikhulu se-hormone ye-thyroid, futhi ukuze uvikele ukukhulelwa kwakho nempilo yengane yakho, kubalulekile ukuthi uqinisekise ukuthi une-hormone eyanele yokwelapha phakathi nokukhulelwa kwakho.
Iphuzu elibaluleke kunazo zonke ngemuva kokukhulelwa futhi ngesikhathi sokuqala kwakho, lapho ingane yakho ekhula ixhomeke ngokugcwele kuwe wonke amahomoni wegciwane elibalulekile eliqinisekisa ukuthi ingane iqhubekela phambili ekuthuthukisweni kwegazi.
Uma uthola ukuthi une-hypothyroidism emnene noma engaphansi kwe-hypothyroidism ngesikhathi ukhulelwe, ochwepheshe bayeluleka ukuthi uphathwe ngemithi yokwelapha i-hormone esikhundleni sokulibala. Umgomo ukubuyisela amazinga akho e-thyroid ngendlela evamile ngokushesha ngangokunokwenzeka.
Qinisekisa ukuthi odokotela bakho balandela izinkombandlela futhi basebenzisa umthamo wokulondoloza, ukukhulelwa-okucacile okuyi-TSH yesilinganiso
Iqiniso eliqakathekileko lokukwazi ukuthi ibanga lendabuko lokusetjenziswa elisetshenziselwa odokotela abavamile ukuhlola nokuphatha i-hypothyroidism likhulu kakhulu ngesikhathi ukhulelwe . Ngenkathi ama-laboratories amaningi anamazinga aphezulu okubhekisela ku-reference cutoff kusuka ku-4.0 kuya ku-6.0 mIU / L 4.5, izinkombandlela zincoma ukuthi ngesikhathi sokukhulelwa , izinga lakho le-TSH ku-trimester yokuqala kufanele ligcinwe ezingeni eliphakathi kuka-0.1 no-2.5 mIU / L, I-3.0 mIU / L ngesikhatsi sakho sesibili sesithathu, no-0.3 kuya ku-3.0 mIU / L ku-trimester yakho yesithathu.
> Imithombo:
> Stagnaro-Green, Alex, et 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)
> Taylor PN, et al. Abstract # OC6.3. Kuthulwe ku: Umhlangano Wonyaka We-Society for Endocrinology; NgoNovemba 7-9, 2016; Brighton, e-United Kingdom.