Cov ua rau goiter muaj ntau, txawv nyob ntawm seb nws puas yog homogeneous lossis heterogeneous, nrog lossis tsis muaj cov thyroid ua haujlwm txawv txav. Nws tuaj yeem txuas tau:

- khoom noj khoom haus, noob caj noob ces thiab hormonal yam (li no ntau zaus ntawm cov poj niam);

- haus luam yeeb uas txhawb nqa goiter los ntawm kev sib tw nrog iodine;

- raug hluav taws xob, cervical irradiation thaum yau los yog ib puag ncig raug.

Homogeneous goiters

Cov no yog goiter nyob rau hauv uas cov thyroid caj pas yog o thoob plaws nws lub ntim nyob rau hauv ib homogeneous yam.

Homogeneous goiter nrog cov thyroid ua haujlwm ntsib nyob rau hauv 80% ntawm cov neeg mob ntawm cov poj niam. Nws tsis mob, ntawm qhov loj me, thiab tsis xav tau kev saib xyuas tshwj xeeb.

Goiter nrog hyperthyroidism los yog Graves' kab mob: ntau dua rau cov poj niam dua li cov txiv neej, thiab feem ntau ntawm tsev neeg keeb kwm, nws yog nrog los ntawm kev poob phaus, khaus khaus, kub taub hau, tawm hws ntau, tshee. Qee zaum muaj exophthalmos, piv txwv li lub qhov muag loj, muab qhov muag ntawm lub qhov muag, tawm ntawm lub orbit.

Homogeneous goiter nrog hypothyroidism kuj muaj ntau dua rau cov poj niam. Nws tuaj yeem tshwm sim los ntawm cov tshuaj xws li lithium, lossis tsis muaj iodine hauv qee thaj tsam ntawm Fabkis xws li Alps, Pyrenees, thiab lwm yam. Goiter feem ntau tshwm sim ua ntej siv iodine fortified ua noj ntsev. Nws tuaj yeem yog tsev neeg keeb kwm lossis tshwm sim los ntawm tus kab mob autoimmune (Hashimoto's thyroiditis) uas lub cev ua cov tshuaj tiv thaiv kab mob rau nws tus kheej cov thyroid.

Goiter vim iodine overload tom qab radiography nrog cov neeg ua haujlwm sib txawv lossis kev kho mob nrog amiodarone (kev kho mob los kho plawv arrhythmias) yuav ua rau hypo lossis hyperthyroidism. Lawv regress spontaneously nyob rau hauv thawj rooj plaub los yog tom qab nres amiodarone.

Goiters uas mob thiab txuam nrog kub taub hauTej zaum yuav sib haum mus rau subacute Quervain's thyroiditis ua rau hypothyroidism thiab feem ntau hyperthyroidism. Nws feem ntau kho ntawm nws tus kheej li ob peb lub lis piam lossis hli. Tus kws kho mob yuav sau tshuaj aspirin, corticosteroids, thiab kev kho mob kom qeeb lub plawv hauv tachycardia.

Heterogeneous los yog nodular goiters.

Palpation los yog ultrasound qhia tau hais tias muaj ib los yog ntau tshaj nodules, txawm los yog tsis txuam nrog ib tug txawv txav thyroid function. Cov nodule (s) tej zaum yuav yog "tsis nruab nrab" nrog kev ua haujlwm hormonal ib txwm, "txias" lossis hypoactive nrog txo qis ntawm cov thyroid hormones lossis "kub" lossis overactive nrog nce tso tawm ntawm cov thyroid hormones. Cov nodules kub tsis txawv txav. Tab sis cov khoom, kua los yog sib xyaw txias nodules tuaj yeem nyob rau hauv 10 mus rau 20% ntawm cov neeg mob sib xws rau cov qog nqaij hlav, yog li ntawd mob qog noj ntshav.

Tus kws kho mob twg los sab laj thaum koj muaj goiter?

Nyob rau hauv pem hauv ntej ntawm ib tug goiter, yog li ntawd ib tug nce nyob rau hauv lub ntim ntawm cov thyroid caj pas nyob rau hauv lub hauv paus ntawm lub caj dab, ib tug muaj peev xwm sab laj nrog nws tus kws kho mob uas raws li kev soj ntsuam thiab cov thawj yam ntawm cov kev ntsuam xyuas yuav xa mus rau ib tug endocrinologist (tshwj xeeb ntawm hormonal). ua haujlwm) lossis ENT.

Kev kuaj mob.

Kev kuaj ntawm lub caj dab los ntawm tus kws kho mob yuav saib xyuas seb qhov o ntawm lub hauv paus ntawm lub caj dab puas cuam tshuam nrog cov thyroid. Nws kuj tso cai rau pom tias nws mob los tsis yog, homogeneous los yog tsis, yog hais tias qhov o muaj kev txhawj xeeb txog ib lobe los yog ob qho tib si, nws nyuaj, ruaj los yog mos sib xws. Kev kuaj xyuas los ntawm tus kws kho mob kuj tseem tuaj yeem tshawb xyuas qhov muaj cov qog ntshav hauv lub caj dab.

Thaum kuaj xyuas kev kho mob dav dav, tus kws kho mob cov lus nug ua ke nrog kev kuaj lub cev saib xyuas cov tsos mob ntawm kev ua haujlwm tsis zoo ntawm cov thyroid.

Tus kws kho mob tseem yuav nug dab tsi yog cov kev kho mob feem ntau coj los ntawm tus neeg, yog tias muaj teeb meem thyroid 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 kuaj mob lom.

Lawv txheeb xyuas kev ua haujlwm ntawm cov thyroid los ntawm kev soj ntsuam cov thyroid hormones (T3 thiab T4) thiab TSH (hormone tsim los ntawm pituitary caj pas uas tswj kev tso tawm ntawm cov thyroid hormones). Hauv kev xyaum, nws yog qhov siab tshaj tag nrho TSH uas yog ntsuas rau thawj qhov kev ntsuas. Yog tias nws nce ntxiv, nws txhais tau hais tias cov thyroid tsis ua haujlwm txaus, yog tias nws qis, qhov tso tawm ntawm cov thyroid hormones ntau dhau.

Tus kws kho mob kuj tseem tuaj yeem txiav txim mus kuaj kuaj seb puas muaj cov tshuaj tiv thaiv thyroid.

Kev ntsuam xyuas hluav taws xob.

Qhov kev ntsuam xyuas tseem ceeb yog qhovluam theej duab uas qhia txog qhov loj me, tus cwj pwm heterogeneous lossis tsis yog goiter, cov yam ntxwv ntawm nodule (s) (kua, khoom lossis sib xyaw), nws qhov xwm txheej thiab tshwj xeeb tshaj yog qhov txuas ntxiv ntawm goiter mus rau hauv lub thorax (dab tsi yog hu ua plunging. goiter). Nws kuj nrhiav cov qog ntshav hauv lub caj dab.

La cov thyroid scan. Nws muaj xws li muab tus neeg uas yuav mus xeem cov xov tooj cua cov cim uas muaj ib yam khoom uas yuav khi rau cov thyroid caj pas (iodine los yog technetium). Raws li cov cim no yog cov xov tooj cua, nws yooj yim kom tau txais cov duab ntawm thaj chaw ntawm kev khi ntawm cov cim. Qhov kev sim no qhia txog kev ua haujlwm tag nrho ntawm cov thyroid caj pas. Nws tuaj yeem pom cov nodules tsis pom ntawm palpation thiab qhia

- yog tias cov nodules yog "txias": lawv khi me me ntawm cov khoom siv hluav taws xob, thiab qhov no qhia tau tias txo qis hauv cov thyroid hyperfunction,

- yog tias cov nodules yog "kub", lawv kho ntau cov cim hluav taws xob, uas qhia tau hais tias kev tsim khoom ntau dhau

- yog tias cov nodules nyob nruab nrab, lawv txhim kho cov cim hluav taws xob nruab nrab, uas qhia txog kev ua haujlwm hormonal ib txwm.

La puncture ib nodulestso cai rau saib seb muaj cov kab mob malignant lossis tshem tawm cov cyst. Nws yog systematically ua rau tag nrho cov nodules txias

La yooj yim radiology tuaj yeem pom calcifications ntawm goiter thiab nws txuas mus rau hauv siab

L'IRM Nws yog qhov nthuav rau kev qhia txog qhov txuas ntxiv ntawm cov thyroid mus rau cov tsev nyob sib ze thiab tshwj xeeb tshaj yog muaj cov kab mob goiter plunging ntawm lub thorax, mus nrhiav cov qog ntshav.