Thyrotoxic goiter: izinto kunye nonyango

Thyrotoxic goiter - sisifo esingapheliyo samathambo ngemvelaphi lengqula ndlala. Etotnedug ephelekwa ukwanda secretion of hormone, leyo ngokunjalo kuchaphazela imo yonke eziphilayo. Njengoko esi sifo mongo le ezidalwe omzimba hypertrophy yokuqalisa - ukunyuka gland ubukhulu. Hi ndlela leyi, amayeza, esi sifo owayekwabizwa ngokuba isifo Basedow wekota emva kokuba ugqirha waseJamani ngubani kuqala wachaza iimpawu.

Ngelishwa, iingxaki ezifanayo abajongene abadala abaninzi. Kwaye, kakade, ngoko nangoko baqalisa ukukhangela ulwazi kwentamo thyrotoxic goiter yaye kutheni khona. Ziziphi iimpawu kufuneka sinikele ingqalelo kuyo? Yintoni unyango isigulane bangalindela? Yintoni imiphumo sifo kunokwenzeka? Iimpendulo zale mibuzo kuya kuba luncedo kubafundi abaninzi.

Kuyenye yeendlela goiter ityhefu: ulwazi ngokubanzi malunga nesifo

Kakade ke, kuqala, kukuba ukuthetha yintoni thyrotoxic goiter. Le Pathogenesis kwesifo kucaca ukuba siyiqonde imisebenzi esisiseko ye ingaba lengqula.

Thyroid - nobubovu yonyango, ekukho nomhlehlo asekhohlo nasekunene, eziqhagamshelene sezwe. Umsebenzi kulo mzimba kubaluleke kakhulu, kuba apha kuhlelwe iihomoni ezibalulekileyo ezifana thyroxine kunye triiodothyronine. Ezi izinto eziphilayo esebenzayo elawula phantse zonke izigaba yokucolwa emzimbeni womntu, ukubonelela ukwanda eqhelekileyo, ukulawula ukutya amandla. Ngapha koko, iiseli ezithile nokulungelelanisa lengqula ihomoni calcitonin, ebonelela calcium yokucolwa eziqhelekileyo emzimbeni, ithintela uphuhliso kwamathambo.

ndlala Umsebenzi lilawulwa inkqubo hypothalamic-yebhinqa ingxelo. Hi ndlela leyi, le ndlala lengqula lelona candelo kakhulu perfused emzimbeni womntu.

goiter Thyrotoxic - sisigulo sikhatshwa hypertrophy ye inwebu yesinye, kwakunye nokwanda secretion of hormone. excess yabo kwandisa abasabela pathways ngomzimba, ekhokelela luya yayo. Eyona ukuhlupheka luvo kunye seredechno nemithambo.

Ngokutsho manani, esi sifo kule yokugula kwabasetyhini abaminyaka yobudala eyi-20 ukuya ku-50. Thyrotoxic goiter emadodeni kwakhona kunokwenzeka, kodwa abhalwe phi alufane.

Yintoni ebangela esi sifo?

Yintoni ebangela isifo Graves '? Ubangelwa sifo, ngelishwa, akukaqondwa kakuhle. Yinto eyaziwayo nje ukuba isifo samathambo ngokwendalo. Ngenxa yezizathu inkqubo omnye umntu omzimba aqale avelise nezakhi ezithile ezihlasela iiseli yalo ingaba lengqula.

Indlela ingenzeka lokungaphumeleli ezifanayo eziphilayo wafunda ngokwaneleyo. Noko ke, oosonzululwazi baye bakwazi ukuchonga ubungozi eziliqela ezinegalelo ukuvela esi sifo:

• Kukho yofuzo (ukuba ngaba entsatsheni, kukho abantu abaphethwe zizifo lengqula, amathuba kuphuhliso goiter kuni ngasentla).
• Imiba yomngcipheko ziquka ukuphazamiseka kwamadlala, kuquka uphazamiseko ukusebenza kwenkqubo hypothalamic-yebhinqa.
• ukusetyenziswa kwamalweyile ngendlela amalungiselelo ayodini ekhuthaza ukwanda Yindibanisela hormone.
• Isifo kuxhokonxwa ntshikilelo onamandla rhoqo, ukuphatheka.
• Imiba yomngcipheko ziquka isifo seswekile.
• izifo ezinzima, welula deplete amajoni omzimba, nto leyo enokuphazamisa nokusebenza yayo yesiqhelo.
• Ngokutsho manani, thyrotoxic goiter kabini njengoko kusenokwenzeka ukuba sifo e iintshayi.

Ngelishwa, hayi kuzo zonke iimeko, ugqirha ilawula qondile unobangela thyrotoxic goiter.

goiter Thyrotoxic: yokuhlela

Kukho iindlela ezininzi yokuhlelwa kwesi sifo. Kuxhomekeka ayikhuphi ebukhulwini:

• goiter enomoya - ukuphazamiseka zophendlo lwezifo kwezinye izigqeba ezidalwe engekhoyo, arrhythmias ezesifuba akuzange kwenzeke, izigulane ezikhala iimpawu ngesimilo bangonwabi;
• aqine avareji ifomu sifo, oko kukhatshwa tachycardia, iyangongoza, yaye ngokukhawuleza Ukwehla kobunzima (ukuya kwi-10 kg ngenyanga nganye);
• uhlobo kakhulu, nto leyo sikhatshwa ilahleko enkulu kakhulu emzimbeni, nokudinwa umzimba, ukuphazamiseka komsebenzi intliziyo, isibindi kunye nezintso.

Kuxhomekeka iimpawu izitshanguba lengqula, ukukhululwa:

• kuyenye yeendlela goiter - izilonda ezincinane asasazwa ngokufanayo kulo lonke emzimbeni umzimba;
• nodular goiter tireotoksicski - kukho amanxeba eziliqela ezinkulu, apho kwakhiwa endaweni itywina (maqhuqhuva);
• ifomu mixed idibanisa zombini ukwenzakala lengqula nodular kunye kwentamo.

Ukongeza, neenqwelwana, thyrotoxic kuthiwa-amanyala le goiter. Kule meko ngumbuzo pregnancy sisilonda esidumbileyoesingaphakathi esiqwini lengqula, amalungiselelo ecaleni bile tireoglossalnogo (ecaleni loo ngenxa ukuhlukumeza kweenkqubo embryogenesis). Kufanelekile ukuba sikhankanye ukuba ngokoyiswa izihlunu amanyala kuthathwa ukuba yingozi kakhulu, njengoko kudla ngokukhokelela iiyunithi inguqu elinobuhlungu kunye nophuhliso zomhlaza.

goiter kwentamo (tireotoksicski): iifoto kunye neempawu

Ngokuqhelekileyo, ingongoma ebalulekileyo izigulane ezininzi umfanekiso kwezonyango sifo. Ngoko ke yintoni izifo kunye goiter thyrotoxic? Iimpawu zesi sifo zinokuba nomahluko, kuba ukwanda kwinqanaba ihomoni kuchaphazela umsebenzi phantse onke amalungu kunye neenkqubo. Sekunjalo, izigulane ezininzi akhalaze ukuphazamiseka bangonwabi kunye neengxaki zentliziyo.

Ukunyhashwa yegazi ichazwa tachycardia. Nokuba sele izinga intliziyo lokuphumla angandiswa ukuya ibetha 120-130 ngomzuzu. Izigulane bathi maxa wambi ukubetha sakhe esifubeni sakhe, isisu, intloko kunye nemilenze. Njengoko esi sifo kwandisa uxinzelelo iSystolic, kwaye ukuzala, icala, kunciphisa. Izigulane zikwaqaphele, uphelelwa ngumphefumlo, ukwanda ukuthambekela pneumonia. Xa kungekho unyango, hyperthyroidism inokukhokelela kakhulu engabalulekanga muscular.

syndrome Catabolic - omnye disorder okuhambisana goiter ehlasela (tireotoksicski). Iimpawu ngayo - kukuthi, kuqala kwiinto zonke, ukuba ngumngani weight ilahleko kwi imvelaphi zokuphila. Ngamanye amaxesha izigulane ukunciphisa umzimba nge 10-15 kg ngeenyanga 1-2. Ngaphezu koko, kukho ubuthathaka jikelele umzimba, ukubila wande, thermoregulatory kunye nokuhlukunyezwa. Nokuba kumaqondo obushushu asezantsi, izigulane badla ezikhala ingqiqo ubushushu. Ngokuhlwa, ifiva mhlawumbi ngakanye ukuba subfebrile amaxabiso.

Thyrotoxic goiter kunye ophthalmopathy wahamba, ezizezi, yegciwane-amehlo, oko kuvela njengokuba isifo siqhubeka. Ngenxa kokushiywa ezisezantsi ze aphakamise iinkophe eliphezulu zivaliwe ukuba ezivelileyo ngokupheleleyo amehlo. Izigulane thyrotoxicosis phambili kulula ukubona - ubuso bakhe kuthatha phezu njengembonakaliso bentshontsho kunye wothuka. Ngenxa yokuba iimvalo musa ukuvala ngokupheleleyo, umntu onesifo kome kwi conjunctiva kunye nemvakalelo rhoqo "intlabathi emehlweni." ingxaki rhoqo conjunctivitis ezigulo ezondeleyo. ngcembe izihlunu Periocular ukukhula, nokudumba periorbital kwenzeka, nto leyo ekhokelela ucinezelo lweliso lakho nemithambo neziphelo, buso okanye epheleleyo ukulahleka umbono.

Kwemfuneko ihomoni kuchaphazela ukusebenza kwenkqubo luvo. Izigulane kuchazwe ucaphuka wande, ixhala, ukuba ndlongondlongo, tearfulness, utshintsho kwimo, iingxaki yoxinaniso, ngamafutshane, ezinye ukungazinzi kwengqondo. Iimpawu zesi sifo ziquka ukudakumba, ukuphazamiseka kokulala. Kwiimeko onomoya, abantu, nokungcangcazela omhle neminwe. Njengoko esi sifo unciphisa isixa izihlunu, kodwa ngenxa yokuba isigulane kunzima ukuya ngenkuthalo.

Ngokuchasene imvelaphi thyrotoxic goiter kunye nezinye iintshukumo zokwaphulwa kwemithetho okunokwenzeka:

• njengokuba isifo siqhubela phambili njani na izigulane, ukuncipha kwamathambo ngenxa iziniki-calcium phosphorus;
• iintlobo okunzima sifo zihamba kunye uphuhliso insufficiency adrenal ukuba abangaboniyo ebonakaliswa ibala lesikhumba;
• akuthethi ukuba abekele ukugxojwa kwinkqubo yokwetyisa, kuquka nesisu esibuhlungu, ukugabha, isitulo ezingazinzanga, kwaye kwiimeko ezinzima ngakumbi - steatosis ziyityhefu kwaye kwesibindi;
• inkunzi erectile kwekhono, kunye gynecomastia lisenokuba nokuphazamiseka hormone;
• utshintsho kunokwenzeka kwinkqubo ababhinqileyo nezenzala, kubandakanywa kwekhono ovarian, izitenxo sexesheni, uphuhliso isifo webele fibrocystic;
• ukuba iimpawu zesi sifo zibandakanya vitiligo, kunye mnyama ulusu kummandla ezibayeni zendalo, ilahleko iinwele, buthathaka lezikhonkwane;
• ukwanda ubukhulu lengqula kwakhona kunokwenzeka, kodwa akunyanzelekanga - izigulane ezininzi ziya kuba hyperthyroidism kakhulu ngezixa eqhelekileyo yendlala; nangona kunjalo, ukwanda ubungakanani yesinye, imbonakalo "lwezityalo" esenzekayo 20-30% amatyala, oko kukhokelela ucinezelo ye uqhoqhoqho, ukuvela umzimba imvakalelo angaphandle emqaleni.

Ziintoni ezinobuzaza kungabangela izifo? crisis thyrotoxic

Njengoko ubona, ukuba ekhohlo lunganyangwa, esi sifo sichaphazela phantse kuzo zonke iinkqubo omzimba, kukhokelele kuphuhliso sisifo sentliziyo, ukuqina kwesibindi, ukuphazamiseka wemisebenzi adrenal.

Noko ke, kukho nenye ingxaki eziyingozi inokubangelwa kwentamo goiter ityhefu. Thyrotoxic crisis - imeko etsolo apho ngokuqhelekileyo senzeka nothomalaliso ephosakeleyo okanye emva kotyando.

Imiqondiso yokuqala sentlekele yi fever (ngamanye amaxesha ubushushu bomzimba liyanda kakhulu ukuya kutsho kuma-40), ukubila ukwanda, lability ngokweemvakalelo. Maxa wambi ukuphazamiseka luvo central kugqame kakhulu - kwanexhala unika indlela eya sohlaselo kwaye mania kakhulu.

Imiphumo thyrotoxic ngxaki ziquka ngokukhawuleza phambili ukusilela congestive intliziyo, ukuwa yokujikeleza, nokudumba yemiphunga, ukufa isiqaqa. Malunga nama-30-40% isiguli ukufa ubunzima iphela. Kubalulekile ke ngoko ixesha kubalulekile ngoxilongo goiter thyrotoxic. Iimpawu ngayo - ukuba isizathu sokuba ufune iingcebiso unyango ngoko nangoko.

iindlela Modern loxilongo

Kuphela emva kokuba kugqitywe uviwo ngenyameko, ugqirha ungenza isifo. Ngaphezu koko, kufuneka sibe sifo elula mahluko of goiters thyrotoxic.

Enyanisweni, nasemva yamagcisa uviwo lwangaphandle Qalisa ukukrokra ubukho hyperthyroidism. Ngokusekelwe kule, isigulane emiselweyo iimvavanyo ezingaphaya. zoviwo ultrasound ibonisa ukukhula ehlasela ngayo esinobubovu lengqula kunye notshintsho echogenicity yayo.

uxilongo mahluko of goiters ezilula kunye thyrotoxic ngokuyimfuneko lubandakanya uvavanyo igazi ngenxa amanqanaba hormone thyroid ekhuthazayo hormone yebhinqa. Macingo zePCR kumajoni omzimba kuvumela ukuba ukuchonga ubukho omzimba athile kwi thyroglobulin igazi, lengqula peroxidase kunye receptors TSH (leyo ebonisa ubukho inkqubo sokuhlasela).

ukufunda enengcombolo na lengqula scintigraphy, nto leyo evumela ukufumanisa ngokuchanekileyo umthamo nomzimba imilo, ubukho nodular, aqingqa isixa izicwili asebenzayo apho, enyanisweni, kuhlelwe iihomoni.

amayeza

Kuthekani ukuba isigulane bene thyrotoxic goiter? Unyango kuxhomekeke nenqanaba esi sifo, ukuphazamiseka langoku, iqondo womxhuzulane thyrotoxicosis.

Xa sincokola ngayo unyango ngamachiza, oko kuthetha ukuthatha amachiza antithyroid, ingakumbi "Merkazolil", "tirozol", "metizol" yaye "propitsil". Ezi amayeza zokumisa iinkqubo ze Yindibanisela hormone ancedisana ndlala ndlala.

Ngaphezu koko, ukuqaliswa iodine lwalusanda ibe ephilayo okanye iityuwa yayo iyenze kumgaqo elibi imveliso iibhloko Uxhulumaniso hormone yebhinqa ezivuselela umsebenzi ingaba lengqula. Kakade ke, unyango olunjalo kufuneka lwenziwe kuphela phantsi kweliso gqirha.

Ekubeni hyperthyroidism ephelekwa ukuphazamiseka kwenkqubo sentliziyo, kucetyiswa izigulane abafumana beta-blocker, leyo ukunciphisa izinga intliziyo, umyinge intliziyo ephantsi, engabalulekanga ukuphucula isondlo kwaye bunjani uxinzelelo lwegazi. Kuxhomekeka ekufumanekeni iimpawu ezithile, isigulane unokunikwa nadlamkisayo kunye hypnotics, relaxants kwezihlunu, anticonvulsants kunye antipsychotics.

Basengozini yokuvela thyrotoxic lobunzima kwi hormone irejimeni yonyango elawulwa, eyile steroids ezithintela uphuhliso olukhawulezayo insufficiency adrenal.

zonyango steel

Umsebenzi lanikwa ukuba izigulane awanikeleyo isifo siqhubela phambili ngokukhawuleza okanye unesigulo kwi zigaba kamva, kunye nonyango ngamachiza ayiniki ziphumo. Le inkomba uqhaqho kukunyuka ngamandla kule ndlala.

Ngokwendalo, ukususa ngokupheleleyo esinobubovu lengqula akwenzeki, ngenxa yokunqongophala hormone kuya kuquka utshintsho zizonke emzimbeni. Kungenxa yoko le nto oogqirha ukwenza resection kwenxenye umzimba, ngexesha ilondoloza indawo encinane inyama glandular. Ngenxa yoko, iihomoni nangoku kuhlanganiswa, kodwa amanani amancinci.

Amatyala ukuphinda emva kotyando kunokwenzeka. Kuba ukhuseleko olukhulu phambi nasemva kotyando olwenziwa unyango endala, yaye ngamanye amaxesha unyango kunye iodine.

Unyango iodine radioactive kunye neempawu zayo

Yilwa sifo kunokwenzeka esebenzisa iodine. Isibakala sokuba ukusungulwa Radioactive umzimba kakhulu ngokukhawuleza ngakumbi kwelifunekayo nezihlunu esinobubovu lengqula kunye di- rays beta, zitshabalalisa organ iiseli ezisebenzayo. Endaweni yazo akhiwa kwizicwili, abakwazi ukuvelisa iihomoni.

Le irejimeni yonyango zilwe ngamandla, nto leyo enokukhokelela imiphumo ezifana hypothyroidism, kohlobo, ukukrala nokoyika le ndlala lengqula. Kungenxa yoko le nto kumiselwe kuphela kwiimeko kakhulu. Ezibonisa ukuba unyango olunjalo iquka iintlobo kakhulu zesi sifo, ukuqhubela emva kotyando, kwakunye nokungasebenzi unyango.

Le abane ukuba izigulane

Kuyenye yeendlela goiter thyrotoxic - isifo esiyingozi kakhulu. Ukuba lunganyangwa, esi sifo kukhokelela ukugqitywa chu umzimba, ukuphazamiseka kwengqondo, ukusilela sentliziyo kunye nokufa nomonde.

Kwelinye icala, abantu abathe bathatha ikhosi yonyango, ebesiyiqikelele kakhulu entle. Ngoncedo amayeza akakwazi ukubuyisela ukusebenza yesiqhelo kunye hormone zendalo. Njengoko isifundo statistical, emva kokuphela unyango ifumaneke cardiomegaly nomonde ngcembe regresses, yaye sinus isingqi luyagcinwa kwakhona. Ngokuqhelekileyo, kucetyiswa ukuba uphephe iziyobisi kunye nokutya equlathe amathamo eliphezulu ayodini.

Ngokubhekiselele unyango ngotyando, emva kotyando, abantu badla ukuphuhlisa hypothyroidism efuna ukulungiswa ezithile zonyango.

Ingaba zikhona iindlela zokuthintela?

Ngelishwa, namhlanje, abantu abaninzi ezijongene unesifo "goiter thyrotoxic." Imbali esi sifo, unobangela kwaye iingxaki kunokwenzeka, unyango olusebenzayo - awona mathuba ezibalulekileyo isigulane ngasinye. Kwelinye icala, akukho mfihlakalo ukuba esi sifo kulula kakhulu ukuthintela Ngaphezu koko ukujongana neziphumo zesi sifo.

Ngelishwa, musa ayisekho naziphi na iindlela ezithile zokuthintela. Ukuba unayo yofuzo, kucetyiswa kabini ngonyaka ubuncinane ukuya kutyelela ofisi endocrinologist ngayo. Ke ukusuka kwangethuba sifo kwafunyaniswa, kokukhona kuya kuba ukulungisa imeko yesigulane.

ixesha kubalulekile ukuba ufumane unyango lwe naziphi na izifo ezosulelayo. Kakade ke, indlela yokuphila esempilweni, kuquka ukungabikho ntshikilelo rhoqo, ukusebenza komzimba, okunesondlo, kube nefuthe elihle kwi imeko hayi nje ndlala, kodwa zonke iinkqubo zomzimba.