Kuna da ciwon daɗaɗɗa? Idan likitanku ya bincikar ku da ciwon thyroid nodules, gwargwadon maganin kawanci, ko kara girma na thyroid-wanda aka sani da goiter - za ku so ku koyi game da alamun, alamu, gwaje-gwajen, da kuma jiyya don waɗannan yanayin thyroid.
Menene Goiter?
Kalmar goiter yana nufin duk wani yanayi inda thyroid gland shine ya zama mahaukaci kara girma.
A al'ada thyroid glandar gland shine yayi la'akari game da ozace kuma ba a bayyane waje. Amma tare da goiter, thyroid ya kara girma don haka canjin zai iya ganewa ta hanyar duban dan tayi ko haskoki, kuma a wasu lokuta, wuyanka zai iya nuna kullun da aka gani ko faduwa.
Goiter zai iya faruwa a wasu yanayi:
- a lokacin da kajin gwiwar thyroid ya samar da yawancin hormone thyroid (hyperthyroidism)
- lokacin da thyroid ba ya samar da isasshen hormone thyroid (hypothyroidism)
- lokacin da kake da cutar thyroid cuta- autoimmune ko cutar Hashimoto - wannan yana haifar da mai kumburi a cikin thyroid
- idan kana da guda ɗaya ko mahara thyroid nodules
- idan kana da ciwon daji na thyroid
- lokacin da kuka kasance mai raunin aidin
Alamun da aka saba da alamomi na Goiter
Alamun goiter sun hada da:
- wuyansa ƙara
- sutura mai gani ko busawa a cikin wuyan wuyan
Lura, duk da haka, wasu yanayi na goiter bazai iya kasancewa a bayyane ba, kuma ana iya gano su ta hanyar gwajin hoto.
Kwayoyin cuta na goiter sun hada da:
- tausayi ga taɓawa
- a ji na fullness a wuyansa
- jin damuwar iska ko iska
- wahala a haɗuwa, ko kuma jin cewa abinci yana cike a cikin bakin ka
- rashin ƙarfi na numfashi ko wahalar numfashi, musamman ma da dare
- tari
- hoarseness
- rashin kwanciyar hankali tare da turtlenecks, dangantaka, da yadudduka
A wasu lokuta, zaku iya samun hypothyroidism ko bayyanar hyperthyroidism tare da goiter.
A wasu lokuta, goiter bazai haifar da alamar bayyanar ba.
Gwaje-gwaje da kuma hanyoyin da za a gwada Goiter
Sane na goiter an fi sau da yawa a hankali ko hannu a lokacin binciken likita daga likitanku. A wasu lokuta, ana iya gano goiter a lokacin gwajin hoto.
Lokacin da aka gano goiter, mataki na gaba shi ne don kimanta dalilin da kuma sanin abin da rashin haɗarin karoid ya haifar da fadada. Wannan gwagwarmaya za ta hada da mahimmancin gwaje-gwajen thyroid, ciki har da TSH, Free T4, Free T3, da gwaje-gwajen maganin karoid don neman Hashimoto (thyroid peroxyidase antibodies / TPO) da kuma cututtukan Graves (thyroid stimulating immunoglobulins / TSI). Hakanan za'a iya kimanta matakan da za a iya amfani da su a ciki don bincika nauyin Idin.
Kwararka zai iya yin umurni da gwaje-gwaje na hotunan kamar kamfurin tayi, MRI, CT scan, ko maganin maganin karoid, don nazarin yawan goiter, don ganin ko yana shafan numfashinka ko haɗiye, da kuma ƙayyade idan kana da nodules.
Goiter Jiyya
Jiyya don goiter ya dogara da dalilin da alamun bayyanar.
- Idan kana da karamin goiter ba tare da alamar cututtuka ba kuma babu sauran cututtukan thyroid, likita naka na iya bayar da shawarar kulawar lokaci ba tare da magani ba.
- Idan goiter ya kasance saboda rashi na iodine, za a ba ku karin kariyar iodine. Wannan zai yi jinkiri ko dakatar da ci gaba, kuma zai iya rage girman dancin, amma sau da yawa ba gaba daya ba.
- Idan goiter yana hade da hypothyroidism, jiyya tare da maganin maye gurbin maganin hormone zai iya rage ko dakatar da ci gaban gland. Maiyaya ba zai iya rage mai goiter ba.
- Idan goiter din yana hade da hyperthyroidism saboda cutar cututtuka, jiyya-ciki har da iodine rediyo, ko magungunan antithyroid - na iya jinkirta ko dakatar da gland din, kuma zai iya shuruwa da goiter.
- Idan goiter din ya ci gaba da girma yayin da kake yin maganin jinya, alamun cututtuka ne mai laushi, ko kuma goiter lafiya, wadanda likitoci za su iya ba da shawara ga tiyata, wanda ake kira thyroidectomy.
Mene ne Thyroid Nodules?
Thyroid nodules ne swellings ko lumps a cikin thyroid gland shine. Nodules na iya zama cikakke, ko kyakken ruwa. Yourroid nodules ne na kowa, kuma an kiyasta cewa rabin yawan jama'a yana da akalla daya nodule, ko da yake mafi yawan ba su san shi. Thyroid nodules kuma sun fi dacewa kamar yadda kake da shekaru, kuma an kiyasta cewa kimanin kashi 70 cikin dari 70 cikin dari na mutane suna da akalla ɗaya daga cikin ƙwayar thyroid.
Nodules na iya faruwa don dalilai masu yawa:
- Ciwon daji na thyroid. Wannan shi ne mafi mahimmancin dalilin thyroid nodules, kuma kimanin kashi 95 cikin dari na thyroid nodules ba wadanda ba zasu yiwu ba.
- Hanyoyin maganin jinƙai, kamar Hashimoto da kuma Graves, wanda zai haifar da kumburi da gland shine ya haifar da nodules.
- Ƙaruwa daga al'ada thyroid nama. Wannan sananne ne a matsayin adinoma thyroid, kuma mafi yawanci ba zato ba ne ko la'akari da tsanani sai dai idan nodule yana haifar da bayyanar cututtuka saboda girmansa.
- Iodine rashi. Wannan zai iya haifar da ci gaban nodule, tare da goiter.
- Gida mai yawa, wanda aka sani da adenoma mai guba, inda kake da yawan nodules. Yawancin lokaci, waɗannan nodules suna samar da hormone na thyroid kuma zasu iya haifar da hyperthyroidism.
Alamai na Common & Ka'idojin cututtuka na Thyroid Nodules
A wasu lokuta, idan kana da babban nau'in nodule, ko yana kusa da farfajiyar jikinka, ana iya gani a waje ko iya jin dadin gwajin mai aikinka. Yawancin nodules, duk da haka, ba a bayyane ba ne kuma ba za a iya gano su ba ta hanyar gwaje-gwaje.
A lokuta da dama, nodules basu haifar da bayyanar cututtuka ba. Amma idan lokuttan karoid din suna haifar da bayyanar cututtuka, wasu sun haɗa da:
- alamu
- rashin barci
- asarar nauyi ko riba
- damuwa
- girgiza
- gajiya
- bakin ciki
- hankali a wuyansa
- wahala a haɗiye
- a ji na cikar ko tausayi a wuyansa
- hoarseness
Gwaje-gwaje da kuma hanyoyin da za a gwada lafiyar Thyroid Nodules
Lokacin da aka gano ƙwayar thyroid, likitanka zai kimanta wasu tambayoyi masu mahimmanci:
- Shin nodule yayi yawa da hormone thyroid da haddasa hyperthyroidism?
- Shin nodule yana hana thyroid ta ikon samar da isa thyroid hormone da haddasa hypothyroidism?
- Shin yakinku na nodule ne?
- Shin nodule naka zai shafi numfashinka ko haɗiye?
Mataki na farko a kimantawa shine yawancin gwaje-gwajen jini, ciki har da TSH, Free T4, Free T3, da kuma gwaje-gwaje na kwayoyin cuta ga cutar Hashimoto da Graves. Wannan zai iya taimakawa wajen gane idan gurbin yana haifar da hyperthyroidism ko hypothyroidism.
Mataki na gaba shine yawancin gwaje-gwajen maganin thyroid wanda zai iya haɗawa da duban dan tayi, MRI, CT scan, ko yadin maida rediyo. Ana yin su ne don kimanta girman da halaye na nodule, da kuma gano halaye masu tsattsauran ra'ayi wanda zai tabbatar da bincike. Wasu daga cikin siffofin gwaje-gwaje da aka ɗauka suna da alaƙa sun hada da:
- wani gurbin nodule (game da nau'in nodules)
- gaban microcalcification a cikin nodule
- girman da ya fi 2 cm
- abu mai ƙarfi na nodule
- "Properties na" sanyi "akan gwajin gwajin, ma'anar cewa nodule bata shafar guba ko samar da hormone
- da sauri girma na wani nodule
Idan an yi la'akari da nodule mummunan, mataki na gaba shine yawan ciwon gurasar ƙwararru mai kyau (FNA) . A cikin wannan gwaji, an saka wani allura a cikin nodule-yawanci ana jagorantar da duban dan tayi-don janye samfurin don nazarin bincike. Ana iya buƙatar ɗaya ko fiye da samfurori domin gwaji sosai. Yawanci, FNA sunyi ta hanyar endocrinologists, cytopathologists, ko likitoci. Kwayoyin suna nazarin kwayoyin halitta kuma sun lissafta su. Yawancin FNA da aka yi a ofishin likita, kodayake wasu za a iya yin aiki a matsayin asibiti a asibiti ko kuma aikin tiyata.
Yana da muhimmanci cewa mai yin aikin FNA yana da kwarewa mai yawa, don tabbatar da hanya ta samar da samfurori mafi kyau. Ana kiyasta yawan kashi na FNA na marasa lafiya, ma'ana ba za a iya amfani da su ba, kuma dole ne a sake sa; wani sakamako zai iya faruwa a lokacin da masu kwarewa ba su yi samfurin ba. Babban haɗarin thyroid FNA yana zub da jini ko jini. Amma tare da gwani mai gwadawa, wannan hadarin yana da ƙananan, kuma ana ɗaukar FNA din thyroid lafiya, kusan ba zai haifar da wani rikitarwa ba.
Ɗaya daga cikin kalubale mafi takaici shine lokacin da sakamakon na FNA ya zama "rashin daidaituwa" ko kuma "rashin tabbas." A wannan yanayin, kwarewar ilimin lissafi ba zai iya yin maganin ciwon daji ba. Hanyar mataki na gaba don wannan yanayin shine thyroidectomy - tiyata don cire karoid , wanda aka kimantawa don ganowa ko kuma fitar da ciwon maganin ciwon maganin thyroid.
Idan ba a gano ciwon daji na thyroid ba, abin da ya faru a mafi yawan lokuta, mai haƙuri yana bukatar rayuwa tare da hypothyroid na rayuwa, bayan da ba ka da mahimmanci thyroidectomy.
An kiyasta cewa ana gudanar da kimanin rabin biliyan na FNA a Amurka a kowace shekara, kuma har zuwa kashi 30 na waɗanda suka dawo kamar yadda ba a ƙayyade ba, ko kuma abin da ba a yarda ba. Sai kawai kashi 20 zuwa 30 cikin dari na ƙwayoyin nodules ba su da kyau.
Ya kamata ku lura da gwajin da ake kira Afirma Thyroid FNA Analysis , wanda idan aka gudanar a lokacin da aka fara nazarin halittu ya shafe kusan dukkanin sakamako na FNA wanda bai dace ba. Yi la'akari da cewa kana buƙatar tabbatar da cewa likitanka yana amfani da wannan tsarin kafin FNA ta shirya, ko samun likita wanda ke aiki tare da wannan gwaji.
Thyroid Nodule Jiyya
Idan an gano nodule ya zama mummunan, mataki na gaba shine cirewa da kuma magani na gaba bisa ga nau'in da mataki na ciwon daji da aka gano.
Idan kana da nodules wanda ba su da kyau, ko kuma suna da ikon haɗuwa ko numfashi, ana amfani da tiyata sau da yawa.
Idan nodule ba tare da wani hyperthyroid ko hypothyroidism ba, za a yi la'akari da shi akai-akai ta hanyar duban dan tayi da jarrabawa ta likita.
Yawancin lokaci, ga wani nodule wanda ya haifar da hypothyroidism, magani shine a rubuta rubutun maye gurbin maganin hormone. Wannan na iya taimakawa rage ƙwayar jikin, ko hana shi daga girma. Idan nodule ya ci gaba da girma, likita zai iya sake sake shi, ya bada shawara akan cirewa, ko bayar da shawarar likita kamar inhanol injection (PEI) cikin nodule, wanda zai iya taimakawa wajen dakatar da nodule.
Idan ciwon daji ko adenoma mai haɗari yana tare da hyperthyroidism, magani ne yawanci antithyroid magani, ko kuma a wasu lokuta, rediyoactive iodine ablation ko tiyata, dangane da har na hyperthyroidism, da amsa ga magunguna, da sauran dalilai ƙaddara da likita .
Kalma Daga
Ka tuna cewa duk da cewa hadarin ciwon ciwon thyroid yana da ƙananan ƙwayar, dole ne mai gwadawa ya yi la'akari da dukan nodules, don yin sarauta akan ƙananan haɗarin cewa suna da rauni.
> Sources:
> Braverman L, Cooper D. Werner & Ingbar's Thyroid, Edition na 10th. WLL / Wolters Kluwer; 2012.
> Haugen B. et. al. "Yarjejeniyar Gudanar da Ƙungiyar Karoid ta Amirka ta Amirka da ke Cike da Thyroid Nodules da Cikin Warayar Thyroid Cutar Cancer / Cibiyar Nazarin Ta'idodin Ƙungiyar Karoid ta Thyroid ta Thyroid Nodules da Cancer Cancer. Thyroid . Volume 26, Lamba 1, 2016. DOI: 10.1089 / ka.2015.0020