Iwe une utachiona hwakawedzerwa here? Kana chiremba wako akawana kuti iwe une chirwere chetachiona, chirwere chetachiona, kana kuti kuwedzera kwetachiona-inozivikanwa se goiter-iwe unoda kudzidza zvakawanda pamusoro pezviratidzo, zviratidzo, kuedza, uye kurapwa kwemamiriro aya ehutachiona.
Chii Chinonzi Goiter?
Izwi rokuti goiter rinoreva chero mamiriro ezvinhu apo chirwere chako chetrosi chakave chichiwedzera zvisina kukwana.
Chirwere chetachiona chetachiona gland rinorema rinenge rimwe chete uye harisi kuonekwa kunze. Asi nejeri, utachiona hunowedzera zvakakwana kuitira kuti kuchinja kuonekwe ne ultrasound kana x ray, uye mune dzimwe nguva, mutsipa wako unogona kuratidza bundu rinooneka kana kuti bhuru.
Goiter inogona kuitika mumamiriro ezvinhu akawanda:
- apo chirwere chako chetachiona chinokonzera utachiona hwakawandisa hutoni (hyperthyroidism)
- apo utachiona hwako husingaiti hutori yakakwana yehomoni (hypothyroidism)
- paunenge uine chirwere chetachiona chemotokari- Chirwere cheCheves kana chirwere chaHashimoto -chiri kukonzera kupisa kwemaitiro mukati mako
- paunenge uine hutachiona hune kana hutano huzhinji
- paunenge uri nekenza yekenza yepamusoro
- apo iwe une iodine yakashaya
Zviratidzo Zvinowanzoonekwa uye Zviratidzo zveMutungamiriri
Zviratidzo zve goiter zvinosanganisira:
- kuwedzera kwemutsipa
- bundu rinooneka kana kuzvimba mukati memutsipa
Cherechedza, zvisinei, kuti mamwe mamiriro ezvinhu eve goiter angave asina kuonekwa kunze, uye anongowanikwa nemifananidzo yekufungidzira.
Zviratidzo zve goiter zvinosanganisira:
- unyoro kune vanobata
- manzwiro ekuzadzwa mumutsipa
- manzwiro ekumanikidzwa pamhepo yako yepipu kana sopu yako
- kuoma kunomedza, kana kunzwa kuti zvokudya zviri mumutsipa wako
- kupfupika kwemhepo kana kuoma kufema, kunyanya usiku
- kukwaya
- hoarseness
- kusagadzikana ne-turtlenecks, zvisungo, uye zvitsvuku
Mune zvimwe zviitiko, unogona kuva ne hypothyroidism kana zviratidzo zve hyperthyroidism zvinotungamira ne goiter.
Mune zvimwe zviitiko, goiter inogona kutadzisa zviratidzo.
Miedzo & Nzira dzekuona Diagnose Goiter
Kuziva kuti goiter inowanzoitwa muchioni kana kunyora panguva yekuongorora chiremba nachiremba wako. Mune zvimwe zviitiko, goiter inogona kuonekwa munguva yekufungidzira.
Apo goiter inowanikwa, danho rinotevera nderekuongorora chikonzero chacho uye kuziva kuti chinyorwa chinokonzerwa nehutori hwakaita sei kuwedzera. Izvi zvinowanzobatanidza hutachiona hwemashoko makuru, kusanganisira TSH, Free T4, Free T3, uye utachiona hwemashure ehutachiona hunotarisa Hashimoto's (utachiona peroxidase antibodies / TPO) uye Graves 'chirwere (utachiona hunokurudzira immunoglobulins / TSI). Iodine mazinga anogonawo kuongororwa kutarisa kushayikwa kweiodini.
Chiremba wako anogonawo kuronga fungidziro dzekuongorora zvakadai sa ultrasound, MRI, CT scan, kana kuti utachiona hunotaridzika, kuti uongorore huwandu hwenyika, kuti uone kana iri kukukanganisa kufema kwako kana kumedza, uye uone kana iwe uine dutu.
Goiter Treatments
Mishonga ye goiter inobva pachikonzero uye zviratidzo.
- Kana iwe uine goiter duku isina zviratidzo uye kwete chimwe chirwere chetachiona chiri pasi, chiremba wako angakurudzira nguva nenguva kutarisa pasina kurapa.
- Kana goiter yako inokonzerwa nokushayikwa kweiodini, iwe uchapiwa iodine supplementation. Izvi zvishoma nezvishoma zvinononoka kana kumira kukura, uye zvinogona kuderedza ukuru hwego goiter zvishoma, asi kazhinji haisi zvachose.
- Kana goiter yako inobatanidzwa ne hypothyroidism, kurapwa nekemikari inonzi hormone replacement zvinodhaka zvinogona kuderedza kana kumira kukura kweglandu. Izvo hazvingaiti, zvakadaro, kuderedza goiter yako.
- Kana goiter yako inobatanidza ne hyperthyroidism nekuda kweGerves 'chirwere, kurapwa-kusanganisira iodine radioactive, kana madhiragi antivithyroid-inogona kuderedza kana kumira kukura kweglandu, uye inogona kuderedza goiter.
- Kana goiter yako inoramba ichikura mukurapa kwehutano, zviratidzo zvinokanganisa, kana kuti goiter isingasviki pakuona, vanachiremba vako vanogona kukurudzira kuvhiyiwa, inozivikanwa setiroidectomy.
Chii Chinonzi Thyroid Nodules?
Utachiona hwekurota hutachiona hunyoro kana hutachiona muhutano hwetroroid yako. Nodules inogona kuva yakasimba, kana mazaya akazara nemvura. Utachiona hwehutachiona hunowanzozara, uye inofungidzirwa kuti hafu yevagari vayo inenge iine nhengo imwe chete, kunyange zvazvo vakawanda vasingazvizivi. Utachiona hwemashoko ehutachiona hunowanikwawo zvakare sezvaunoita, uye zvinofungidzirwa kuti nezera remakore makumi manomwe nemakumi manomwe nezana rezana revanhu vane musana umwechete weganda.
Nodules inogona kuitika nokuda kwezvikonzero zvinoverengeka:
- Chirwere chetachiona. Ichi ndicho chikonzero chinonyanya kukosha chemashure ehutachiona, uye anenge 95 muzana yemadonules ose ehutachiona haasati ane kenza.
- Zvinotapira mamiriro ezvinhu ehutachiona, zvakadai seHashimoto's uye Graves 'chirwere, chinokonzera kuvhiringidza gland uye kuguma mumagununu.
- Kuwanda kwehutachiona hwechirwere chako. Izvi zvinozivikanwa seytroroid adenoma, uye kazhinji haisi kenza kana kuti inofungidzirwa zvakakomba kunze kwekuti chigunun'una chinokonzera zviratidzo nekuda kwehukuru hwayo.
- Iodine kukwana. Izvi zvinogona kukonzera kukura kwechigamba, pamwe ne goiter.
- Multinodular goiter, inozivikanwa seyodhekisi adenoma, kwaunenge uine huwandu hweshizha. Kazhinji, izvi zvinokonzera hutoni uye zvinogona kukonzera hyperthyroidism.
Zviratidzo Zvinozivikanwa Nezviratidzo zveTyroid Nodules
Mune zvimwe zviitiko, kana iwe uine dutu guru kwazvo, kana iri pedyo nechepamusoro peganda rako, rinogona kuonekwa kunze kana kuti rinogona kuonekwa nehuwandu hwekuongorora kwebhuku rako. Mishonga yakawanda, zvisinei, haisi kuonekwa kana inogadzika, uye inogona kuonekwa chete nekufungidzira miedzo.
Mune zviitiko zvakawanda, mishonga inokonzera zviratidzo zvisingaoneki zviratidzo. Asi kana utachiona huchiwedzera hunoita zviratidzo, zvimwe zvinowanzobatanidza zvinosanganisira:
- palpitations
- kusuruvara
- kurasikirwa kana kuyerwa
- kuzvidya mwoyo
- kudengenyeka
- kuneta
- kuora mwoyo
- kunzwisisika mumutsipa
- kuoma kunomedza
- manzwiro ekuzara kana unyoro mumutsipa
- hoarseness
Miedzo uye Nzira Dzokuona Kuongorora Matanho eTroroid
Kana chirwere chetachiona chikaonekwa, chiremba wako ari kuongorora mibvunzo yakawanda inokosha:
- Icho chinotyisa chinokonzera utachiona hwakawandisa uye huchiita hyperthyroidism here?
- Icho chinokonzera kuora mwoyo kwekodzero yekukwanisa kubudisa hutoni yakakwana yehutachi uye kukonzera hypothyroidism here?
- Ndiro kamukutu kako kenza here?
- Ndiro dumbu rako rinokanganisa kufema kwako kana kumedza here?
Nhanho yekutanga mukuongorora ndiyo inowanikwa boka rekuongororwa kweropa, kusanganisira TSH, Free T4, Free T3, uye zvirwere zvema antibodies zveHashimoto's and Graves's disease. Izvi zvinogona kubatsira kuziva kana chigamba chinokonzera hyperthyroidism kana hypothyroidism.
Nhanho inotevera inowanzoita zvirwere zvehutori , izvo zvinogona kusanganisira ultrasound, MRI, CT scan, kana iodacid iodine inowedzera scan. Vanowanzoitwa kuti vaongorore ukuru uye maitiro ehutundu, uye kuziva hutu hunhu hunozoita kuti uongorore zvakare. Zvimwe zvezviitiko zvekufungidzira zvinonzi zvinofungidzirwa zvinosanganisira:
- bhururu rega roga (rinopesana nemakumbo akawanda)
- kuvapo kwe microcalcification mu nodule
- chikamu chikuru kupfuura 2 cm
- kuumbwa kwakasimba kweiyo mushure
- "inotonhorera" padziviriro yekudzidzira, zvinoreva kuti chirungu chisina kuvhara iodine kana kuti kubudisa utachiona hwehomoni
- kukurumidza kukurumidza kwechigununu
Kana chirwere chinonzi chinokonzera, danho rinotevera rinowanzove rakanakira tsono yekutsvaga (FNA) biopsy . Muchiyero ichi, nheyo inowanikwa mumuduleti-kazhinji inotungamirirwa ne ultrasound-kutora sampu yekuongorora tsvina. Chimwechete kana kupfuura zvidzidzo zvingada kuongororwa zvakakwana. Kazhinji, FNAs inogadzirwa nema endocrinologists, cytopathologists, kana chiremba. Masero aya anodzidza uye anoongororwa ne cytopathologist. Zvizhinji zveFNA zvinowanikwa muhofisi yechiremba, kunyange zvazvo zvimwe zvingaitwa sechirongwa chekubuda kunze muchipatara kana chirwere chekuvhiya.
Zvakakosha kuti muongorori anoita FNA yako ane ruzivo rwakawanda, kuitira kuti ave nechokwadi chokuti nzira yacho inobereka zvakanakisisa zvingaitwa. Chikamu chezvikamu zveFNA zvinyorwa zvinonzi hazvisi kuongororwa, zvichireva kuti hazvigoni kushandiswa zvachose, uye zvinofanira kuva redone; zvinoguma zvingaitika kana vadzidzisi vasina ruzivo vanoita sampuli. Dambudziko guru rehutachiona FNA riri kubuda ropa kana kuora ropa. Asi nemunhu ane ruzivo, iyo ngozi ine shoma, uye utachiona FNA inowanzoonekwa yakachengeteka, inenge isingaiti mamiriro ose ematambudziko.
Imwe yezvinonyanya kuoma zvinetso ndeye apo zviitiko zveFNA zvinodzoka se "zvisingazivikanwi" kana kuti "indeterminate." Munyaya iyi, kuongorora kwehutachiona hakugoni kubvisa kenza. Chiitiko chinotevera chechiitiko ichi chirwere chetroroidectomy-chirwere chokubvisa utachiona , iyo inozoongororwa kuti iongororwe kana kugadzirisa kunze kwekenza yekameti.
Kana pasina kenza yemukati inowanikwa, inowanzoitika muzviitiko zvakawanda, murwere anoda kurarama nehupenyu hwose hypothyroid, mushure mekunge iwe usingaziviki thyroidectomy.
Inofungidzirwa kuti inenge mamiriyoni emamiriyoni eFNA biopsies inoitwa muUnited States gore roga rega, uye kusvika 30 muzana yevaya vanodzoka sevasingagumi, kana kusagadzikana. Asi 20 kusvika ku30 muzana yehutachiona husingazivikanwi inowanikwa kuva yakaipa.
Saka iwe unofanirwa kuziva nezveruzhinji runonzi Afirma Thyroid FNA Analysis , iyo iyo yakarongedzwa panguva yekutanga biopsy inopedza zvese zvisinganzwisisiki uye zvisingagoneki zvinogadzirwa neFNA. Cherechedza kuti iwe unoda kusimbisa kuti chiremba wako ari kushandisa shanduro iyi FNA yako isati yasarudzwa, kana kuti kuwana chiremba anoshanda nekuedza uku.
Thyroid Nodule Treatments
Kana chirwere chinowanikwa chiine kenza, danho rinotevera ndiko kubviswa kushandiswa uye kurapa kunotevera kunobva pamhando uye chirwere chekenza chinowanikwa.
Kana iwe une hutachiona husingaoneki, kana kuti huri kukanganisa kukwanisa kwako kumedza kana kufema, chirwere chinowanzokurudzirwa.
Kana bhinign nodule isingafambidzani nehupi hupi hyperthyroidism kana hypothyroidism, inowanzoongororwa nguva nenguva ne ultrasound uye kuongororwa nachiremba wako.
Kazhinji, nokuda kwebenign nodule iyo inokonzera hypothyroidism, kurapwa ndiko kurondedzera utachiona hwemaprojoni mushanduro yemishonga. Izvi zvingabatsira kuderedza chigunun'una chakanaka, kana kuti chidzivise kuti chirege kukura. Kana chirwere ichi chichiri kukura, chiremba wako anogona kuchiita zvakare, kurudzira kubviswa kushandiswa, kana kukurudzira kurapwa kwakadai sekujekesa ethanol injini (PEI) mukati mehutundu, iyo inogona kubatsira kuderedza dutu.
Kana bhinign nodule kana adheoma inotyisa inoperekedzwa ne hyperthyroidism, kurapwa kunowanzoitwa mishonga yeitroithyroid, kana mune dzimwe nguva, kubhadhara iodine kana kuvhiyiwa kwema radioactive, zvichienderana nehuwandu hwe hyperthyroidism, mhinduro yako kumishonga, nezvimwe zvinogadzirirwa nachiremba wako .
Shoko Rinobva
Yeuka kuti kunyange zvazvo njodzi yekenza yekemekari yakanyanya kuduku, zvose zvinokambaira zvinofanirwa kuongororwa nemuongorori, kutonga kunze kwekutyisa kwekuti vane kenza.
> Sources:
> Braverman L, Cooper D. Werner & Ingbar's The Thyroid, 10th Edition. WLL / Wolters Kluwer; 2012.
> Haugen B. et. al. "2015 American Thyroid Association Management Guidelines yeVakuru Vakakura neTyroid Nodules uye Kusiyana neTroroid Cancer / The American Thyroid Association Guidelines Task Force paTyroid Nodules uye Kusiyana neTroroid Cancer." Thyroid . Bhuku 26, Nhamba 1, 2016. DOI: 10.1089 / thy.2015.0020