Kāohi

- Pono e pale aku i ka nele o Iodine, no ka mea, he mea pilikia ia no na nodule thyroid.

- ʻOi aku ka maikaʻi o nā lāʻau lapaʻau a ʻoi aku ka maikaʻi o ka hāʻawi ʻana i ka palena liʻiliʻi e pono ai i kēlā me kēia hihia, a kaupalena i ka hopena i ka thyroid.

Ka hōʻailona

Hoʻoholo mua ke kauka, me ke kōkua o nā hoʻokolohua like ʻole, ke ʻano o ka nodule. Ua koho ʻia ka lāʻau lapaʻau a i ʻole ka lāʻau lapaʻau e like me ia. Ma mua o ka 1980s, ua wehe ʻia ka hapa nui o nā nodules e ka ʻoki. Mai ia manawa, ua hoʻomaʻemaʻe ʻia nā ʻano diagnostic a me ka mālama ʻana i mea e hana wale ai inā pono. 

Ka hoʻokolokolo kino

ʻO ka nānāʻana i ka'ā'ī e hōʻoia aʻaʻole paha ua pili ka pehu i ka thyroid, e nānā inā heʻeha aʻaʻole paha, hoʻokahi a nui paha, paʻakikī, paʻa a palupalu paha, a nānā i ka heleʻana o nā lymph nodes ma ka'ā'ī.

Ke nānā nei ka hoʻokolohua maʻamau i nā hōʻailona o ka hana ʻino thyroid

E nīnau pū ke kauka i nā lāʻau lapaʻau e lawe pinepine ʻia e ke kanaka, ka manaʻo o ka mōʻaukala o nā pilikia thyroid i loko o ka ʻohana, ka ʻāʻī ʻana o ka ʻāʻī i ka wā kamaliʻi, ke kumu ʻāina, nā mea kōkua (ka paka, ka nele o ka iodine, ka hāpai ʻana)

Ka ho'āʻo hormone thyroid 

ʻO ka hoʻāʻo koko o ka hormone TSH e hoʻoponopono ana i ka hana ʻana o nā hormones thyroid e hiki ai ke nānā inā he maʻamau ka huna ʻana o nā hormones thyroid, keu (hyperthyroidism) a i ʻole lawa ʻole (hypothyroidism). ʻAʻole kūpono ʻo TSH. Ke nānā nei mākou i ka hiki ʻana o nā antibodies anti-thyroid. Noi ʻia ʻo Calcitonin inā manaʻo ʻia kekahi ʻano o ka maʻi kanesa, medullary thyroid cancer. 

'Ohanahana

ʻO kēia ke ala i makemake ʻia no ka ʻike ʻana i nā nodules thyroid. Hiki iā ia ke ʻike i nā nodules o 2 mm ke anawaena a ʻoi aʻe a ʻike i ka helu o nā nodules a me ka hiki ʻana mai o ka multinodular goiter. Hoʻohana ʻia ke kiʻi e hoʻokaʻawale i ke ʻano paʻa, wai a hui pū ʻia paha o ka nodule. Ma muli o kona hi'ohi'ona a me kona nui, hā'awi ia i nā mana'o ho'opa'apa'a e pili ana i ke 'ano maika'i a 'ino paha e hiki ai ke nīnau a 'a'ole paha i ka puncture. Hiki iā ia ke hahai ma hope o ka mālama ʻana i ka evolution o ka nodule. 

Ka nānā 'ana i ka thyroid

Noi ʻia ia inā haʻahaʻa ke ʻano o ka hormone TSH.

No ka hana ʻana i ka scintigraphy thyroid, ma hope o ka lawe ʻana i nā hōʻailona radioactive e like me iodine a i ʻole technetium, nānā mākou i ke ʻano o ka hoʻohele ʻia ʻana o ka iodine i ka thyroid gland.

Hōʻike kēia hōʻike i ka hana holoʻokoʻa o ka gland, hiki ke hōʻike i nā nodules ʻaʻole i ʻike ʻia ma ka palpation a nānā inā he "anu" nā nodules me ka emi ʻana o ka hyperfunction thyroid, "wela" me ka hana nui o nā hormones, a i ʻole "neutral »Me ka hormonal maʻamau. hana ana.

ʻAneʻane maikaʻi ka nodule wela, no laila ʻaʻole ia he maʻi maʻi maʻi priori. He maʻi maʻi ʻaʻai pinepine nā nodules anuanu, ʻoiai ʻo 90% mau ka maʻalahi.

ʻO ka puncture Noi ʻia kahi nodule ma lalo o ka mana ultrasound inā ʻike ʻia nā ʻano lapaʻau a i ʻole ka ʻike ʻana i ka ultrasound i ke ʻano ʻino o ka nodule. (cf. pepa) Me ka hoʻohana ʻana i ka nila maikaʻi, hoʻāʻo ke kauka i nā keʻena o ka nodule no ka hoʻokolokolo microscopic o ko lākou mau ʻano a me ka loiloi i ka maoli, maikaʻi a maʻi ʻaʻai paha, o ka nodule. He kōkua nō hoʻi ia e hoʻokuʻu i kahi nodule cystic.

E hoʻohou hou ʻia ka puncture inā ʻaʻole maopopo

Hiki ke hoʻonui ʻia kēia mau hoʻokolohua e kahi scintigraphy thyroid, kahi CT scan a i ʻole MRI. Ke kānalua ʻia ka maʻi ʻaʻai thyroid, ʻo ia ka hana ʻokiʻoki me ka nānā histological o ka maʻi ʻaʻa e hiki ai a ʻaʻole hoʻi e hōʻoia.

Nā hōʻailona

ʻO ka iodine radioactive. Hoʻohana pinepine ʻia ma ke ʻano he mea hoʻohui i ka ʻoki ʻana i ka maʻi maʻi thyroid e hoʻopau i nā pūnaewele thyroid i wehe ʻole ʻia e ka ʻoki.

Hoʻohana pū ʻia ka iodine radioactive e mālama i nā nodules ("wela") e hōʻailona ai i ka hyperthyroidism. ʻO ka hoʻomaʻamaʻa ʻana o 2 a 3 mau mahina he mea maʻamau ia no ka hoʻonā ʻana o nā nodules a no ka nalowale ʻana o nā hōʻailona o ka hyperthyroidism. Lawe ʻia ʻo Iodine ma ka waha ma ke ʻano capsule a i ʻole ka wai. Hoʻopau kēia lāʻau lapaʻau i ka hypothyroidism mau ma kahi o 80% o nā hihia, no ka mea, hoʻopau ka iodine radioactive i nā cell e hana ai i nā hormones. Hiki ke uku maikaʻi ʻia kēia hypothyroidism lua i ka mālama ʻana e ka mālama ʻana me nā hormone thyroid a laila lawe mau ʻia. I kekahi mau hihia, mālama ʻia nā nodules me ke ʻoki.

ʻoki kino. Wehe ia i hoʻokahi lobe a i ʻole ka thyroid holoʻokoʻa (thyroidectomy). Hōʻike ʻia ia i ka wā e maʻi ʻaʻai ai nā nodules a i ʻole i manaʻo ʻia he maʻi ʻino, a inā he hypersecreting lākou (hana nui loa i ka hormone thyroid) a nui paha. Pono pinepine ʻia ka lāʻau lapaʻau hou o ka thyroid hormone replacement therapy (levothyroxine). Ma hope iho, e lawe ka mea hana i nā hormones thyroid i kēlā me kēia lā.

Nodules me ka pilikia ʻole o ka homoni a ʻo ka nui o ka liʻiliʻi ma lalo o ¾ knm ke nānā ʻia i kēlā me kēia 6 mahina a i ka makahiki.