Kev tiv thaiv

- Tsis muaj iodine yuav tsum tau zam, vim nws yog ib qho kev pheej hmoo rau cov thyroid nodules.

- Kev kho hluav taws xob tau zoo dua thiab hloov kho kom zoo dua thiaj li xa cov tshuaj tsawg kawg nkaus uas tsim nyog hauv txhua kis, thiab txwv qhov cuam tshuam rau cov thyroid.

Kev kuaj mob

Tus kws kho mob ua ntej txiav txim siab, nrog kev pab los ntawm ntau yam kev ntsuam xyuas, qhov xwm ntawm nodule. Kev kho mob lossis tsis muaj kev kho mob raug xaiv raws li. Ua ntej xyoo 1980, feem ntau ntawm cov nodules raug tshem tawm los ntawm kev phais. Txij thaum ntawd los, cov kev kuaj mob thiab kev kho mob tau ua kom zoo kom ua haujlwm tsuas yog thaum tseem ceeb. 

Kev kuaj mob

Kev kuaj ntawm lub caj dab yuav paub tseeb tias qhov o yog txuas nrog cov thyroid, xyuas seb nws puas mob los yog tsis, ib leeg lossis ntau yam, tawv, ruaj lossis muag, thiab saib seb muaj cov qog ntshav hauv lub caj dab.

Kev kuaj dav dav saib xyuas cov tsos mob ntawm cov thyroid ua haujlwm tsis zoo

Tus kws kho mob tseem yuav nug seb cov kev kho mob twg feem ntau yog siv los ntawm tus neeg, qhov kev xav ntawm keeb kwm ntawm cov thyroid teeb meem hauv tsev neeg, irradiation ntawm lub caj dab thaum yau, thaj chaw keeb kwm, cov txiaj ntsig (kev haus luam yeeb, tsis muaj iodine, cev xeeb tub)

Kev soj ntsuam ntawm cov thyroid hormones 

Kev kuaj ntshav ntawm cov tshuaj hormone TSH tswj kev tsim cov thyroid hormones ua rau nws tuaj yeem kuaj xyuas seb qhov tso tawm ntawm cov thyroid hormones zoo li qub, ntau dhau (hyperthyroidism) lossis tsis txaus (hypothyroidism) .Cov tshuaj thyroid hormones T3 thiab T4 tsuas yog yuav tsum tau yog tias cov TSH yog txawv txav. Peb kuj nrhiav pom muaj cov tshuaj tiv thaiv thyroid antibodies. Calcitonin yog thov yog tias ib hom mob qog noj ntshav xav tau, medullary thyroid cancer. 

ultrasound

Qhov no yog txoj kev nyiam rau kev kuaj mob thyroid nodules. Nws ua kom pom cov nodules ntawm 2 hli nyob rau hauv txoj kab uas hla los yog ntau tshaj thiab kom paub cov naj npawb ntawm nodules thiab muaj peev xwm muaj nyob rau hauv multinodular goiter. Kev kos duab kuj yog siv los ua qhov sib txawv ntawm cov khoom, kua lossis sib xyaw ntawm cov nodule. Nyob ntawm nws qhov tsos thiab nws qhov loj me nws muab cov lus sib cav hauv kev pom zoo ntawm tus cwj pwm zoo los yog tus cwj pwm phem uas ua rau nug los yog tsis yog puncture. Nws kuj tso cai rau tom qab kev kho mob ua raws li cov evolution ntawm nodule. 

Cov thyroid scan

Nws tsuas yog thov thaum TSH cov tshuaj hormones tsawg.

Txhawm rau ua cov thyroid scintigraphy, tom qab noj cov cim hluav taws xob xws li iodine lossis technetium, peb saib txoj hauv kev uas iodine faib rau hauv cov thyroid caj pas.

Qhov kev ntsuam xyuas no qhia txog kev ua haujlwm tag nrho ntawm lub caj pas, tuaj yeem pom cov nodules tsis pom ntawm palpation thiab saib seb cov nodules "txias" nws yog nrog cov thyroid hyperfunction, "kub" nrog ntau cov tshuaj hormones, los yog "tsis nruab nrab" nrog cov tshuaj hormonal. ua haujlwm.

Qhov kub nodule yuav luag ib txwm zoo, yog li nws tsis yog mob qog noj ntshav ua ntej. Mob khaub thuas nodules yog mob qog noj ntshav ntau dua, txawm tias 90% tseem mob me.

Qhov puncture ntawm lub nodule nyob rau hauv kev tswj ntawm ultrasound yog thov yog hais tias qhov chaw kho mob cov yam ntxwv los yog cov tsos ntawm ultrasound qhia lub malignant xwm ntawm nodule. (cf. daim ntawv) Siv ib rab koob zoo, tus kws kho mob aspirates lub hlwb ntawm nodule rau kev soj ntsuam microscopic ntawm lawv cov yam ntxwv thiab ntsuas qhov xwm, benign los yog mob qog noj ntshav, ntawm nodule. Nws kuj pab kom khiav tawm ntawm lub cystic nodule.

Lub puncture yuav rov ua dua yog tias nws tsis meej

Cov kev kuaj no tuaj yeem ntxiv los ntawm cov thyroid scintigraphy, CT scan lossis MRI. Thaum xav tias mob qog noj ntshav, nws feem ntau yog kev phais mob nrog kev kuaj mob ntawm cov qog uas ua rau nws ua tau lossis tsis lees paub nws.

kev kho mob

Xov tooj cua iodine. Nws feem ntau yog siv los ua ib qho kev phais mob qog nqaij hlav qog nqaij hlav kom tshem tawm cov thyroid caj pas uas tej zaum yuav tsis raug tshem tawm los ntawm kev phais.

Radioactive iodine kuj tseem siv los kho ("kub") nodules ua rau cov tsos mob ntawm hyperthyroidism. Kev kho mob ntawm 2 mus rau 3 lub hlis feem ntau yog txaus rau cov nodules daws thiab rau cov tsos mob ntawm hyperthyroidism ploj mus. Iodine tau noj hauv qhov ncauj hauv cov tshuaj ntsiav lossis kua hauv daim ntawv. Qhov kev kho mob no ua rau muaj kev pheej hmoo ntawm hypothyroidism nyob rau hauv li 80% ntawm cov neeg mob, vim hais tias cov xov tooj cua iodine rhuav tshem cov hlwb uas tsim cov tshuaj hormones. Qhov no hypothyroidism thib ob rau kev kho mob tuaj yeem tau txais txiaj ntsig zoo los ntawm kev kho cov thyroid hormones tom qab noj tsis tu ncua. Qee zaum, cov nodules raug kho nrog kev phais.

phais. Nws tshem tawm ib lobe lossis tag nrho cov thyroid (thyroidectomy). Nws qhia tau hais tias thaum cov nodules yog mob qog noj ntshav lossis xav tias mob malignancy, lossis yog tias lawv yog hypersecreting (ua rau cov thyroid hormone ntau dhau) lossis loj. Lub neej ntev ntawm cov thyroid hormone hloov kho (levothyroxine) feem ntau xav tau. Tom qab ntawd, tus neeg ua haujlwm yuav yog li hloov cov thyroid hormones txhua hnub.

Nodules tsis muaj hormonal secretion teeb meem thiab nws qhov ntim tsawg dua ¾ cm raug saib xyuas txhua 6 lub hlis mus rau ib xyoos.