Goiter - yakawedzerwa thyroid shwanu iri. Goiter: zviratidzo, kupatsanura, zvinokonzera, kurapwa

Muvanhu, thyroid shwanu chinoita basa rinokosha. Kurapa kwemakemikari anobudiswa hurongwa, muviri rinobatanidzwa mutemo simba muviri. lobes maviri akabatana nechimwe nekamukwavarara nayo, vari kumativi ose trachea. Anwa simba iri kuparadzirwa pakati pamakamuri, uye kana zviri kukwana kuti kupindira thyroid mahormone. Kana dhefisiti ari kugara, pane kuchinja kuti machira uye goitre chirwere. Several vakasiyana siyana uye madhigirii zvirwere, izvo zvakasiyana zvikonzero uye zviratidzo. Chero mhando zvokurwara zvinoda nechirwere uye kurapwa.

Thyroid goiter

Achiri havaratidzi kunzwisisa nzira kuti thyroid neoplasms. Nzira yokurapa, aizivikanwa mushonga nhasi hapasi tibudirire uye ingapedza zvokurwara zvachose.

Fabric thyroid kunobvumirwa follicles - masero idenderedzwa. Vachivavhiringidza mumuviri chokuita nhengo dysfunction, kutungamirira deformations. Multinodular goiter thyroid kunokonzera kuchinja munzvimbo dzakasarudzwa uye diffuse - rose tishu. Kunze kwokuwedzera follicles chirwere anogona munguva chitarisiko cysts (cystic-nodular goiter). Kuchiita chirwere kungaita kuti degeneration pamusoro nyanyisa nodes.

zvikonzero

Goiter - chirwere zvinosanganisira siyana kukuvara thyroid. Kune akawanda marudzi, zvimiro uye inosiyana zvokurwara, izvo zvakasiyana zvakasikwa, zvinokonzera uye zviratidzo. The chikonzero chikuru chepfu goiter ndiyo kushayikwa ayodhini pamuviri, izvo zvinoderedza secretory basa thyroid shwanu. Bad zvakatipoteredza zvarinoita kushanda thyroid shwanu. Achiwa kubva zvine chepfu anogona kuderedza basa thyroid shwanu, zvichivhiringidza kuti kwemakemikari anobudiswa hurongwa.

Kukwana kushandisa ayodhini tubhokisi zvigadzirwa (mukaka, michero, hove) anogonawo kukonzera goiter. Zvinokonzera kuti raiva pedyo nebundu mhando hosha - kenza muitiro kana thyroid adenoma. Kusiyanisa uye Sero nokupesana iyi kunoitika pasi pokudzora zvine chepfu, mwaranzi, uye anogona kutakura zvokugarwa nhaka.

Graves zvokurwara kunoitika nokuda pokudzora nhengo zvakananga antibodies of zvirwere. Treatment chinosanganisira kushandisa zvinodhaka kuti inogona kuderedza kugadzirwa mahormone, dzimwe nguva dambudziko riri kugadziriswa kuvhiyiwa.

symptomatology

Goitre - ichi chirwere zvokuti hariwaniki kwokutanga matanho, uye murwere anogona kunyange vachiziva kwayo kuvapo. Chete maererano kuwedzera thyroid kukudziridza dzimwe kunotoda mufananidzo. Zviratidzo shchitovidki dzinoratidzwa kwayo kuzvimba nechemberi pamutsipa, uye compression kuti pedyo tishu. Zvisinei, varwere vanotsutsumwa ane chikosoro chakaoma, hoarseness nenzwi, pfungwa "bundu iri huro", kupfupika mweya. Apo kufamba musoro pane pfungwa makakatanwa uye dzungu nokuda clamping kwemitsipa midziyo. In zvishoma nokushushikana kumedza nokuda compression pakati yegurokuro. Pane akasiyana kadikidiki nzvimbo pamusoro thyroid shwanu. Zvokuita mumamiriro ezvinhu akadaro - saka pakutanga vakafunga kwachiremba.

With kukura zvokurwara nokuda ayodhini kushaikwa iri nechimwe chinonzi kunotoda mufananidzo nezvimwe zviratidzo chokuita hypothyroidism: bloating, kakawanda zvirwere kufema, pasi BP. Kana thyroid adenoma kana Graves 'chirwere, pane zviratidzo hyperthyroidism: uremu, kushatirwa, ruoko chakamira pakunodengenyeka zvine, nzara, fivhiri.

Diffuse euthyroid goiter

The zvokurwara kunokonzerwa ayodhini kukanganisika. Compensatory hyperplastic uye hypertrophic pezvakaitwa ari thyroid shwanu muviri zvainanga kuunza imwe yakakwana azvipire thyroid mahormone. Adaptive zvigadziriswe kuti nekushaya ayodhini chokuita endogenous salvage ayodhini, iodide secretion kudzikira itsvo triyodtirozina usage, kunowedzerwa kubatwa zviri ayodhini pedyo thyroid shwanu. Nenzira iyi, muviri compensates ayodhini kushaikwa, asi pane kutanga hypertrophy thyrocytes, izvo zvinoita kuchengeteka thyroid mabasa. Euthyroid goiter anogona kuomesa vadzore somugumisiro zvinhu zvakadai zvakawandisa karusiyamu kushaikwa micronutrients (molybdenum, mhangura, cobalt, selenium, zingi, manganese), akatora vamwe mishonga, chisingaperi zvirwere, mupfungwa, kusvuta.

In Kakawanda kacho regai kuva zvekuchipatara zviratidzo, sezvo chirwere ichi anenge asingadi kutambura thyroid chaitika. Dzimwe nguva murwere nemamiriro inogona kuchengetwa Kazhinji simba, kuneta, kurukutika. Kuwedzera shchitovidki doro pachena urema zvizorwa achabatsirwa uye kunzwa nevamwe mumutsipa. Other zviratidzo thyroid chirwere chokuita hypertrophy muviri anogona kukonzera zvakakomba yematambudziko: kuzvimba kweprostate, ropa, compression pakati yegurokuro, trachea. Tikafunga zvokurwara ichi vanogona kuva dzimwe mhando goiter, zvikuru kunzwisisa.

chepfu goiter

Vakadzi, avhareji yezera akawanikwa kunyanya diffuse muchetura goiter. chirwere ichi ndicho zvikuru vashoma inobata vana uye varwere vakwegura. Zvisati dzatangwa chose, chii zvinoita sei kukura chirwere, asi ruzhinji mushonga kunoonekwa sechinhu kukonzera vaberekwe vakaremara semubairo iyo ezvinhu mutemo Kugadzirwa antibodies iri zvirwere kwatanga pasi. Zvirwere izvi kukonzera kuti vave antibodies yavo thyroid rinenge murwere. Vaberekwe vakaremara mune iyi - haisi Mhedziso kubatwa uye Statistical kakawanda kuti hakuna hako mwana achirwara, kana hosha iri goiter vane mumwe kubva kuvabereki.

Zvisinganyanyi kuitika mune ichi zvokurwara kunowedzera thyroid vhoriyamu. Muna 30% wevarwere vakawana nokuwedzera mumaziso (Graves ophthalmopathy, kwemakemikari anobudiswa ophthalmopathy, exophthalmos). Huru Zviratidzo mu diffuse hunokachidza goiter Rinobatanidzwa ane nekumwisa mahormone zvinoberekwa thyroid shwanu. Nokuda kunyanyisa basa hormone migumisiro iri murwere wakaputsika mwoyo chinosara kusvikira pave arrhythmias. Amplification pamusoro metabolic pezvakaitwa dzinotungamirira uremu. Varwere tinganetseka zviratidzo zvakadai achiipa kurara, ndichichema uye kuneta, kushatirwa, tremor chitarisiko.

nodular goiter

Nodular goiter - dzinoverengeka pathologies vane chinhu chimwe chakafanana - dzidzo iri thyroid shwanu nodes. Pashure nokufungirana zviri kufambira mberi maperembudzi, murwere vanofanira kuenda zvinoverengeka kuongorora kuona kukura uye mhando. Kana murwere dzakaonekwa anopfuura rimwe raiva pedyo nebundu, zvinonzi akaonekwa multinodular goiter yacho thyroid shwanu. Vakawanda nekuratidza chirwere chinhu colloidal euthyroid goiter. Zviratidzo sezvo vakadaro zvikasaitika, asi zvikanganiso kuonekwa ari pamutsipa kusvikira deformation. Pamwe chete inorwadza nezvekufadza kuonekwa matambudziko, izvo zvinoratidza nokukurumidza kuwedzera idzodzo: ropa muungano, chimiro kuzvimba, mimwe kunowedzera thyroid. The nodes hombe saizi anogona dzvinya trachea kana yegurokuro, izvo achiperekedzwa vachivavhiringidza kufema uye kumedza.

Kugadzirwa nodular goiter iri akwanise ne zvinhu zvakadai kuvabereki kubatwa, chirwere nemavhairasi kana zvirwere zvinokonzerwa noutachiona, mishonga, zvokudya goitrogenic zvinhu, kwezvakatipoteredza zvinhu. Chikonzero chikuru ndechokuti kushaya ayodhini pamuviri. Hazvina zvakafanira kuunza chirwere kumamiriro ezvinhu kuregeredzwa. Endesa pakarepo kuna chiremba kana uchinzwa nokusunungura mapfundo ari thyroid shwanu. Zvokuita raitevera, sei ndeyokubvisa pavo uye kudzivirira matambudziko - unogona kuwanika kushandiswa kubvunza pashure zvizere-siyana kuongorora. Chete ipapo unogona kutora mamwe matanho uye taurira kurapwa.

madhigirii

Mwero nodular goiter akatsunga kubva sei awanda thyroid. Nodes rinogona inosiyana uye zvakasiyana zvakawanda. At ano, pane classifications maviri nodular goiter mumasimba. Chokutanga - pa Nikolaev. Pakanga MAPOKA 5. At razero dhigirii pamusoro thyroid shwanu chisingaoneki uye hazvingavakwizve kunoitwa palpation. Chokutanga - chisingaoneki, asi palpable. The dhigirii yechipiri kunoratidzwa chinooneka nekuratidza shwanu panguva pakuparadza. In wechitatu vematunhu kunowedzera uye richikora mutsipa. Wechina kunoratidzwa kare pachena goiter, izvo anotyora mutsipa configuration. Chechishanu, wokupedzisira mwero chirwere hwakazara matambudziko. Tichitarisa kukura thyroid shwanu kunotungamirira compression pamusoro pedyo nadzo, riri sei chibharo kushanda kufema uye kumwoyo nemudumbu.

Maererano neWHO kupatsanura, pane nhatu (zero, kutanga uye chechipiri) mwero chirwere. At razero goiter haasi wokutanga - chisingaoneki, asi palpable, uye kana pane yechipiri dhigirii goiter, uye kunogona kuonekwa chinoabatsira. Kana kutanga nzendo chirwere kukura havasi kuoneka ngozi mumuviri, kuchiita chirwere kungaita kuti migumisiro, nokuti chirimwa - ihosha chakakomba, mukuwedzera kune zvimwewo kuchinja sei zvakaipa pamusoro nokushanda zvose hurongwa nenyere.

nzira nechirwere

Initial kuzviongorora murwere rinoitwa Via palpation. Kana bundu rakawanikwa aisirwe Ultrasound kuti huwandu thyroid neoplasms uye chaiwo kukura. Fine-tsono chido biopsy rinoitwa panyaya apo inotungamirwa hombe kupfuura 1 masendimita, kana pane kunyumwira kuti malignancy. Ultrassom pamwe biopsy kunowedzera yemashoko kudzidza.

Thyroid goiter, panguva nzvimbo muchipfuva uye pane zvizhinji, zvinogona misha nenzira iri Airways, izvo chinoita matambudziko. Kuti izvi zvisaitika, kugadza mumwe X-ray musiyano barium chipfuva uye yegurokuro. Magnetic resonance kuri rinoshandiswa nokuda kwokukurukurwa kudzidza retrosternal goiter. Chaiye kacho haungopiwi.

How kurapa goiter

goiter kunokwanisa kuchinja uye zvomusejari. Tsanangudzo yokutanga ndiyo inoshandiswa, kana nechirwere diffuse, nodular, multinodular goiter pamusoro thyroid shwanu. NeMhedziso contraindication kuti kuvhiyiwa kuri chikonzero kushandisa kuchinja kurapwa. Inoitwa matanho anoverengeka. Chekutanga, unofanira adzokorore zvaunodya uye atsive nezvinoitika pakati nepakati. Vachiri kugadzirisa utsanana. Panogona mishonga arapwe unyanzvi dzisina. Zvinokosha zvinoumba ari kuchinja kurapwa zvinosanganisira: normalization chiropa uye dumbu basa, kururamiswa pakati foci echirwere zvirwere, normalization kuti ayodhini muviri ari nhengo. Ekupedzisira kunokwanisika nokuda kugamuchira zvinodhaka zvakadaro, "triiodothyronine", "Tireoidin", "Tireotom", "Tireokomb".

Kuvhiya kurapwa iri ushandiswe, kana zvichiratidza kuti kuvhiya: diffuse goiter IV uye V papi diffuse goiter III papi risingagoni kuva kuchinja kurapa, zvakavhenganiswa uye nodular goiter, thyroid kana zvawanzwa. Goiter akabvisa nenzira mbiri: gemistrumektomiya uye resection yacho akafukidza. Kuvhiya kupindira anotakura chiremba pasi pedyo pokudzora imwe endocrinologist. Zvinogonekawo kurapa goiter acho mishonga. Kupfuura vakaedza uye inobudirira nzira ndeyokushandisa makwenzi elecampane. Rinoshandiswa kuti aizomupa vodka uye akashandiswa pavaisukira pahuro kuti mushonga wakakwana.

Kudzivirira goitre

Kuti varege kutarisana chirwere goitre, zvinokosha hwokuchengetedza ezvinhu pasi iyo chirwere havagoni kuva. Tiri kutaura kudzivirirwa, izvo iyi angava guru, boka, munhu. Misa ine pakushandisa iodized munyu, rine yokudengenyeka 1 tani 25 magiramu ose potassium. Kunyanya rinokosha mabiko muzvinhu mikana yakawanda ayodhini kukanganisika. Collective kudzivirira rinoitwa ne "antistrumin" chinodhaka. Vanoishandisa muzvikamu echiuto, vana uye zvikwata chikoro ari dose 1 hwendefa pavhiki. Varwere akasvika munharaunda pamwe ayodhini kushaikwa, uye taurira mushonga "antistrumin".

Chaiwo chokudzivirira Nokuraramisa yaifanira pavanoparidza kuchaitwa sembura zvinhu achishandisa vanoverengeka utsanana uye munzanga matanho (chinorwisa intestinal zvirwere, utsanana tsika yevanhu, kudzivirira hypovitaminosis, zvakasiyana-siyana uye kudya zvinovaka muviri, kuvandudza zvavo magariro).