Izimbangela ze-goiter ziningi, zihlukile kuye ngokuthi i-homogeneous noma i-heterogeneous, noma ngaphandle kokusebenza okungavamile kwe-thyroid. Ingaxhunywa:

- izici zokudla okunomsoco, zofuzo kanye ne-hormonal (yingakho imvamisa enkulu kwabesifazane);

- ugwayi othuthukisa i-goiter ngokuncintisana ne-iodine;

- ukuchayeka emisebeni, ukushiswa komlomo wesibeletho ebuntwaneni noma ekuchayekeni kwemvelo.

Ama-homogeneous goiters

Lawa ama-goiter lapho indlala yegilo ivuvukale kuwo wonke umthamo wayo ngendlela efanayo.

I-homogeneous goiter enomsebenzi ojwayelekile wegilo ihlangana kuma-80% wezigameko kwabesifazane. Ayinabuhlungu, inobukhulu obuguquguqukayo, futhi ayidingi ukunakekelwa okukhethekile.

I-Goiter ene-hyperthyroidism noma i-Graves’ disease: ivame kakhulu kwabesifazane kunabesilisa, futhi ngokuvamile imvelaphi yomndeni, ihambisana nokuncipha kwesisindo, ukucasuka, ukushisa komzimba, ukujuluka ngokweqile, ukuthuthumela. Kwezinye izimo kukhona i-exophthalmos, okungukuthi ama-eyeballs amakhulu, anikeza ukubonakala kwamehlo ayi-globular, aphuma ngaphandle kwe-orbit.

I-goiter ene-homogeneous ne-hypothyroidism ivame kakhulu kwabesifazane. Kungabangelwa izidakamizwa ezifana ne-lithium, noma ukuntuleka kwe-iodine ezindaweni ezithile zaseFrance njenge-Alps, i-Pyrenees, njll. I-Goiter yayivame kakhulu ngaphambi kokusetshenziswa kosawoti wokupheka oqinile we-iodine. Kungase futhi kube ngemvelaphi yomndeni noma kubangelwa isifo esizimele (i-Hashimoto's thyroiditis) lapho umzimba wenza khona amasosha omzimba ngokumelene negilo lawo.

I-goiter ngenxa yokugcwala kwe-iodine Ngemuva kwe-radiography equkethe ama-ejenti ahlukile noma ukwelashwa nge-amiodarone (ukwelashwa okuhloselwe ukwelapha i-cardiac arrhythmias) kungase kubangele i-hypo noma i-hyperthyroidism. Bahlehla ngokuzenzakalelayo esimweni sokuqala noma ngemva kokumisa i-amiodarone.

Ama-goiters abuhlungu futhi ahambisana nomkhuhlaneingase ihambisane ne-subacute Quervain's thyroiditis eholela ku-hypothyroidism futhi ngokuvamile i-hyperthyroidism. Ivamise ukuzelapha yodwa phakathi namasonto noma izinyanga ezimbalwa. Udokotela angase anikeze i-aspirin, i-corticosteroids, nemithi yokwelapha ukunciphisa inhliziyo ku-tachycardia.

Ama-heterogeneous noma ama-nodular goiters.

I-Palpation noma i-ultrasound ibonisa ukuba khona kweqhuqhuva elilodwa noma ngaphezulu, kungakhathaliseki ukuthi kuhlotshaniswa noma kungahlobene nokusebenza okungavamile kwe-thyroid. I-nodule (ama) ingase "ingathathi hlangothi" ngomsebenzi ojwayelekile we-hormonal, "ibanda" noma i-hypoactive ngokuncipha kokukhiqizwa kwamahomoni egilo noma "ishise" noma isebenze ngokweqile ngokukhushulwa kwamahomoni egilo. Amaqhuqhuva ashisayo anomdlavuza ngendlela engavamile. Kodwa izigaxana eziqinile, eziwuketshezi noma ezibandayo ezingaba ngu-10 kuya ku-20% ezimweni zingahambisana nesimila esiyingozi, ngakho-ke sinomdlavuza.

Imuphi udokotela okufanele uthintane naye uma une-goiter?

Ngaphambi kwe-goiter, ngakho-ke ukwanda kwevolumu ye-gland yegilo phansi kwentamo, umuntu angabonisana nodokotela wakhe jikelele othi ngokusho kokuhlolwa kanye nezakhi zokuqala zokuhlola uzobhekisela ku-endocrinologist (uchwepheshe we-hormonal. ukusebenza) noma i-ENT.

Ukuhlolwa komtholampilo.

Ukuhlolwa kwentamo udokotela kuzobheka ukuthi ukuvuvukala phansi kwentamo kuhlobene yini ne-thyroid. Ibuye ivumele ukubona ukuthi ibuhlungu noma cha, i-homogeneous noma cha, uma ukuvuvukala kuthinta i-lobe eyodwa noma kokubili, ukuhambisana kwayo okuqinile, okuqinile noma okuthambile. Ukuhlolwa kukadokotela kungabheka nokuba khona kwama-lymph nodes entanyeni.

Ngesikhathi sokuhlolwa kwezokwelapha okujwayelekile, imibuzo kadokotela ehlangene nokuhlolwa ngokomzimba ibheka izimpawu zokusebenza okungavamile kwegilo.

Udokotela uzophinde abuze ukuthi yiziphi izindlela zokwelapha ezivame ukuthathwa ngumuntu, uma kwakukhona izinkinga ze-thyroid emndenini, i-irradiation yentamo ebuntwaneni, imvelaphi yendawo, izici ezinomthelela (ugwayi, ukuntuleka kwe-iodine, ukukhulelwa).

Ukuhlolwa kwezinto eziphilayo.

Bahlaziya ukusebenza kwendlala yegilo ngokuhlola amahomoni egilo (T3 ne-T4) ne-TSH (ihomoni ekhiqizwa indlala yegilo elawula ukukhiqizwa kwamahomoni egilo). Empeleni, ingaphezu kwayo yonke i-TSH elinganiswa ekuhloleni kokuqala. Uma inyuswa, kusho ukuthi i-thyroid ayisebenzi ngokwanele, uma iphansi, ukuthi ukukhishwa kwamahomoni e-thyroid ngokweqile.

Udokotela angase futhi acele ukuhlolwa kwaselabhorethri ukuze ahlole ukuthi amasosha omzimba alwa negilo yini.

Ukuhlolwa kwe-Radiological.

Ukuhlolwa okubalulekile yilokhuukuskena ecacisa usayizi, uhlamvu oluhlukahlukene noma okungeyona lwe-goiter, izici ze-nodule (ama) (uketshezi, okuqinile noma okuxubile), isimo sawo ngqo futhi ikakhulukazi ukunwetshwa kwegotha ​​ngasesifubeni (lokho okubizwa ngokuthi i-plunging). i-goiter). Aphinde abheke ama-lymph nodes entanyeni.

La ukuhlolwa kwe-thyroid. Kuhlanganisa ukunikeza umuntu ozohlola izimpawu zomsakazo eziqukethe into ezobopha indlala yegilo (iodine noma i-technetium). Njengoba lezi zimaki zinemisebe, kulula ukuthola isithombe sezindawo zokubopha omaka. Lokhu kuhlolwa kucacisa ukusebenza okuphelele kwendlala yegilo. Ingabonisa izigaxana ezingabonwa ku-palpation kanye nemibukiso

- uma ama-nodule "ebanda": abopha umaka omncane kakhulu we-radioactive, futhi lokhu kubonisa ukwehla kwe-hyperfunction ye-thyroid,

- uma ama-nodule "eshisa", alungisa izimpawu eziningi ze-radioactive, ezibonisa ukukhiqizwa ngokweqile

- uma ama-nodules engathathi hlangothi, alungisa izimpawu ze-radioactive ngokumaphakathi, okubonisa ukusebenza okuvamile kwama-hormone.

La ukubhoboza a I-noduleivumela ukubheka ubukhona bamaseli ayingozi noma ukukhipha i-cyst. Kwenziwa ngokuhlelekile kuwo wonke amaqhuqhuva abandayo

La i-radiology elula ingabonisa izibalo ze-goiter nokunwetshwa kwayo esifubeni

L'IRM Kuyathakazelisa ukucacisa ukunwetshwa kwendlala yegilo ezakhiweni ezingomakhelwane futhi ikakhulukazi ukuba khona kwe-goiter ephonseka ngasesifubeni, ukuze ifune ama-lymph node.