A Tarisa Anthithyroid Zvinodhaka, Irovhoni Iodine, uye Kuvhiya
Iyo yakanakisisa kurapwa kwako ye hyperthyroidism inobva pane zvikonzero zvakasiyana, kubva pamusana wehutano hwako kusvika kuzera hwako, kuoma kwechiitiko chako kuhutano hwako hwose. Kunyange zvazvo zvinodhaka zvinonzi antithyroid (Tapazole, somuenzaniso) zvinogona kushandiswa kubatsira chirwere chetachiona zvakajairika, mamwe marapirwo-akadai se beta-blockers-angafungidzirwa kuti aderedze zviratidzo zve hyperthyroid.
Zvisarudzo zvakadai sekupararira kwetachiona neoday iodine kana kuvhiyiwa kubvisa gland (thyroidectomy) inogonawo kufungwa.
Kunyange zvazvo zvinhu zvitatu zvingasarudzwa zvinobudirira, mumwe nomumwe ane zvisizvo zvakasiyana uye zvinogona kuitika. Ichi ndicho chikonzero kukurukurirana kwakanyatsonaka uye kwakakwana nachiremba wako kunofanirwa usati wagadzirira chirongwa chekurapa.
Zvinyorwa
Mishonga yemishonga inowanzoita mushonga mukuru we hyperthyroidism. Iwe unogonawo kupiwa mamwe mishonga kuti ikubatsire kutarisa zviratidzo zvakabatana.
Antithyroid Drug Treatment
Chinangwa chezvinodhaka zvevhitithyroid ndezvekuita hutachiona hwemazuva ose kana maviri kubva pakutanga. Zvadaro munhu anogona kuenderera mberi nekusarudza:
- Undergo definitive therapy with radioactive iodine kana chirwere
- Ramba uchishandisa mishonga yeva antithyroid kune rimwe gore kana maviri, ane tariro yekuwana kukanganwirwa (izvo zvinowanzoitika kune vanhu vane hyperthyroidism vanyoro uye zvishoma nezvishoma kune vanhu vane goiter huru nevaya vanosvuta)
- Tora mishonga inoshandiswa nevhidhiyo inotora nguva refu
Kunyange zvazvo kurapwa kwemishonga inorapwa kwenguva refu kwenguva yakareba (iwe une mukana wokuregererwa, kurapwa kunodzokororwa, uye iwe unogona kudzivisa njodzi uye mari dzinobatanidza nekuvhiyiwa), iyo inonyadzisa ndeyokuti vatsvakurudzi vanofungidzira kusvika kusvika makumi manomwe kubva muzana yevanhu vachadzokerazve shure antithyroid mishonga yokurapa yakamira.
Mishonga miviri yeitrotyroid inowanikwa muUnited States iTapazole (methimazole, kana MMI) uye propylthiouracil (PTU). Pamusana pekuti MMI ine zviduku zvishoma uye inoderedza hyperthyroidism nokukurumidza kupfuura PTU, MMI ndiyo sarudzo yakasarudzwa.
Izvozvo zvakati, PTU inoshandiswa kurapa hyperthyroidism munguva yekutanga kwemitatu yekudzivirira uye kune vanhu vari kutarisana nedutu reyroid . Inogona kupiwawo kune avo vakagadziriswa ne methimazole uye vasingadi kuve neododacacia kana kuvhiyiwa.
Zvimwe zvingave zvisingabatsiri zvikamu zvinokonzerwa nekutora kana MMI kana PTU zvinosanganisira:
- Itching
- Mapundu
- Kurwadziwa pamwe chete nekudzimba
- Nausea
- Fever
- Kuchinja mukuravira
Kunyanya zvakakomba, chiropa chinokuvadza pamwe neMMI kana PTU (chinowanzozivikanwa neyekupedzisira) chinogona kuitika. Zviratidzo zvekukuvadzwa kwechiropa zvinosanganisira kurwadziwa kwepamuviri, jaundice, mumvuri werima, kana zvidhori zvevhu. Kunyange zvazvo zvisingawanzoitiki, chirwere chinogona kutyisa upenyu chinonzi agranulocytosis (kuderera kwemaswere-mauto masimba mumuviri wako) kunogona kuitika pamwe ne MMI kana PTU. Zvakakosha kuti vanhu vatore mishonga iyi kuti vazivise chiremba wavo pakarepo kana vachikura zviratidzo zvehutachiona hwakafanana nefivhiri kana maronda.
Beta Blocker Therapy
Kunyange zvazvo isiri kurapa hyperthyroidism, vanhu vazhinji vane hyperthyroidism vanorayirwa beta-adrenergic receptor anopikisa (anozivikanwa kakawanda se beta-blocker).
Beta-blocker inoshanda mumuviri kuti kuderedze migumisiro yekodhoni yakawanda yekemikari mukati memwoyo uye kuparadzirwa, kunyanya kukurumidza kwema moyo, kuwedzerwa kweropa, kupindira, kudengenyeka, uye kusagadzikana maitiro. Beta blockers vanoitawo kuderedza kufema, kupedza kutuka zvakanyanya uye kupisa kusagadzikana, uye kazhinji kuderedza kunzwa kwekutya uye kuzvidya mwoyo.
Zvinodhaka zveTyroiditis
Nokuda kwenguva shoma kana "self-limited" maitiro e hyperthyroidism (somuenzaniso, subacute thyroiditis kana postpartum thyroiditis ), chinonyanya kukosha pakurapa zviratidzo. Zvinorwadza zvinogona kupiwa nokuda kwehutano hwehutachiona nekuputika, kana kuti beta blockers inogona kurongerwa zviratidzo zvine chokuita nemwoyo.
Pane dzimwe nguva, mishonga inoshandiswa nevan antithyroid inorayirwa kwenguva pfupi.
Ablation
Iodine inokonzerwa nehutachiona (RAI) inoshandiswa kuparadza mishonga yehutachiona gland, chii chinozivikanwa sekubvisa. Inoshandiswa kurapa huwandu hwevanhu vakawana chirwere cheBraves muUnited States, asi hachigone kushandiswa kuvakadzi vane pamuviri kana kunyamwisa, kana vanhu vane kenza yekenza pamwe nekuwedzera kwavo hyperthyroidism.
Munguva yekurapa kweRI, iodine inokonzerwa neyodine inopiwa seyero imwe chete, mune capsule kana nehururo remuromo. Mushure mekunge munhu apinza RAI, zvinokonzerwa neIodine uye inopinda murotori, iyo inopisa majekiseni echitendero, ichikuvadza uye ichivauraya. Somugumisiro, chirwere chetachiona chinoderera uye utachiona hunoita kuti zvishoma nezvishoma, kuchinja munhu hyperthyroidism .
Izvi zvinowanzoitika mukati memasvondo matanhatu kusvika kwema 18 mushure mekudyisa iodine inodhaka, kunyange zvazvo vamwe vanhu vanoda chikamu chechirwere cheRI.
Muvanhu vakwegura, vane hutano hwehutano hwakafanana nehutano hwemwoyo, kana vane vane zviratidzo zvehutachiona hwehutachiona, chirwere che antithyroid (methimazole, kazhinji) chinoshandiswa kugadzirisa utachiona musati wawana chirwere cheRI. Methimazole inopiwawo kwemazuva matatu kusvikira kune manomwe mushure mekurapa kweRI muvanhu ava, uye zvishoma nezvishoma zvakapfa sezvinoitwa nehutachiona hwemaitiro.
Migumisiro Yechiratidzo uye Kunetseka
RAI inogona kuva nedzimwe migumisiro, kusanganisira kusuruvara, kurwadziwa kwehuro, uye kupfugama kwezvinyungudzwa zvemuti, asi izvi zvinowanzoitika kwenguva pfupi. Chikamu chiduku zvikuru chevarwere vari pangozi yehutachiona hwehutachiona huri shure kweRAI.
Uyezve, kune uchapupu hwezvesayenzi hunoratidza kuti chirwere cheRI chinogona kutungamirira kukurudzirwa kana kuwedzera kweHerves 'eye chirwere (orbitopathy). Kunyange zvazvo kuwedzera kukura kunowanzova munyoro uye kwenguva pfupi, mirayiridzo yeAmerican Thyroid Association haina kukurudzira kupa chirwere cheRI kuvanhu vane chirwere chemaziso chakakomba.
Kana iwe uine RAI, chiremba wako achakurukura nezvenzira yehutachiona uye chero matanho aungada kutora kuti udzivirire mhuri yako kana vanhu vose. Izvo zvakati, ivai wakasununguka kuti chiyero chemishonga inoshandiswa murai reRI iduku uye haisi kukonzera chirwere, kusabereka, kana kukanganisa kuberekwa.
Kazhinji, zvakadaro, mumaawa 24 ekutanga mushure meRI, rega kushamwaridzana uye kutsvoda. Mumazuva mashanu ekutanga kana zvakadaro mushure meRAI, rega kuisa vana vaduku nevakadzi vane pamuviri, uye, kunyanya, usarega kutakura vana nenzira iyo vachazoonekwa nayo panzvimbo yako yehutachiona.
Surgery
Kuvhiya kwechirwere (inozivikanwa seytroidectomy) inowanzo sarudzo yekupedzisira yekugadzirisa chirwere chetrojeni chisina simba. Paunenge uchibvisa chirwere chetachiona chinoshanda zvikuru pakurapa hyperthyroidism, kuvhiyiwa kunoparadza, kunodhura, uye kune ngozi.
Kakawanda, chirwere chinokurudzirwa mumamiriro ezvinhu anotevera:
- Kana mishonga yeitrothyroid uye / kana RAI yakange isingakwanisi kudzora mamiriro acho
- Kana munhu aine allergiki kune mishonga ye antithyroid uye haadi chirwere cheRI
- Kana munhu ane chikafu, zvichida kenza yekroidy mushure
- Kana munhu ane goiter yakakura zvikuru (kunyanya kana ichivhara mhepo kana kuti zvichiita kuti zvive zvakaoma kumedza), zviratidzo zvakakomba, kana zvirwere zvinoshanda zveGraves '
Paunenge uchivhiyiwa chirwere chetachiona, chiremba wako achasarudza kana akabvisa chirwere chetachiona yose (inonzi chiroyirosevirus yakazara) kana chikamu cheglandhi (inonzi thyroidectomy). Iyi sarudzo haisi nguva dzose iri nyore uye inoda kukurukura nekufungisisa uye kuongorora.
Kazhinji kutaura, chirwere chipi chekuvhiya iwe unowira chinoenderana nechinokonzera hyperthyroidism yako. Semuenzaniso, chirwere chimwe chete chinokonzera utachiona hwetrojeni huri kuruboshwe rworwere rwako rwetrosi inogona kurapwa nehutachiona hwehutachiona husinganzwisisiki (kuruboshwe rwomukati wekrosi rinobviswa). Kune rumwe rutivi, goiter huru iyo inotora kumativi ose ehutachiona inogona kurapwa nehutachiona hwemajeri.
Post-Surgical Management uye Njodzi
Kana iwe uine utachiona hwehutachiwana hwehutachiona, hutachiona hwehutori hupenyu hwose hunodiwa. Kune rumwe rutivi, nehutachiona hwehutachiona husina kukwana, kune mukanano wakanaka wekuti hauzorevi mishonga yakagadzikana yehutachiona, chero bedzi paine hosha yakasara yakasara kuti ibudise huwandu hwakakwana hwehomoni yehomoni.
Sezvo nekuvhiyiwa chero kupi zvako, zvakakosha kudzorera njodzi dzinogona kuitika kune chiremba wako. Nekuvhiya kwehutachiona, zvinogona kuisa njodzi dzinosanganisira kubuda ropa, uye kunokonzerwa nehutachiona hwemapuranga (zvichikonzera hoarseness) uye / kana chirwere chepathyroid (chinotungamirira calcium balance muviri). Ndiine chirwere chechirwere chechirwere ane ruzivo, zvisinei, njodzi idzi iduku.
Panguva yekudzivirira
Zvinowanzokurudzirwa kuti kana mukadzi ari hyperthyroid uye achida kutakura pamuviri munguva pfupi iri kutevera kuti anofunga nezvekurapa kweRI kana kuvhiyiwa mwedzi mitanhatu asati aita pamuviri.
Vakadzi vane pamuviri vane zviratidzo uye / kana kuenzanisa-ku-yakanyanya hyperthyroidism vanoda chirwere. Chirongwa chekurudziro inonzi drug antithyroid, inotanga ne PTU mumutatu wekutanga uye inoshandura kune methimazole mumutsara wechipiri uye wechitatu (kana kugara pa PTU).
Kunyange zvazvo mishonga iyi inotakura mungozi kuvakadzi vane pamuviri, chinangwa chechiremba wako ndechekushandisa sechidiki sezvinobvira kuti uchengetedze hyperthyroidism uye kuderedza dambudziko rinowedzera kwauri nevana vako.
Kazhinji, vanachiremba vanokurudzira vana vaduku vanogona kuita chirwere chinogona kudzora mamiriro acho. Sezvo mishonga yose yemitambo inopinda mumugwagwa, zvisinei, zvakakosha kunyanya kutevera mirairo yezvinyorwa uye kuchengetedza pamwe nekuongororwa kunongororwa (zvichiitika masvondo maviri kusvika mana).
Pakushanyirwa kwehutano, kuwedzera kuongororwa kwehutano, kupisa kwako, kuwedzera , uye kuwanda kwetachiona kuchaongororwa. Pulse inofanira kugara pasi pemakore zana nematatu paminiti. Iwe unofanirwa kuedza kuchengetedza uremu hwako huri mukati memaitiro akaenzana ekudzivirira, saka taura nachiremba wako nezvekudya kwakakodzera uye ndeapi maitiro ekuita muviri akakodzera mararamiro ako iye zvino. Kukura kwekurera uye kupisa kunofanirawo kuongororwa pamwedzi.
Muvana
Sezvakakura, hyperthyroidism muvana inogona kurapwa nea antithyroid drug therapy, iodine radioactive, kana thyroidectomy.
Mushonga wekusarudzwa nevana vane hyperthyroidism ndeye drug antithyroid MMI, sezvo inotakura njodzi duku kana ichienzaniswa neRI kana kuvhiyiwa, uye ine zvishoma zvingava nemigumisiro yakaenzaniswa ne PTU. Kunyange zvazvo RAI kana kuvhiyiwa kana nzira dzakagamuchirwa dzisina kugadziriswa, RAI inodziviswa muvana vari pasi pemakore mashanu.
Complementary Medicine (CAM)
MuChina nedzimwe nyika, maHindu eChina dzimwe nguva anoshandiswa kurapa hyperthyroidism, ingave yoga kana pamwe chete nemishonga inoripiritsiyroid. Kunyange zvazvo nzira yakananga isiri pachena, vamwe vanotenda kuti maruva anobata nekudzivirira kutendeuka kwe thyroxine (T4) ku triiodothyronine (T3) nekuderedza migumisiro yeT4 pamuviri.
Muchidzidzo chikuru chekuongorora, izvo zvakaongorora miedzo gumi nematatu yevanhu vanopfuura 1700 vane hyperthyroidism, kuwedzerwa kwemishonga yeChina kumishonga ye antithyroid yakabudirira pakuvandudza zviratidzo uye kuderedza zvose zvinokonzerwa nemishonga ye antithyroid uye kudzokazve kwemitambo (kureva kudzokorora kwe hyperthyroidism) mune vamwe vanhu. Vanyori vekudzidza, zvisinei, vakataura kuti zvose izvi miedzo zvakanga zvisina kunyatsogadzirwa. Pamusana pemhando yavo yakaderera, vanyori vanotaura kuti hapana simba rakasimba rakakwana kusimbisa kushandisa mishonga yemishonga yeChina mukurapa hyperthyroidism.
Sezvo Chinese herbs (kana mamwe maitiro apiwo mamwe maitiro) angakanganisa mushonga wako uye mazinga ehutachiona zvisina kunaka, zvakakosha kungovatora pasi pekutungamirirwa kwekupedzisira kwako.
Kunze kwemashizha eChina, vitamini D yakagamuchirwa zvakanyanya mukati mehutachiona hwevanhu. Kunyange zvazvo kuwirirana kwakawanikwa pakati pehutachiona hwehutachiona uye hutachiona hwehutachiona (zvose zveGraves 'uye chirwere chaHashimoto), hazvisati zvanyatsozivikanwa kuti iyo sangano inorevei, zvakadai sokuti kushayikwa kwevitamine D kunokonzera kana kusagadzikana kwetachiona.
Isu tinoziva kuti hyperthyroidism inogona kuita kuti pfupa rive nekushaya simba (osteoporosis), kuitira kuti kuve nechokwadi kuti vitamin D yakakodzera uye kudya kwekasiamu kunokosha. The Institute of Medicine inokurudzira mazana matanhatu emakwikwi enyika (IUs) e vitamin D pazuva kune vanhu vakuru vane makore 19 kusvika ku70 uye 800 IU kuvanhu vakuru vanopfuura makore makumi manomwe. Izvo zvakati, ichiri chirevo chakanaka chekusimbisa chirwere chako che vitamini D nechiremba wako. Anokwanisa kukurudzira kuongorora vitamin D yako nehutachiwana; kana iwe usina kukwana, iwe unogona kudha doses yakakwirira kudarika izvi zvinoratidzira zvinoratidza.
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