Utachiona Nodules Inowedzera Kuwedzera Mukukura Panguva Yokudzivirira
Kuberekwa kunogona kukanganisa maronomiro ehutachiona , ayo ari kuputika kana mavhinga muhutano hwetrosi, uye anogona kuva musimba wakasimba, kana kristi yakazadzwa nemvura. Nyaya yehutachiona yakawanda inofadza, asi chikamu chiduku chinogona kuva nekenza.
Thyroid Nodules
Maererano ne " 2011 " Mirayiridzo yeAmerican Thyroid Association yekuziva uye Kurapa Matenda eTroroid PaKuberekwa uye Postpartum, " mishonga inowanzova yakawanda mushure mokunge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uine pamuviri .
Kana zvivharadzi zvikawanikwa panguva yekuzvitakura, zvinokurudzirwa kuti mukadzi wacho abvunzwe nezvemhuri yake nhoroondo yehutano kana hutachiona hwehutachiona hwehutachiona uye zvirwere zve endocrine, chirwere chekare kana kuti kurapwa kunosanganisira mutsipa (kunyanya, marapirwo chero ipi zvayo ekurohwa kumusoro kana mutsi pahuduku ), uyewo kana dutu raionekwa, uye kukurumidza kukura sei.
Iyi Nhungamiro inokurudzira kuti vakadzi vose vane chirwere chetachiona vane TSH uye Free T4 vakayerwa. Kana mukadzi ane nhoroondo yemhuri ye medullary thyroid carcinoma kana akawanda endocrine neoplasia (MEN) 2, calcitonin mazinga anofanirawo kuyerwa.
Maererano neMirayiridzo, ultrasound inokurudzirwa kuti ione zvikamu zvehutundu, uye iongorore kukura kwayo. Kana chirwere chisina kudarika 10mm muhukuru, chidimbu -chidimbu chinoshuva (FNA) chiziviso chetachiona hachidikanwi kunze kwekunge kune zvinganetseka.
Kana chirwere chiri kukura, kana kana kune chifukidziro chinoramba chiripo kana matambudziko ezwi, kana zvimwe zvikwangwani zvinoshungurudza zvinobva munhau, Mitungamiri inokurudzira kuti FNA iite.
FNA inonzi yakachengeteka panguva yekuzvitakura.
Kushandiswa kwe-radionuclide kuenzana kwehutundu - iyo inowanzoita kuti munhu asafungidzire kunze kwekuita pamuviri - inopesana panguva yekuzvitakura, nekuda kwekunyanya kunetseka pamusoro pemirasi yakaiswa pamucheche. Maererano neMirayiridzo, zvidzidzo zvakawanda zvekutsvakurudza zvakaratidza, zvisinei, kuti kushandiswa kwemaRI kusati kwasvika masvondo gumi nemaviri ekuberekwa kusina kuonekwa kunokanganisa utachiona hwe fetal.
Nokuda kwehutachiona hwehutachiona hunofadza, iyo Mirayiridzo inoratidza kuti hapana kurapwa. Kana zvipembenene zvichiratidza kukura nokukurumidza, kuchinja kunetseka kwekenza, kudzokorora FNA kunofanira kuitwa. Kana zvipembenene zvichinyanya kuderedza chetrachea kana sophagus, chirwere chetachiona chinogona kuongororwa.
Thyroid Cancer
Kana kenza yekemikari inowanika, rudzi rwekenza yekemokari inotora kurapwa. Nokuda kwechirwere chetachiona chakasiyana-siyana chakakonzerwa panguva yekuzvitakura, Mirayiridzo inoratidza kuti kurapwa kunogona kuendeswa mberi kusvikira mushure mokuberekwa.
Kurapa inorwara yekirori, chirwere chinokurudzirwa panguva yekubata kana pane chiremera chakakura chikuru, kana kupararira kupararira kune lymph nodes.
Izvo zvinokonzerwa ne thyroidectomy panguva yekuzvitakura zvakadzidzwa, uye kazhinji, kana chirwere chetachiona chichiitwa munguva yechipiri chegumi, hachina kubatanidzwa nehutachiwana hwemwana kana hwemucheche.
Iyo Mirayiridzo inokurudzira kuti kana kuvhiyiwa kwechirwere chetachiona chakasiyana-siyana kuchikanganiswa kusvikira mushure mokuberekwa, an ultrasound inofanira kuitwa panguva imwe neimwe yemitatu kuti ione kukurumidza kukura kwekura. Kana paine kukura nokukurumidza, kana kune kupararira kune lymph nodes, chirwere chinokurudzirwa.
Mumukadzi ane kenza yepamusoro yakasiyana yakasiyana-siyana iyo inorambidza chirwere kusvikira mushure mokuberekwa, chirwere chinonzi levothyroxine chinogona kushandiswa, nechinangwa chokudzivisa TSH kusvika ku 0.1-1.5mIU / L.
Kurapa Hypothyroidism muKuberekwa Kwekirori yeChroid Cancer
Maererano neMirayiridzo, kune vakadzi vane chirwere chetachiona chinopfuurira, TSH inogona kuchengetwa pasi pe 0.1 mIU / L panguva yekuzvitakura. Madzimai vasina ruswere yekemikari asi avo vaiva nehutachiona hwepamusoro munguva yakapfuura, kuderedza kunofanira kuchengetedzwa paTSH mahara pakati pe 0.1 mIU / L uye 0.5 mIU / L. Mune mungozi yevatachiona vasina zviratidzo zvekenza yekenza, TSH inogona kuchengetwa pamucheto wezasi wehutano hwakakwana (0.3-1.5 mU / L).
Kazhinji, vakadzi vane pamuviri vane utachiona hwetachiona mushure mekutevera kenza yekotori inoda kuwedzera kuwedzera kwekuenzanisa nevakadzi vari hypothyroid nekuda kwezvimwe zvinetso.
Iyi Nhungamiro inokurudzira kuti kune vakadzi ava, TSH iongororwe vhiki dzose mavhiki mana panguva yekuzvitakura, kusvika pamasvondo gumi nemasere kusvika kumakumi maviri ekuberekwa, uye zvakare kamwe kamwe pakati pevhiki makumi maviri nemaviri nemakumi matatu ekuberekwa.
RAI Kuchengetedzwa Kwekenza uye Migumisiro yeKubata pamuviri
Vatsvakurudzi havana kuwana kuwedzera kwekusabereka, kupererwa kwepamuviri, kuberekwa, kufa kwevana, kuberekwa kwemazuva ekutanga, kuberekwa kwekutanga, kuberekwa kwekuberekwa, kana kufa mukati megore rokutanga rehupenyu mushure mehutachiona iodine (RAI) kurapwa kwekenza yekenza . Kune, zvisinei, kuwedzerwa kungozi yekuparara mushure memwedzi inotevera RAI iyo inogona kuguma nekushaya kukwana kudzora mahomoni ehutachiona . Iyi Nhungamiro inokurudzira kumirira kwemwedzi mitanhatu mushure meRI kuongorora hutano hwetachiona husati hwavapo mushure mokuberekwa.
Kuberekwa hakuratiki kuwedzera kungozi yekenza yekodhi inodzokorora kune vakadzi vasina chirwere chinouya musati mimba. Madzimai vane chero musara wekenza yehutachiona, zvichienderana nemasikirini ehutachiona anoonekwa, kana kuti yakakwirira ye thyroglobulin (Tg) mazinga, pamuviri unogona kuita kuti kenza yekroid inokura.
Kana mukadzi ave ane chirwere chetachiona chakasiyana chakaremberedzwa, uye zvisingaoneki thyroglobulin (Tg) mazinga, hapana kuongorora kunokosha kunodiwa panguva yekuzvitakura. Zvisinei, Mirayiridzo inokurudzira ultrasound panguva imwe neimwe yechitatu mumukadzi aimboporerwa kuti aparadzaniswa nekenza yekenza uyo ane marefu eTg mazinga kana humwe uchapupu hwezvirwere zvisingaperi.
> Kwakabva:
> Stagnaro-Green, Alex, uye. al. "Nhungamiro yeAmerican Thyroid Association yekuziva uye Kurapa Matenda eTroroid Panguva Yokuberekwa uye Postpartum." Thyroid . Bhuku 21, Nhamba 10, 2011 (Online)