Zomwe zimayambitsa goiter ndizochuluka, zosiyana malingana ndi momwe zimakhalira kapena zosiyana, kapena popanda ntchito ya chithokomiro. Ikhoza kugwirizanitsidwa:

- zakudya, majini ndi mahomoni (motero amachulukirachulukira mwa amayi);

- fodya amene amalimbikitsa goiter popikisana ndi ayodini;

- kukhudzana ndi ma radiation, kuwala kwa khomo pachibelekero paubwana kapena kukhudzana ndi chilengedwe.

Matenda a homogeneous goiters

Awa ndi ma goiter omwe chithokomiro chimatupa mumtundu wake mosiyanasiyana.

A homogeneous goiter ndi ntchito yachibadwa ya chithokomiro amakumana mu 80% ya milandu kwa akazi. Ndiwopanda ululu, wa kukula kosiyana, ndipo safuna chisamaliro chapadera.

Goiter ndi hyperthyroidism kapena Graves 'matenda: ofala kwambiri mwa amayi kuposa amuna, ndipo nthawi zambiri ochokera kubanja, amatsagana ndi kuwonda, kukwiya, kutentha thupi, thukuta kwambiri, kunjenjemera. Nthawi zina pali exophthalmos, mwachitsanzo, diso lalikulu, kupereka maonekedwe a globular maso, kutuluka kunja kwa kanjira.

Homogeneous goiter ndi hypothyroidism imafalanso kwambiri mwa amayi. Zitha kuyambitsidwa ndi mankhwala monga lithiamu, kapena kusowa kwa ayodini m'madera ena a France monga Alps, Pyrenees, etc. Goiter inali yofala kwambiri musanayambe kugwiritsa ntchito mchere wophikira wa ayodini. Zitha kukhalanso zochokera m'banja kapena chifukwa cha matenda a autoimmune (Hashimoto's thyroiditis) momwe thupi limapanga ma antibodies ku chithokomiro chake.

Goiter chifukwa cha kuchuluka kwa ayodini Pambuyo pa radiography ndi mankhwala osiyanitsa kapena chithandizo ndi amiodarone (mankhwala ochizira mtima arrhythmias) angayambitse hypo kapena hyperthyroidism. Iwo amabwerera modzidzimutsa mu nkhani yoyamba kapena pambuyo kusiya amiodarone.

Goiters omwe ndi opweteka komanso ogwirizana ndi malungoZingafanane ndi subacute Quervain's thyroiditis yomwe imatsogolera ku hypothyroidism ndipo nthawi zambiri hyperthyroidism. Nthawi zambiri amadzichiritsa okha mkati mwa milungu kapena miyezi ingapo. Dokotala angapereke aspirin, corticosteroids, ndi mankhwala ochepetsera mtima mu tachycardia.

Mitundu yosiyanasiyana ya goiter kapena nodular.

Palpation kapena ultrasound imasonyeza kukhalapo kwa tinthu tating'onoting'ono tomwe tating'onoting'ono, kaya tikugwirizana ndi vuto la chithokomiro. Nodule (s) ikhoza kukhala "yosalowerera ndale" ndi ntchito yachibadwa ya mahomoni, "ozizira" kapena hypoactive ndi kuchepa kwa kupanga kwa mahomoni a chithokomiro kapena "kutentha" kapena kusokoneza kwambiri ndi kuchulukitsidwa kwa mahomoni a chithokomiro. Manodule otentha amakhala ndi khansa modabwitsa. Koma zolimba, zamadzimadzi kapena zoziziritsa kuzizira zimatha mu 10 mpaka 20% yamilandu yofanana ndi chotupa choyipa, chifukwa chake ndi khansa.

Ndi dokotala uti yemwe muyenera kukaonana ndi chotupa?

Pamaso pa goiter, chifukwa chake kuchuluka kwa chithokomiro m'munsi mwa khosi kumatha kukaonana ndi dotolo wake wamkulu yemwe malinga ndi kuwunika ndi zinthu zoyamba za kuwunikako adzanena za endocrinologist (katswiri wamahomoni). ntchito) kapena ENT.

Kuyeza kwachipatala.

Kuyeza kwa khosi ndi dokotala kudzawona ngati kutupa m'munsi mwa khosi kumagwirizana ndi chithokomiro. Zimathandizanso kuti muwone ngati ndi zowawa kapena ayi, zofanana kapena ayi, ngati kutupa kumakhudza lobe imodzi kapena zonse ziwiri, zolimba, zolimba kapena zofewa. Kuwunika ndi dokotala kungayang'anenso kupezeka kwa ma lymph nodes pakhosi.

Pa kafukufuku wamankhwala, mafunso a dokotala pamodzi ndi kuyezetsa thupi amayang'ana zizindikiro za matenda a chithokomiro.

Dokotala adzafunsanso mankhwala omwe nthawi zambiri amatengedwa ndi munthuyo, ngati panali mavuto a chithokomiro m'banja, kuwala kwa khosi paubwana, komwe kumachokera, zomwe zimayambitsa (fodya, kusowa kwa ayodini, mimba).

Kuyeza kwachilengedwe.

Amasanthula momwe chithokomiro chimagwirira ntchito poyesa mahomoni a chithokomiro (T3 ndi T4) ndi TSH (hormone yopangidwa ndi pituitary gland yomwe imayang'anira kutulutsa kwa mahomoni a chithokomiro). M'malo mwake, ili pamwamba pa TSH yonse yomwe imayesedwa pakuyesa koyamba. Ngati chiwonjezeke, zikutanthauza kuti chithokomiro sichigwira ntchito mokwanira, ngati chiri chochepa, kuti kutulutsa kwa mahomoni a chithokomiro kumakhala kochuluka.

Dokotala athanso kuyitanitsa mayeso a labotale kuti awone ngati alipo odana ndi chithokomiro.

Kuyezetsa magazi.

Kufufuza kofunikira ndijambulani lomwe limatchula kukula, mawonekedwe osasinthika kapena ayi, mawonekedwe a nodule (zamadzimadzi, olimba kapena osakanizika), momwe zimakhalira ndipo makamaka kukulitsa kwa goiter kupita ku thorax (komwe kumatchedwa kugwa. goiter). Amayang'ananso ma lymph nodes m'khosi.

La chithokomiro scan. Zimapangidwa ndi kupereka kwa munthu yemwe ati adzayeze mayeso omwe ali ndi zolembera zama radioactive zomwe zimamangiriza ku chithokomiro cha chithokomiro (iodine kapena technetium). Popeza zolemberazi zili ndi radioactive, ndikosavuta kupeza chithunzi cha madera omwe amamangirira zolembera. Mayesowa amafotokoza momwe chithokomiro chimagwirira ntchito. Itha kuwonetsa tinthu tinatake tomwe sitinawone pa palpation ndi mawonetsero

- ngati tinthu tating'onoting'ono tating'onoting'ono tating'onoting'ono tikhala "ozizira": amamanga cholembera chochepa kwambiri, ndipo izi zikuwonetsa kuchepa kwa chithokomiro chambiri,

- ngati ma nodules ndi "otentha", amakonza zizindikiro zambiri za radioactive, zomwe zimasonyeza kupanga kwambiri

- ngati tinatake tozungulira salowerera ndale, amakonza zolembera zokhala ndi ma radioactive, zomwe zimawonetsa kugwira ntchito bwino kwa mahomoni.

La kuphulika kwa a manoduleamalola kuyang'ana kukhalapo kwa maselo owopsa kapena kuchotsa chotupa. Izo zimachitidwa mwadongosolo kwa onse ozizira tinatake tozungulira

La Radiology yosavuta akhoza kusonyeza calcifications a goiter ndi kufalikira kwake pachifuwa

Mtengo wa IRM Ndizosangalatsa kufotokoza kufalikira kwa chithokomiro kupita kumagulu oyandikana nawo makamaka kukhalapo kwa goiter yomwe imalowera ku thorax, kufunafuna ma lymph nodes.