Uhlolojikelele lwezokwelapha ze-Thyroid
Ukwelashwa kwesimo sakho se-thyroid kuxhomeke kunhlobo lwezinkinga ze -roid nokuthi ngabe i-thyroid yakho ingasebenzi ngokweqile, ingasebenzi kahle, ikhulisiwe, noma isifo somdlavuza. Nakhu okuningiliziwe kwezokwelapha ezahlukene ezihlinzekwe izimo ze -roid.
Imithi yokwelapha ye-Hyperthyroidism / Graves '
Uma i-thyroid yakho ishaya ngokweqile noma ingasebenzi ngokweqile-isimo esibizwa ngokuthi i- hyperthyroidism- uveza i-hormone ekhulu kakhulu yegciwane.
I-hyperthyroidism ivame ukuvela ngenxa yesimo sokuzimela esibizwa ngokuthi yi- Graves ' , noma kwezinye izimo ngenxa yezinyosi ze- thyroid ezithengisa i-hormone yegciwane noma i-thyroiditis.
I-Hyperthyroidism iphathwa ngokuvimbela i-thyroid ekubeni i-hormone engaphezu kwemithi, ukunciphisa ikhono le-thyroid lokukhiqiza i-hormone, noma ukuyisusa ngokuhlinzwa. Ngokuqondile, ukwelashwa kufaka:
- Izidakamizwa ze-Antithyroid , kuhlanganisa i-methimazole (i-Tapazole), i- propylthiouracil (PTU), ne-carbimazole (i-Neo-Mercazole). Ngenxa yokuthi i-PTU ngezinye izikhathi ihlotshaniswa nemiphumela emibi kakhulu, i-methimazole ithathwa njengesidakamizwa esithandwayo se-antithyroid e-US (i-PTU, noma kunjalo, kunconywa ukwelashwa phakathi no-trimester wokuqala wokukhulelwa ngenxa yengozi encane yezinkinga zokuzalwa ezihlobene ne-methimazole.)
-
I-Hypothyroidism Ngokuvamile Ayinakukhululwa yi-Levothyroxine ne-Normal TSH
-
Ukuvikela Umndeni Wakho Ngemuva kokunakekelwa kwe-Iodine ye-radioactive
- Ukwelashwa kwe-iodine yomsakazo (RAI) , owaziwa nangokuthi i-radioiodine ablation . Lokhu ukwelashwa kuhilela ukuthatha umthamo we-iodine omsakazo, obese ubangelwa yi-thyroid futhi ubhubhise-noma uqede-konke noma ingxenye yekhono lokugcoba ukwenza i-hormone ye-thyroid.
- Ukususwa kokuhlinzwa konke noma ingxenye ye-thyroid, eyaziwa ngokuthi i-thyroidectomy.
- Kwezinye izimo, ukukhubazeka kwezimpawu ze-hyperthyroidism njengezinga lokushaya kwenhliziyo okusheshayo, i-palpitations, noma umfutho wegazi ophakeme nawo uphathwa ngezidakamizwa ezibizwa ngokuthi yi-beta blockers.
Ngokuvamile, indlela esetshenziselwa ukwelashwa incike ebukhulu besimo sakho, kungakhathaliseki ukuthi ungakwazi ukubekezelela izidakamizwa ze-antithyroid, futhi uma ukhulelwe noma uhlela ukukhulelwa maduzane.
I-Geography nayo isici, njengoba kungenzeka ukuthi unikezwe i-RAI e-United States-ngokumelene nokuhlinzwa noma izidakamizwa ze-antithyroid. E-US, ukuhlinzwa akuvamile ukwenza hyperthyroidism, ngaphandle kokuthi ukhulelwe futhi ngeke ukwazi ukubekezelela izidakamizwa ze-antithyroid. Ngaphandle kwe-US, ukwelashwa kwezidakamizwa ze-antithyroid cishe kuyindlela yokuqala yokwelapha ukwelashwa, futhi ukuhlinzeka ngokuhlinzwa kakhulu, ikakhulukazi kubantwana nakwabesifazane abaneminyaka yobudala.
Ezinye izinkinga zokwelapha ezingabangela ukuphikisana, ezithintekayo zihlanganisa ukuvimbela / ukushintsha indawo yokwelashwa (i-BRT) -kuhlanganiswa kwemithi ye-hormone ye-hormone esikhundleni kanye nezidakamizwa ze-antithyroid-kanye nenqubo eyaziwa ngokuthi i-thyroid- based embolization .
Iziguli eziningi ze-thyroid ezithola ukwelashwa kwe-RAI noma ukuhlinzwa ngokugcina ziphelisa i-hypothyroid, futhi ziphathwa ngezidakamizwa ze-hormone esikhundleni somuthi .
Abanye abasebenza ngokubambisana batusa ukunciphisa ukucindezeleka kanye nokuphathwa kwemikhakha njengokuzindla okuqondisiwe, ukudla kwe-antithyroid kanye nokushintsha okunomsoco, imithi yendabuko yaseShayina, nezinye izindlela eziphelele zokusiza i-thyroid engasebenzi.
Imithi yokwelapha
I-Goiter ibhekisela kwi- thyroid ekhulisiwe , engathuthuka kokubili hypothyroidism kanye ne-hyperthyroidism.
Kuye ngobukhulu nendawo, uma unayo i-goiter, kungabangela umuzwa wokugcwala entanyeni yakho, ubuhlungu, nokungajwayelekile, kungenza kube nzima ukugwinya noma ukuphefumula.
Uma unayo i-goiter encane engabonakali futhi ayihambisani nanoma yimaphi ama-irregularities emazingeni akho wegciwane, udokotela wakho anganquma ukuqapha-hhayi ukuphatha-i-goiter yakho.
Ukuze uthole okuncane, i-goiter ephawulekayo, odokotela ngokuvamile bakuphatha ngemithi ye-hormone esikhundleni somuthi . Kwezinye izimo, izidakamizwa zinganciphisa noma zibeke ukukhula kwe-goiter yakho kodwa kungenakwenzeka ukuba uyihlehlise.
Uma i-goiter yakho ikhulu, iyaqhubeka ikhula naphezu kokuba i-hormone yegciwane, ikukhathaza ngokuziqhenya, noma iphazamisa ukugwinya noma ukuphefumula, udokotela wakho angancoma i-iodine ye-radioactive (i-RAI) ukunciphisa i-thyroid yakho, noma ukuhlinzwa ukususa konke noma ingxenye yakho i-gland gland.
Endabeni ye-goiter engenxa yokuntuleka kwe-iodine, udokotela wakho cishe uzotusa ukusetshenziswa kwe-iodine eyengeziwe.
Ukwelashwa kwe-Nodule ye-Thyroid
Iningi lezinyosi ze-thyroid zinezinhle. Ezingxenyeni ezincane, ezinamahlombe angenayo izimpawu, abahlengikazi abaningi bakhetha ukuqapha iziguli. Iphesenti elikhulu labantu-abanye ochwepheshe basikisela iningi labantu-babe nalezi zinhlayiya ezingenasifo, futhi abadingi ukwelashwa okuqhubekayo.
Ukuze uthole ama-nodules angama-symptomatic, inqubo yokuqala yokwelashwa ngokuvamile i-hormone ye-hormone esikhundleni sokusebenzisa izidakamizwa ze- levothyroxine , okungase ngezinye izikhathi zinciphise ama-nodule, zivimbele ama-nodules ekukhuleni, futhi zisize ukuvimbela ama-nodules amaningi ekubunzeni. Ngenxa yokuthi ukwelashwa kusebenza ngokugcwele kulesiguli seziguli kuphela, i-levothyroxine therapy ibhekwa njengokungathi iphikisana.
Kwezinye izimo, uma i-nodule ihambisana ne-hyperthyroidism, i-iodine ye-radioactive (RAI) isetshenziselwa ukunciphisa i-nodule ne-gland yegland. Uma i-nodule enobungozi inkulu futhi ingasabeli emithini yemithi noma i-RAI, ukuhlinzwa kuvame ukuphakanyiswa.
Enye indlela esetshenziselwa ama-nodules yi- injection ethanol (PEI) ekhishwa ngamanzi, lapho i-nodule ishaywa khona ngomjovo.
-
Iziguli Zigciwane: Ingabe Udinga i-T3 noma i-Natural Desiccated Thyroid?
-
I-Metformin ne-Your Thyroid
Olunye ubuchwepheshe obusha obungaqiniseki bokuhlinzeka ngamagundane yi- high-intensity ultrasound technology .
Uma i-nodule noma ama-nodules amaningi anqunywa ukuba abe nomdlavuza, i-thyroid yakho ivame ukukhishwa ngokuhlinzwa njalo noma ingxenye. Endabeni yokulimala , izinqubo zokwelashwa komdlavuza we-thyroid zilandelwa ngokususelwa kunhlobo lomdlavuza otholiwe.
Esikhathini esedlule, i-thyroidectomy yenziwa ngemuva kokuthandwa kwe- needle emihle (i-FNA) yabonisa izigulane ezingenakulinganiswa noma ezingavumelani , kodwa inqubo entsha yokuhlaziywa kwe-Veracyte Afirma Thyroid inciphisa kakhulu imiphumela engapheli futhi ivimbela ukuhlinzwa okungadingekile .
Imikhombandlela eningiliziwe yokwelashwa kwama-nodules afakwe ku- American Association of Clinical Endocrinologists ' Guidelines for Clinical Practice for the diagnosis and management of Nodules Thyroid.
Ukwelashwa kwe-Thyroiditis
I-Thyroiditis isho ukuvuvukala kwegciwane lakho le-thyroid. Ngenkathi i-autoimmune (Hashimoto's) thyroiditis yinto evame kakhulu, kunezinye izinhlobo ze-thyroiditis, kuhlanganise ne-post-partum thyroiditis, i-De Quervain's (ebizwa nangokuthi i-subacute noma i-granulomatous) ye-thyroiditis, kanye ne-viral thyroiditis, phakathi kwabanye.
Njengoba kuphawuliwe, kwezinye izimo, i- Hashimoto's thyroiditis iphathwa ngemithi ye-hormone esikhundleni somuthi . Ezimweni ze-thyroiditis ezibuhlungu, odokotela ngokuvamile bancoma ukukhulula ubuhlungu ngezindawo eziphikisayo, njenge-aspirin, ibuprofen (Advil / Motrin), noma i-naproxen (i-Aleve).
Uma i-thyroiditis isicindezeleke kakhulu, odokotela ngezikhathi ezithile bancoma izidakamizwa ze-steroid ukunciphisa ukuvuvukala, kanye nezidakamizwa ze-hormone esikhundleni somuthi, ukuze i-thyroid iphumule emsebenzini wayo wokukhiqizwa kwe-hormone.
Ngaphambi kokudla okunomsoco, kunobunye ubufakazi bokuthi ukufakazela nge-mineral selenium kungasiza i-thyroiditis.
Nansi ulwazi oluthe xaxa ngezinhlobo ezithile ze- thyroiditis :
- Riedel's thyroiditis
- subacute thyroiditis ye-granulomatous
- i-thyroiditis enesifo esithathelwanayo
- i-thyroiditis engenabuhlungu
- i-postpartum thyroiditis
Ukwelapha Igciwane le-Thyroid
Kunezinhlobo ezine ezahlukene zomdlavuza wegciwane: i-papillary, i-follicular, i-medullary, ne- plastic . Izindlela zokwelapha umdlavuza we-thyroid zisekelwe kuhlobo lomdlavuza, futhi kwezinye izimo, isiteji-ukuthi umdlavuza usakaze kangakanani kwezinye izingxenye zomzimba-kanye nokuthi ungumdlavuza omusha noma umdlavuza ophindaphindiwe.
Ukwelapha umdlavuza wegciwane kuhlanganisa:
- Ukuhlinzwa ukukhipha umdlavuza, owaziwa ngokuthi i-thyroidectomy . Ezinye iziguli zithola i-lobectomy, esusa ohlangothini olulodwa lwe-thyroid. I-thyroidectomy esondelene nayo isusa cishe yonke ingubo. I-thyroid yonke isuswe ku- thyroidectomy yakho yonke . I-lymph node dissection nayo ngezinye izikhathi yenziwa ngesikhathi sokuhlinzwa kwe-thyroid, ukuhlola ukusakazeka komdlavuza wegciwane.
- Ukwelashwa kwezidakamizwa ukubulala amangqamuzana omdlavuza. Ngomdlavuza wegciwane, imisebe ivame ukunikezwa ketshezi noma iphilisi equkethe i-radioactive iodine (RAI). I-thyroid ithatha iodine, futhi ifomu le-iodine elibuthekayo liqoqa izicubu ze-thyroid bese libulala amangqamuzana omdlavuza. Kwezinye izimo, ukukhishwa kwemisebe kukhishwa ngaphandle komzimba, okuhloswe ngqo kwi-thyroid, futhi kuyaziwa ngokuthi imisebe yangaphandle ye-beam.
- Ukwelashwa kwe-hormone, usebenzisa izidakamizwa ezithathelisayo ze-hormone . Ngemuva kokuhlinzwa kwe-thyroid noma i-RAI, cishe uzoba i-hypothyroid, futhi udinga izidakamizwa zokuvuselelwa kwe-hormone ye-thyroid. Kwezinye izimo, odokotela bazonikeza umthamo ozogcina i-TSH yakho iphansi noma ingabonakali, ukusiza ekuvimbeleni umdlavuza we -roid kusuka ekuphindaphindiwe.
- Imithi ehlosiwe, kuhlanganise nezidakamizwa ezintsha ezihlukahlukene zemithi yomdlavuza we-thyroid, kuhlanganise nalawo angamelana nemithi yokwelapha ioday.
- I-Chemotherapy ayivamile, kodwa ingasetshenziswa kwezinye izimo, ngokuyinhloko ukusiza ukukhulula izimpawu.
I-Hypothyroidism / Isifo Sokugula KwamaHashimoto
I-Hypothyroidism yisimo lapho i-thyroid ingasebenzi, ichithekile ngamakhemikhali, noma isuswe ngokuhlinzwa, ngakho-ke ayikwazi ukukhiqiza amazinga anele wehomoni ye-thyroid. Sishiye isikhathi sokugcina ngoba, ngokuyinhloko, eziningi zokwelapha ezinye ze-thyroid-ngoba zibandakanya ukususa i-radioactively noma ukukhishwa ngokucophelela i-thyroid-zivame ukuphela uma uba i-hypothyroid.
I-Hypothyroidism iphathwa ngokususa i-hormone elahlekile, i-hormone ebalulekile emisebenzini esemqoka yomzimba. Lokhu kufezwa ngokuthatha izidakamizwa ze-hormone esikhundleni esikhundleni sakho esinikezwe udokotela wakho.
Imithi ye-hormone esikhundleni se-thyroid ithatha indawo ye-hormone ye-thyroid engekho emzimbeni wakho. Zihlanganisa okulandelayo:
- Isidakamizwa se-hormone esikhundleni se-thyroid ebizwa ngokuthi i-levothyroxine, uhlobo oluthile lwe-hormone thyroxine (T4) ye-thyroid. Amagama omuthi ajwayelekile ahlanganisa i-Synthroid, i-Levoxyl, i-Unithroid, ne-Tirosint.
- Kukhona nefomu lokufakelwa kwe-T3 hormone, eyaziwa njenge-liothyronine, ngezinye izikhathi yengezwe ku-levothyroxine yokwelashwa kwe-T4 / T3. Igama lomkhiqizo e-US yi-Cytomel.
- Futhi, kunezidakamizwa ezithathelwanayo ezibizwa nge-hormone ebizwa ngokuthi i-natural disiccated thyroid, ngezinye izikhathi ezifingqiwe i-NDT noma okuthiwa "i-extract ye-thyroid." Nakuba selukhona isikhathi esingaphezu kwekhulu futhi lisasebenza nanamuhla, i-NDT ibhekwa ingxabano ngumphakathi wezokwelapha ovamile, kodwa inqunywe kaningi ngama odokotela abaphelele kanye nabasebenzayo. Amagama omuthi ajwayelekile ahlanganisa i-Nature-throid, i-Armor Thyroid, ne-WP Thyroid.
Ukwelashwa kwesifo sikaHashimoto, isimo esizimele esivame ukuphumela ku-hypothyroidism, siphikisana kakhulu. Abaningi abasebenza ngokuyinhloko bakholelwa ukuthi uHashimoto akadingi ukwelashwa, futhi baphatha kuphela izidakamizwa ze-hormone esikhundleni somuthi lapho uHashimoto eholele ku-hypothyroidism. (Funda kabanzi mayelana nokuhlukana: Hashimoto vs. Hypothyroidism: Uyini umehluko?)
Abanye odokotela bakholelwa ukuthi isifo sikaHashimoto, esingaqinisekiswa ngokuhlolwa kwamagciwane omzimba we- thyroid , sidinga ukwelashwa kwezinye iziguli ezinomzimba, ngisho noma ezinye izifo ze-thyroid zivamile. Kukhona nobufakazi bokuthi ukwelapha isifo sikaHashimoto ngezidakamizwa ze-hormone esikhundleni se-thyroid ngaphambi kokuba i -hormone ye-hormone (stimulating) ye-hormone (TSH) ikhuphuke izinga linganciphisa ezinye izimpawu. Olunye ucwaningo lubonisa ukuthi ukwelapha umuntu onamaHashimoto okunye okuvivinya igazi okujwayelekile, kuhlanganise nezinga elijwayelekile le-TSH , kungasiza ekuvimbeleni ukuphakama kwezinga le-TSH nokuqhubekela phambili ekugcwaliseni i-hypothyroidism. Ukwelapha amaHashimoto uma i-TSH ingavamile ingxabano, noma kunjalo.
Indawo entsha enethembisayo yokwelashwa kukaHashimoto: ukusetshenziswa kwesilinganiso semithi esincane esine-naltrexone (i-LDN) ne-autologous stem cell transplants. Kokubili ukwelashwa kungasiza ama-antibodies aphansi futhi aphumelele kwezinye iziguli.
Emtholampilo wokuhlanganiswa ngaphambili, abanye abasebenza ngokugcwele batusa i- iodine supplementation , nezinye izithako zokudla okunomsoco, izinguquko zokudla, i-yoga poses ethile, imithi yomzimba, nezinye izindlela ezihambisanayo zokusiza i-thyroid.
Ezinye izindlela zokudidiyela zokwelapha zihlanganisa:
- Ukwengezwa nge-selenium kuma-antibodies aphansi
- Ukubhekisana nokungalingani okuhambisana nokungaqondakali okungenzeka kube nzima ukwenza ukwelashwa kwegciwane
- Izinguquko zezinkukhu ukunciphisa ukuvuvukala
- Ukuqeda i-gluten ekudleni ngenxa yokuxhumana phakathi kwe-gluten nokuzimela
- Ukunciphisa ukucindezeleka nokuphathwa
Izwi elivela
Uma kuziwa ekukhetheni ukwelashwa kwegciwane, udinga ulwazi. Isiqalo esihle sokuqala silapha, nezinsiza zethu eziphelele mayelana nazo zonke izinkinga zezinkinga ze -roid .
Udinga ukuthola udokotela ongcono we-thyroid , futhi uhlanganyele naye. Futhi khumbula: Unganqikazi ukuthola umbono wesibili ekunakekeleni kwakho kwe-thyroid uma unemibuzo mayelana nendlela yakho yokwelashwa.
Imithombo:
Bahn R, Burch H, Cooper D, et al. I-Hyperthyroidism nezinye izimbangela ze-Thyrotoxicosis: Iziqondiso Zokuphatha ze-American Thyroid Association ne-American Association of Endocrinologist Clinic . I-Endocrine Practice . I-Vol 17 No. 3 Meyi / Juni 2011.
> Garber J, uCobin R, Gharib H, et al. Imihlahlandlela Yokuzivocavoca Yomtholampilo ye-Hypothyroidism Kubantu Abadala: I-Cosponsored yi-American Association of Clinical Endocrinologists kanye ne-American Thyroid Association . I-Endocrine Practice . I-Vol 18 No. 6 Novemba / Disemba 2012.
I-Smallridge R, Ain K, Asa S, et al. Imikhombandlela ye-American Thyroid Association Yokuqondisa Iziguli ezine-Anaplastic Cancer Cancer. I-Thyroid . Umqulu 22, Inombolo 11, 2012 kufanele: 10.1089 / kwakho.2012.0302
Stagnaro-Green A, Abalovich M, Alexander E. et al. Imihlahlandlela ye-American Thyroid Association Yokuthola Ukuhlolwa Nokuphathwa Kwezifo Ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum. I-Thyroid . Umqulu 21, Inombolo 10, 2011 ini: 10.1089 / thy.2011.0087
U-Wells S, uAsa S, uDralle H, et al. I-American Revised Thyroid Association Guidelines ye-Management of Medullary Thyroid Carcinoma. I-Thyroid . Umqulu 25, Inombolo 6, 2015. ini: 10.1089 / thy.2014.0335