Ukubheka izidakamizwa ze-Antithyroid, Iodine ye-radioactive, nokuhlinzwa
Ukwelashwa okungcono kakhulu kwe- hyperthyroidism yakho kuxhomeke ezintweni eziningana, ngenxa yezizathu zenkinga yakho kuze kube sesikhathini sakho, ubukhulu becala lakho empilweni yakho yonke. Nakuba izidakamizwa ze-antithyroid (isibonelo, i-Tapazole, isibonelo) zingasetshenziswa ukusiza umsebenzi we-thyroid ngokujwayelekile, ezinye izindlela zokwelapha-njenge-beta-blockers-zingase zibhekwe njengokunciphisa izimpawu ze-hyperthyroid.
Izinketho ezifana nokuqeda i-thyroid nge-iodine ye-radioactive noma ukuhlinzwa ukuze ususe i-gland (i-thyroidectomy) nayo ingacatshangwa.
Nakuba zonke izinketho ezintathu ziphumelela, zinezindleko ezihlukahlukene kanye nemiphumela emibi. Yingakho ukuxoxa ngokucophelela nodokotela wakho kuyadingeka ngaphambi kokuhlela uhlelo lokulashwa.
Imigomo
Imithi ye-prescription ngokuvamile iyona yokwelashwa okuyinhloko ye-hyperthyroidism. Ungase futhi unqunywe ezinye izidakamizwa ukukusiza ukuphatha izimpawu ezihlobene.
I-Antithyroid Drug Treatment
Umgomo wezidakamizwa ze-antithyroid ukufeza umsebenzi ovamile we -roid esikhathini esingangenyanga noma ezimbili kokuqala ukwelashwa. Khona-ke umuntu angaqhubeka nezinketho ezilandelayo:
- Yenza ukwelashwa okucacile nge-iodine noma i-radioactive
- Qhubeka nomuthi we-antithyroid wesinye isikhathi noma unyaka owodwa, ngethemba lokuthola ukuxolelwa (cishe okungenzeka kubantu abane-hyperthyroidism emnene futhi cishe kunabantu abano-goiter enkulu nalabo abasola)
- Thatha i-antithyroid izidakamizwa isikhathi eside
Ngenkathi ukwelashwa kwezidakamizwa ezithatha isikhathi eside kudala kuyathandeka (unethuba lokuxolelwa, ukwelashwa kuguqulwa, futhi ungagwema izingozi nezindleko ezihlobene nokuhlinzeka), ukuphazamiseka ukuthi abacwaningi bathi bangamaphesenti angu-70 abantu bazobuyela emuva Ukwelashwa kwezidakamizwa ze-antithyroid kumisiwe.
Imithi emibili ye-antithyroid etholakala e-United States yiTapazole (methimazole, noma i-MMI) ne- propylthiouracil (PTU). Ngenxa yokuthi i-MMI ine-side effects emincane futhi ivuselela i-hyperthyroidism ngokushesha kakhulu kune-PTU, i-MMI yikhethe lokukhetha.
Lokhu kusho ukuthi i-PTU isetshenziselwa ukwelapha i-hyperthyroidism ngesikhathi sokuqala kokukhulelwa kanye nabantu ababhekene nesiphepho se- thyroid . Kungabuye kunikezwe abantu abaye basabela kumethimazole futhi abafuni ukuthola iodine noma i-radioactive radioactive.
Eminye imiphumela emibi emibi ehambisana nokuthatha i-MMI noma i-PTU ifaka phakathi:
- Itching
- Rash
- Ubuhlungu obuhlangene nokuvuvukala
- I-nausea
- Fever
- Izinguquko ukunambitha
Okubaluleke nakakhulu, ukulimala kwesibindi nge-MMI noma i-PTU (okuvame kakhulu nalokhu okulandelayo) kungenzeka. Izimpawu zokulimala kwesibindi zihlanganisa ubuhlungu besisu, i-jaundice, umchamo omnyama, noma izitshalo ezinobumba. Nakuba kungavamile, isimo esingasongela ukuphila esibizwa ngokuthi i-agranulocytosis (ukwehla kwamaseli okulwa nokutheleleka emzimbeni wakho) kungenzeka nge-MMI noma i-PTU. Kubalulekile ukuthi abantu bathathe lezi zidakamizwa bazise udokotela wabo ngokushesha uma beveza izimpawu zokutheleleka okunjengomkhuhlane noma umkhuhlane.
I-Beta I-Blocker Therapy
Nakuba kungewona ukwelashwa kwe-hyperthyroidism, abantu abaningi abanesifo se-hyperthyroidism banikezwa i-beta-adrenergic receptor antagonist (eyaziwa ngokuvamile ngokuthi i-beta-blocker).
I-beta-blocker isebenza emzimbeni ukunciphisa imiphumela yehomoni ye-thyroid engaphezu kwenhliziyo nokusabalalisa, ikakhulukazi izinga lokushaya kwenhliziyo, ukucindezeleka kwegazi, ukuguqulwa kwegazi, ukuthuthumela, kanye nezilinganiso ezingavamile. Abavimbela i-Beta banciphisa izinga lokuphefumula, banciphise ukujuluka okukhulu ngokweqile nokushisa ukushisa, futhi ngokuvamile banciphise imizwa yokwesaba nokukhathazeka.
Izidakamizwa ze-Thyroiditis
Ngezinhlobo zesikhashana noma "ezilinganiselwe" ze-hyperthyroidism (isibonelo, i-subacute thyroiditis noma i- postpartum thyroiditis ), okugxile kakhulu ekuphatheni izimpawu. Ukunciphisa ubuhlungu kunganikezwa ubuhlungu be-thyroid nokuvuvukala, noma izivimbela ze-beta zingase zibekwe ezinkomba ezihlobene nenhliziyo.
Ngezinye izikhathi, umuthi we-antithyroid umisiwe okwesikhashana.
Ablation
Iodine ye-radioactive (RAI) isetshenziselwa ukubhubhisa izicubu zegciwane le-thyroid, okuyaziwa ngokuthi yi-ablation. Isetshenziselwa ukuphatha iningi labantu elibhekene nesifo se-Graves e-United States, kodwa ngeke lisetshenziswe kwabesifazane abakhulelwe noma abancancisayo, noma abantu abanomdlavuza wegciwane ngaphezu kwe-hyperthyroidism yabo.
Ngesikhathi ukwelashwa kwe-RAI, ioday radioactive inikezwa njengesilinganiso esisodwa, ku-capsule noma ngesisombululo somlomo. Ngemuva kokuba umuntu engene i-RAI, i-target iodine futhi ingena e-thyroid, lapho idlulisa khona amangqamuzana e-thyroid, ewalimaza futhi ewabulala. Ngenxa yalokho, igulane le-thyroid liyancipha futhi umsebenzi we-thyroid uphuthukisa phansi, uguqula i- hyperthyroidism yomuntu.
Lokhu kuvame ukuvela phakathi kwamasonto ayisithupha kuya kwangu-18 emva kokufaka iodine e-radioactive, nakuba abanye abantu badinga ukwelashwa kwesibili kwe-RAI.
Kubantu asebekhulile, abanezimo ezingaphansi kwezempilo ezinjengezifo zenhliziyo, noma abanezimpawu ezibalulekile ze-hyperthyroidism, i-antithyroid (i-methimazole, ngokuvamile) isetshenziselwa ukuvuselela umsebenzi we -roid ngaphambi kokuthola ukwelashwa kwe-RAI. I-Methimazole nayo inikezwa cishe ngezinsuku ezintathu kuya kweziyisikhombisa emva kokwelashwa kwe-RAI kulaba bantu, bese kancane kancane igxilile njengoba umsebenzi wabo we-thyroid ujwayelekile.
Imiphumela emibi kanye nokukhathazeka
I-RAI ingaba nemiphumela emibi, kuhlanganise ne-nausea, ubuhlungu bomphimbo, nokuvuvukala kwezigqoko zamathe, kepha ngokuvamile lezi zesikhashana. Iphesenti encane kakhulu yeziguli zisengozini yokuphefumula isifo se-thyroid ngemuva kwe-RAI.
Ngaphezu kwalokho, kunobufakazi besayense obonisa ukuthi ukwelashwa kwe-RAI kungabangela ukuthuthukiswa noma ukuwohloka kwesifo se-Graves '(i-orbitopathy). Ngenkathi lokhu kukhula kubonakala kunomusa futhi kufushane, imihlahlandlela ye-American Thyroid Association ayikhuthazi ukunikeza ukwelashwa kwe-RAI kubantu abanesifo esilinganiselwe nesilonda.
Uma unesi-RAI, udokotela wakho uzoxoxa ngezinga le-radiation nanoma yiziphi izinyathelo okumele uzithathe ukuze uvikele umndeni wakho noma umphakathi. Lokho kusho ukuthi, ukukhululeka ukuthi inani lemishanguzo elisetshenziselwa ukwelashwa kwe-RAI lincane futhi alibanga imbangela yomdlavuza, ukungabi namntwana, noma ukukhubazeka kokuzalwa.
Ngokuvamile, noma kunjalo, emahoreni angu-24 okuqala ngemva kwe-RAI, gwema ukuthintana obuseduze nokumanga. Ezinsukwini eziyisihlanu zokuqala noma ngemuva kwe-RAI, ukunciphisa ukuvezwa kwezingane ezincane nabesifazane abakhulelwe, futhi ikakhulukazi, gwema ukuthwala izingane ngendlela eyokwehliselwa endaweni yakho ye-thyroid.
Ukuhlinzwa
Ukuhlinzwa kwe-thyroid (eyaziwa ngokuthi i-thyroidectomy) ngokuvamile kuyindlela yokugcina yokukhetha ukwelashwa okweqile kwe-thyroid. Nakuba ukususa igciwane le-thyroid kusebenza kakhulu ekuphatheni i-hyperthyroidism, ukuhlinzwa kuyingozi, kuyabiza futhi kuyingozi kakhulu.
Ngokuvamile, ukuhlinzwa kunconywa ezimweni ezilandelayo:
- Uma izidakamizwa ze-antithyroid kanye / noma i-RAI behluleka ukulawula lesi simo
- Uma umuntu ehlonza izidakamizwa ze-antithyroid futhi akafuni ukwelashwa kwe-RAI
- Uma umuntu enolisayo, mhlawumbe unomdlavuza we-thyroid onomdlavuza
- Uma umuntu enendawo enkulu kakhulu (ikakhulukazi uma ivimbela ukuhamba komoya noma ukwenza kube nzima ukugwinya), izimpawu ezinzima, noma isifo se-Graves 'esisebenzayo
Uma uhlinzwa ngokuhlinzwa kwegciwane, udokotela wakho uzothatha isinqumo sokuthi uzokhipha yini igciwane le-thyroid (elibizwa ngokuthi i-thyroidectomy yakho yonke) noma ingxenye yegland (okuthiwa i-thyroidectomy eyingxenye). Lesi sinqumo akusiso sonke isikhathi esilula futhi sidinga ingxoxo nokucubungula okucabangelayo.
Ngokuvamile, yiluphi uhlobo lohlinzekwa olutholayo luncike ekubambeni kwe-hyperthyroidism yakho. Ngokwesibonelo, i-hormone eyodwa engaphezu kwesifo se-thyroid ehlala ngakwesobunxele segciwane lakho le-thyroid lingase liphathwe nge-thyroidectomy encane (ohlangothini lwesobunxele we-gland gland isusiwe). Ngakolunye uhlangothi, i-goiter enkulu ethatha izinhlangothi zombili ze-thyroid ingaphathwa nge-thyroidectomy yakho yonke.
Ukuphathwa kwePost-Surgical nezinhlekelele
Uma unesifo sakho se-thyroidectomy esiphelele, i-hormone ye-thyroid yokuphila yonke iyadingeka. Ngakolunye uhlangothi, nge-thyroidectomy encane, kunethuba elihle lokuthi ngeke udinga imishanguzo yegciwane lengunaphakade, uma nje kunesisindo esanele sokushiya ukukhiqiza inani elanele lehomoni yegciwane.
Njenganoma yikuphi ukuhlinzwa, kubalulekile ukubukeza izingozi ezingase zibe khona nodokotela wakho. Ukuze kuhlinzekwe ngegciwane, izingozi ezingase zibandakanye ukuphuma kwegazi, nokulimala kwimbangela yokuphindaphinda yomswakama (okwenza kubangele) kanye / noma ingulube ye-parathyroid (elawula ukulinganisela kwe-calcium emzimbeni). Ngomunye udokotela ohlinzayo we-thyroid, lezi zingozi zincane.
Ngesikhathi sokukhulelwa
Kuvame ukululekwa ukuthi uma owesifazane ephethe i-hyperthyroid futhi efisa ukukhulelwa esikhathini esizayo esiseduze ukuthi ucabange ukwelashwa kwe-RAI noma ukuhlinzeka izinyanga eziyisithupha ngaphambi kokukhulelwa.
Abesifazane abakhulelwe abanezibonakaliso kanye / noma i-hyperthyroidism enomthelela ekudleni badinga ukwelashwa. Ukwelashwa okunconywayo kuyisidakamizwa se-antithyroid, kuqala nge-PTU ku-trimester yokuqala bese ushintshela ku-methimazole kumakhomitha wesibili nowesithathu (noma uhlala ku-PTU).
Nakuba lezi zidakamizwa zifaka ingozi kubesifazane abakhulelwe, umgomo wakho udokotela ukuwusebenzisa njengendlela encane ngangokunokwenzeka ukuze ulawule i-hyperthyroidism futhi unciphise izingozi ezithinta wena nomntanakho.
Ngokuvamile, odokotela batusa umthamo omncane kunazo zonke ozolawula lesi simo. Njengoba zonke izidakamizwa ze-antithyroid ziwela i-placenta, noma kunjalo, kubalulekile ngokukhethekile ukulandela imiyalelo yokugonywa futhi uqhubeke nokuhlolwa okuphakanyisiwe (okwenzeka njalo ngemva kwamasonto amane).
Ekuvakasheni kwezempilo, ngaphezu kokuhlolwa kwe-thyroid, ukushayela kwakho, inzuzo yesisindo , nosayizi we-thyroid uzohlolwa. I-Pulse kufanele ihlale ngaphansi kwezingu-100 ngomzuzu. Kumelwe uzame ukugcina isisindo sakho singene ezindaweni ezijwayelekile zokukhulelwa, ngakho-ke khuluma nodokotela wakho mayelana nokudla okunempilo nokuthi yiziphi izinhlobo zomsebenzi ongokomzimba ezifanele isimo sakho samanje. Ukukhula kwe-Fetal kanye ne-pulse kufanele futhi kuqashwe njalo ngenyanga.
Ezinganeni
Njengabantu abadala, i-hyperthyroidism ezinganeni ingaphathwa nge-antithyroid yokwelapha izidakamizwa, i-iodine ye-radioactive, noma i-thyroidectomy.
Ukuphathwa kokhetho ezinganeni ezine-hyperthyroidism yi-MMI yezidakamizwa ze-antithyroid, njengoba ithwala izingozi ezincane uma kuqhathaniswa ne-RAI noma ukuhlinzwa, futhi kunemiphumela emibi kakhulu uma kuqhathaniswa ne-PTU. Ngenkathi i-RAI noma ukuhlinzwa noma ezinye izindlela zokwelapha ezamukelekayo, i-RAI igwenywe ezinganeni ezingaphansi kweminyaka engu-5.
Imithi Ephelele (CAM)
E-China nakwamanye amazwe, amakhambi aseShayina ngezinye izikhathi asetshenziselwa ukuphatha i-hyperthyroidism, noma eyedwa noma kanye nomuthi we-antithyroid. Ngenkathi inqubo eqondile ingacacile, abanye bakholelwa ukuthi ama-herbs asebenza ngokuvimbela ukuguqulwa kwe-thyroxine (T4) kuya ku-triiodothyronine (T3) nangokunciphisa imiphumela ye-T4 emzimbeni.
Esifundweni esikhulu sokubuyekeza, esihlola izilingo eziyishumi nesishiyagalolunye zabantu abangaphezu kuka-1700 abane-hyperthyroidism, ukwengezwa kwezihlahla zaseChina ezidakamizwa ze-antithyroid kwaphumelela ekwenzeni ngcono izimpawu nokunciphisa kokubili imiphumela emibi yemithi ye-antithyroid nokuphindaphinda kwamazinga (okusho ukuphindaphinda kwe-hyperthyroidism) kwabanye abantu. Kodwa abalobi besifundo, bathi, zonke lezi zivivinyo aziklanyelwe kahle. Ngenxa yekhwalithi yabo ephansi, abalobi basho ukuthi abukho ubufakazi obuqinile bokusekela ukusebenzisa imithi yama-Chinese yemithi ekwelapheni kwe-hyperthyroidism.
Kusukela amakhambi aseShayina (noma ezinye izindlela zokwelashwa) angathinta imithi yakho kanye namazinga we-thyroid ngokungathandeki, kubalulekile ukuthi uwathathe kuphela ngaphansi kokuqondiswa kwe-endocrinologist yakho.
Ngaphandle kwamakhambi aseShayina, i- vitamin D iye yaqaphela kakhulu emphakathini wegciwane. Ngenkathi isixhumanisi sitholakale phakathi kokuntuleka kwe-vitamin D kanye nesifo se-autoimmune se-thyroid (kokubili isifo se-Graves nesifo sikaHashimoto), kusacacile ukuthi lokhu kusho ukuthini, njengokuthi ukutholakala kwe-vitamin D kungumphumela wokushona komzimba we-thyroid.
Siyazi ukuthi i-hyperthyroidism ingase ibe negalelo ekutheni amandla aphethwe amandla (i-osteoporosis), ngakho ukuqinisekisa ukuthi i-vitamin D efanele ne-calcium yokudla ibalulekile. I-Institute of Medicine incoma ama-vitamini D angu-600 ngosuku (iUs) ngama-adults kubantu abaneminyaka engama-19 kuya ku-70 no-800 ama-UU kubantu abadala abangaphezu kweminyaka engu-70. Lokho kusho ukuthi kusengumqondo omuhle ukuqinisekisa umthamo wakho we-vitamin D nodokotela wakho. Angase ancoma ukuhlola izinga lakho levithamini D ngokuhlolwa kwegazi; uma ungenalutho, ungadinga ukulinganisa okuphezulu kuneziphakamiso ezibonisa.
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