He nui nā kumu o ka goiter, ʻokoʻa ma muli o ka homogeneous a i ʻole heterogeneous, me ka hana ʻole o ka thyroid. Hiki ke hoʻohui ʻia:

- nā meaʻai, genetic a me nā hormonal (no laila ka nui o ka pinepine i nā wahine);

- ka paka e hoʻoikaika ana i ka goiter ma ka hoʻokūkū me ka iodine;

- ka ʻike ʻana i ka radiation, ka irradiation cervical i ka wā kamaliʻi a i ʻole ka ʻike kaiapuni.

ʻO nā goiters homogeneous

ʻO kēia ka goiter kahi e pehu ʻia ai ka ʻili thyroid i loko o kona leo ma ke ʻano homogeneous.

ʻO kahi goiter homogeneous me ka hana thyroid maʻamau hui ʻia ma 80% o nā hihia ma nā wahine. ʻAʻole ʻeha, ʻano nui ka nui, ʻaʻole pono e mālama kūikawā.

ʻO Goiter me ka hyperthyroidism a i ʻole ka maʻi ʻo Graves: ʻoi aku ka maʻamau o nā wahine ma mua o nā kāne, a pinepine hoʻi no ka ʻohana kumu, ua hui pū ʻia me ka pohō kaumaha, huhū, feverishness, nui ka hou ʻana, haʻalulu. I kekahi mau hihia he exophthalmos, ʻo ia hoʻi nā pōpō maka nui, e hōʻike ana i ke ʻano o nā maka globular, e puka mai ana i waho o ka orbit.

Homogeneous goiter me ka hypothyroidism ʻoi aku ka maʻamau i nā wahine. Hiki ke kumu ia e nā lāʻau lapaʻau e like me ka lithium, a i ʻole ka iodine deficiency ma kekahi mau wahi o Farani e like me nā Alps, nā Pyrenees, a pēlā aku. No ka ʻohana a i ʻole ma muli o kahi maʻi autoimmune (ka thyroiditis Hashimoto) kahi e hana ai ke kino i nā antibodies e kūʻē i kona thyroid ponoʻī.

ʻO Goiter ma muli o ka nui o ka iodine ma hope o ka radiography me nā mea ʻokoʻa a i ʻole ka mālama ʻana me ka amiodarone (ka lāʻau i manaʻo ʻia e mālama i ka arrhythmias cardiac) hiki ke hoʻoulu i ka hypo a hyperthyroidism. Hoʻihoʻi wale lākou i ka hihia mua a i ʻole ma hope o ka pau ʻana o ka amiodarone.

ʻO nā goiters e ʻeha a pili pū me ke kunipili paha i ka thyroiditis subacute o Quervain e alakaʻi ana i ka hypothyroidism a me ka hyperthyroidism pinepine. Ho'ōla maʻamau iā ia iho i loko o kekahi mau pule a i ʻole mau mahina. Hiki i ke kauka ke kuhikuhi i ka aspirin, corticosteroids, a me nā lāʻau lapaʻau e hoʻolohi i ka puʻuwai i ka tachycardia.

Heterogeneous a nodular goiters.

Hōʻike ka Palpation a i ʻole ka ultrasound i ka hele ʻana o hoʻokahi a ʻoi aku paha nā nodules, inā pili a ʻaʻole paha me kahi hana thyroid maʻamau. He "kūʻokoʻa" paha ka nodule me ka hana hormonal maʻamau, "anu" a i ʻole hypoactive me ka emi ʻana o ka hana ʻana o nā hormones thyroid a i ʻole "wela" a i ʻole overactive me ka piʻi ʻana o ka huna ʻana o nā hormones thyroid. He maʻi maʻi maʻamau nā nodules wela. Akā, hiki i nā nodules paʻa, wai a hui pū ʻia paha i loko o 10 a 20% o nā hihia e pili ana i kahi maʻi maʻi maʻi, no laila ke kanesa.

ʻO wai ke kauka e nīnau ai ke loaʻa ʻoe i ka goiter?

I mua o kahi goiter, no laila ka piʻi ʻana o ka nui o ka thyroid gland ma ke kumu o ka ʻāʻī, hiki i kekahi ke nīnau i kāna kauka lapaʻau e like me ka hoʻokolokolo a me nā mea mua o ka loiloi e kuhikuhi i kahi endocrinologist (specialist in hormonal. e hana ana) a i ʻole he ENT.

Ka hoʻokolokolo kino.

ʻO ka nānāʻana i ka'ā'ī e ke kauka e nānā inā pili ka pehu ma ke kumu o ka'ā'ī i ka thyroid. Hiki iā ia ke ʻike inā he ʻeha a ʻaʻole paha, homogeneous a ʻaʻole paha, inā pili ka pehu i hoʻokahi lobe a i ʻole nā ​​mea ʻelua, kona paʻa paʻa, paʻa a palupalu paha. Hiki i ke kauka ke nānā i ka hiki ʻana o nā lymph nodes ma ka ʻāʻī.

I ka wā o ka hoʻokolokolo lāʻau maʻamau, ua hui pū ʻia nā nīnau a ke kauka me ka nānā kino i nā hōʻailona o ka hana ʻino o ka thyroid.

E nīnau pū ke kauka he aha nā lāʻau lapaʻau maʻamau e lawe ʻia e ke kanaka, inā he pilikia thyroid i loko o ka ʻohana, irradiation o ka ʻāʻī i ka wā kamaliʻi, ke kumu ʻāina, nā mea e hoʻopili ai (ka paka, nele i ka iodine, hapai).

Nā hoʻokolohua olaola.

Hoʻopili lākou i ka hana o ka thyroid ma ka hoʻāʻo ʻana i nā hormones thyroid (T3 a me T4) a me TSH (hormone i hana ʻia e ka pituitary gland nāna e hoʻomalu i ka huna ʻana o nā hormones thyroid). Ma ka hoʻomaʻamaʻa, ʻoi aku ia ma luna o nā TSH āpau i ana ʻia no ka loiloi mua. Inā hoʻonui ʻia, ʻo ia hoʻi ʻaʻole lawa ka hana o ka thyroid, inā haʻahaʻa, ʻoi aku ka nui o ka huna ʻana o nā hormones thyroid.

Hiki i ke kauka ke kauoha i kahi hoʻokolohua hoʻokolohua e nānā i ka loaʻa ʻana o nā antibodies anti-thyroid.

Ninaninau uila.

ʻO ka hoʻokolokolo koʻikoʻi kascan NineManga.com ʻO ia ka mea e wehewehe ai i ka nui, ke ʻano heterogeneous a ʻaʻole paha o ka goiter, nā hiʻohiʻona o ka nodule (wai, paʻa a hui pū ʻia), kona kūlana pololei a ʻo ka hoʻonui ʻia ʻana o ka goiter i ka ʻōpala (ka mea i kapa ʻia he plunging. goiter ). ʻIke pū ʻo ia i nā pūnaʻi lymph ma ka ʻāʻī.

La hoʻoheno thyroid. ʻO ia ka hāʻawi ʻana i ka mea e hele ana i ka hōʻike hōʻailona radioactive i loaʻa kahi mea e hoʻopaʻa ai i ka thyroid gland (iodine a i ʻole technetium). No ka mea he radioactive kēia mau māka, maʻalahi ka loaʻa ʻana o kahi kiʻi o nā wahi e hoʻopaʻa ʻia ai nā māka. Hōʻike kēia hōʻike i ka hana holoʻokoʻa o ka thyroid gland. Hiki iā ia ke hōʻike i nā nodule ʻaʻole i ʻike ʻia ma ka palpation a me nā hōʻike

- inā he "anu" nā nodules: hoʻopaʻa lākou i kahi hōʻailona radioactive liʻiliʻi, a hōʻike kēia i ka emi ʻana o ka hyperfunction thyroid,

- inā he "wela" nā nodules, hoʻoponopono lākou i nā hōʻailona radioactive, e hōʻike ana i ka hana nui.

- inā kū ʻole nā ​​nodules, hoʻoponopono lākou i nā māka radioactive moderately, e hōʻike ana i ka hana hormonal maʻamau.

La puncture of a noduleshiki iā ʻoe ke ʻimi i ka hele ʻana o nā cell malignant a i ʻole ka haʻalele ʻana i kahi cyst. Hana ʻia ʻo ia no nā nodule anu a pau

La radiology maʻalahi hiki ke hōʻike i ka calcifications o ka goiter a me kona hoʻonui i ka umauma

MRI He mea hoihoi ia no ka ho'ākāka 'ana i ka ho'onui 'ia o ka thyroid i nā hale pili a me ke 'ano o ka hele 'ana o ka goiter e lele ana i ka o'o, no ka 'imi 'ana i ka lymph nodes.