Y Thyroiditis yog ib yam kab mob ntawm endocrine system. Thaum peb lub caj pas tseem ceeb (cov thyroid caj pas) tsim cov endocrine secretion qis dua lossis siab dua li qub, lub cev muaj teeb meem loj. Cov kab mob ntsig txog cov thyroid tshwm sim thawj zaug hauv tag nrho cov txheej txheem metabolic.
YYuav ua li cas rau cov thyroid caj pas nrog thyroiditis?
Thyroiditis yog hu ua mob ntawm cov thyroid caj pas. Nrog rau txoj kev loj hlob ntawm tus kab mob, lub hlwb ntawm cov kabmob no maj mam tso tseg tsis ua lawv txoj haujlwm. Thiab lub luag haujlwm ntawm lub caj pas yog tsim los ntawm ntau yam tshuaj hormones uas tswj kev coj ua ntawm tag nrho cov txheej txheem metabolic hauv lub cev. Raws li, thaum kev ua haujlwm ntawm lub caj pas cuam tshuam, teeb meem nrog qhov hnyav pib.
Muaj ntau hom mob ntawm lub cev no:
- De Quervain's thyroiditis.
- Acute thyroiditis.
- Riedel's goiter (fibrous form).
- Chronic.
Tus mob thyroiditis ntawm cov thyroid caj pas yuav tsum tau kho tam sim ntawd thiab tsis khiav. Tab sis dab tsi yog nws manifestations thiab yog vim li cas nws yog txaus ntshai? Peb yuav xav txog cov lus nug no.
Cov tsos mob mob
Thyroiditis yog tus cwj pwm los ntawm ntau qhov pom tseeb. Thaum pib ntawm cov txheej txheem inflammatory, kev ua haujlwm ntawm lub caj pas yog ib txwm nce. Cov tsos mob tseem ceeb yog hais tias goiter (nrog caj pas), tes tshee thiab aseptic o ntawm cov thyroid cov ntaub so ntswg (thyroid cov ntaub so ntswg). Tag nrho cov kev tshwm sim no qhia raws nraim qhov ua tsis tiav ntawm cov tshuaj hormonal.
Rau qhov laj thawj ntawm lub cev, cov neeg mob no qee zaum tawm ntawm lawv qhov chaw. Cov neeg no xav tau kev kho mob ceev los ntawm tus kws kho mob endocrinologist.
Mob thiab subacute thyroiditis: ua rau
Subacute daim ntawv ntawm o, lossis de Quervain's thyroiditis, tsis muaj dab tsi ntau tshaj li qhov mob ntawm caj pas los ntawm tus kab mob kis. 3, 4, lossis 5 lub lis piam tom qab kis tus kab mob ua npaws, cov tsos mob ntawm cov thyroid pib.
Cov poj niam raug mob los ntawm qhov mob 8 zaug ntau dua. Tus kab mob no kav txog 6 lub hlis. Cov tsos mob dab tsi tuaj yeem pom hauv daim ntawv subacute?
- Mob hauv lub caj pas thyroid. Kev mob qee zaum kis mus rau pob ntseg lossis lub tuam tsev, ua rau hnyav dhau los ntawm tig taub hau.
- Y Muaj hypermetabolism (nce metabolism)
- Nyob tau nodules.
- qaug zog, mob taub hau.
- nce lub cev kub.
- Ntxhais.
- daim tawv nqaij ntawm caj dab yog hyperemic.
Yuav luag ib txwm ua rau cov thyroiditis subacute yog kis ntawm lwm yam kab mob hauv lub cev mus rau caj pas nws tus kheej.
Yuav Thyroid Hormones
Cov thyroid hormones tsim los ntawmpituitary caj pas nyob rau hauv lub hlwb, qhia lub thyroid caj pas ua hauj lwm. Cov tom kawg tsim tib lub sijhawm cov thyroids - cov proteins. Lub caj pas pituitary yog nyob rau hauv nruab nrab ntawm lub hlwb thiab yog lub luag haujlwm rau kev tsim cov tshuaj hormones uas peb xav tau tshaj plaws. Tus nqi ntawm cov thyroid tsim los ntawm lub caj pas yuav tsum sib npaug ntawm TSH (thyroid-stimulating hormone). Tab sis thaum cov hlau ua haujlwm dhau heev lawm, ib tug neeg yuav tsis tswj tau. Los ntawm qhov muaj zog tshaj overexcitation, tag nrho lub cev tuaj yeem co. Hauv cov poj niam, hysteroid manifestations pib, raws li keeb kwm hormonal cuam tshuam.
Qhov tsis muaj cov thyroid hauv lub cev muab lub cim rau lub caj pas pituitary tias nws xav tau cov tshuaj hormone sai sai. Thiab lub caj pas pituitary tsim ntau TSH. Yog li ntawd, cov neeg uas tau kuaj pom tias muaj cov thyroid tsis ua haujlwm raug txiav tawm tag nrho lossis raug sau tseg kom noj cov qog tsis pub leej twg paub hauv cov tshuaj.
Autoimmune thyroiditis
Tus kab mob no tshwm sim thaum koj tus kheej lub cev tiv thaiv kab mob (cov tshuaj tiv thaiv kab mob) pib tawm tsam cov follicles (hlwb) ntawm cov thyroid. Nyob rau hauv tas li ntawd, lub caj pas ua o, thiab nws cov hlwb puas. Thaum pib ntawm "kev tawm tsam" ntawm leukocytes, tsis muaj cov tsos mob tshwj xeeb. Tab sis tom qab ntawd, raws li cov thyroid caj pas maj mam tawg thiab poob nws cov hlwb, nws pib ua haujlwm ntau dhau. Qhov tshwm sim yog thyrotoxicosis. Tom qab theem ntawm kev ua kom ntau dhau, theem ntawm inhibition ntawm cov thyroid ua haujlwm pib. Tom qab ntawd tus neeg mob yuav qaug zog thiab tsaug zog. Qhov hnyav nce thiab cov plaub hau poob ntau dua. Rau ntau tus neeg, lub cev kub feem ntau poob qis dua li qub.
Yog vim li casCov txheej txheem autoimmune tsis paub. Cov kws tshawb fawb koom nrog cov xwm txheej no nrog kev tsis zoo ntawm ecology, dej qias neeg, genetic predisposition. Lub stimulating yam ntawm tus kab mob yog hu ua tej yam kev nyuaj siab. Raws li qhov tshwm sim ntawm kev ntxhov siab, tej zaum yuav muaj qhov ua tsis tiav hauv kev tiv thaiv kab mob. Tshwj xeeb tshaj yog qhov kev pheej hmoo nce rau cov neeg mob tsis haum tshuaj uas twb muaj qee qhov ua tsis tiav hauv lawv cov txheej txheem tiv thaiv. Mob autoimmune thyroiditis yam tsis muaj kev kho mob yuav ua tau ntev. Thiab o ua rau poob ntawm cov thyroid caj pas tseem ceeb.
YToxic thyroiditis
Tus mob thyroiditis ntawm cov thyroid caj pas tseem txhim kho los ntawm kev puas tsuaj rau cov tshuaj lom, thaum qee cov txheej txheem ntev, qee zaum tonsillitis lossis mob khaub thuas hnyav, kuj cuam tshuam rau cov thyroid caj pas. Toxic thyroiditis, lossis thyrotoxicosis, muaj cov tsos mob hauv qab no:
- tshiav tag nrho lub cev, tshwj xeeb yog txhais tes tshee;
- nce tawm hws;
- chim siab;
- ntshav siab dheev nce;
- lub plawv dhia;
- qee zaum muaj kev cuam tshuam hauv kev ua haujlwm ruaj khov ntawm lub siab.
Raws li kev ua haujlwm ntawm cov thyroid caj pas, tom kawg hnav tawm. Tom qab hyperthyroidism, lub xeev rov qab tshwm sim - hypothyroidism (tsis ua haujlwm). Tus neeg mob qhov kub thiab txias poob qis thiab nws tsaug zog tas li. Lub sijhawm no, xav tau kev pab kho mob, vim qhov xwm txheej tsuas yog hnyav zuj zus, thiab ntau thiab ntau lub qog yuav tuag.
txheej txheem purulent
Acute purulent thyroiditistsim los ntawm kev sib kis ntawm cov txheej txheem inflammatory rau cov thyroid caj pas. Thiab nws tsis muaj dab tsi ua nrog autoimmunity. Qhov ua rau tus kab mob no feem ntau yog hluav taws xob thaum kho mob qog noj ntshav lossis mob nyob ze ntawm cov thyroid caj pas, xws li tonsillitis hnyav lossis mob ntsws. Lwm qhov laj thawj rau kev txhim kho ntawm cov txheej txheem mob hnyav yog hemorrhage ncaj qha rau hauv cheeb tsam no. Cov thyroid caj pas nyob rau hauv xws li mob yog nyuaj rau palpation, tab sis nrog kev loj hlob ntawm purulent masses nws ua softer. Nyob rau tib lub sijhawm nrog kev loj hlob ntawm goiter, cov qog nqaij hlav ua rau mob, uas yog ntuj nrog kev mob. Yog hais tias koj tsis nrhiav kev pab los ntawm kws kho mob nyob rau hauv lub sij hawm, lub abscess yuav tawg los ntawm qhov tshwm sim.
Cov teeb meem ntawm tus mob purulent thyroiditis tuaj yeem yog:
- ntsws abscess;
- sepsis (ntshav lom);
- ncephalitis;
- aspiration pneumonia;
- mediastinitis.
Qhov txaus ntshai tshaj plaws yog tias nws tawg, ces tus kab mob yuav nkag mus rau hauv cov hlab ntsha, thiab feem ntau nws yuav hloov mus rau lub hlwb. Qee lub sij hawm cov abscess tawg tawm.
Diagnosis
Ntau qhov kev kuaj mob yuav tsum tau kuaj xyuas qhov ua rau mob thiab qhov mob ntawm tus neeg mob. Yog tsis muaj kev tshawb fawb, tus kws kho mob yuav tsis muaj peev xwm sau tshuaj kho kom txaus. Yuav tsum tau:
- thyroid scintigraphy;
- analysis for the hormone TSH;
- YThyroid ultrasound;
- pawg.
Dab tsi yog scintigraphy? Qhov no yog kev tshawb fawb hluav taws xob ntawm kev ua haujlwm ntawm cov qog nqaij hlav. Thaum ultrasound, tus kws kho mob tuaj yeem pom qhov abscess lossis nodules hauvcaj pas, thiab tom qab ntawd nqa tawm kev kho mob twb nyob rau hauv lub hauv paus ntawm lub tswv yim meej ntawm tus neeg mob txoj kev noj qab haus huv. Qib ntawm cov thyroid hormones tsis siab yog tias ib tug neeg muaj mob thyroiditis, tab sis nyob rau hauv cov kab mob subacute, nws twb nce. Tsis tas li ntawd, cov kws kho mob yuav tsum tau ua ib qho kev ntsuam xyuas thiab tshawb xyuas seb qib ESR (erythrocyte sedimentation rate) hauv cov ntshav tau nce. Qhov no tseem ceeb heev rau kev kuaj mob hom mob. De Quervain's thyroiditis yog tus cwj pwm los ntawm kev nce ESR thiab leukocytosis. Txawm hais tias cov kev hloov hauv cov ntshav no yuav tsis yog.
Kev kho mob
Thaum cov qog nqaij hlav ua rau mob me ntsis tawm tsam keeb kwm ntawm qhov mob thaum nqos lossis tig sab laug lossis sab xis, ib tus neeg yuav tsum tau kuaj thiab tuaj rau kev sab laj nrog kws kho mob endocrinologist. Tab sis nws tuaj yeem hais qee yam tsuas yog tom qab kev tshawb fawb. Puas yog cov tsos mob ntawm tus mob thyroiditis? Kev kho mob yuav raug qhia kom meej raws li kev kuaj mob.
Kev kho yog raws li kev noj qee yam tshuaj, xws li cov tshuaj hormone thyroxine, los hloov cov qib uas ploj lawm. Puas yog noj cov tshuaj hormone no txaus ntshai? thyroxine, uas yog tsim los ntawm niaj hnub pharmacological tuam txhab uas muag, yog tag nrho raws li tib neeg lub cev thiab tsis muaj txawv teb chaws proteins txhua. Yog li ntawd, cov neeg mob noj nws txhua tag kis sawv ntxov thiab hauv cov koob tshuaj uas sib haum rau qhov hnyav.
Yuav ua li cas ntxiv yuav tsum tau ua kom noj qab haus huv? Ua ntej tshaj plaws, koj yuav tsum tau tshem ntawm qhov teeb meem kev ntxhov siab, txwv tsis pub cov hlau yuav txuas ntxiv mus. Kev mob ntev ntev qee zaum ua rau qhov tseeb tias cov thyroid caj pas nres kiag liua lawv txoj haujlwm. Tom qab ntawd cov kws kho mob pom zoo kom phais kom tshem tawm cov qog. Txawm hais tias qhov tseeb koj tuaj yeem txuas ntxiv noj cov tshuaj hormones yam tsis muaj kev phais.
Txawm li cas los xij, yog tias lub caj dab compression pib, uas twb cuam tshuam nrog nqos, ces kev ua haujlwm yog qhov yuav tsum tau ua. Lwm qhov laj thawj rau qhov yuav tsum tau muaj kev cuam tshuam kev phais yog ib qho abscess kuaj pom thaum kuaj. Nws yuav tsum tau qhib thiab ntws. Qhov ntawd yog, cov kua dej hauv nruab nrab ntawm cov abscess yuav tsum ntws tawm.
Subacute thyroiditis yog kho hormonally hauv ib xyoos. Yog tias purulent thyroiditis raug kuaj pom, yuav tsum tau mus pw hauv tsev kho mob. Tus neeg mob yuav tau txais kev kho mob tshuaj tua kab mob. Xav tau tshuaj antihistamines thiab kev kho mob txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau kis cov kab mob, nws xav tau cov tshuaj tiv thaiv kab mob.
khoom noj kom raug rau cov thyroiditis
Khoom noj khoom haus rau cov teeb meem nrog cov thyroid caj pas yuav tsum yog feem. Lub sijhawm so ntawm cov pluas noj yuav tsum yog 2 lossis 3 teev. Dab tsi tuaj yeem noj tsis tau, thiab yuav tsum noj dab tsi thaum hlau xav tau kev pab? Kev noj zaub mov yog npaj nyob rau hauv xws li ib txoj kev uas thaum lub sij hawm txhua pluas noj muaj ntau ntau zaub, tshuaj ntsuab, paus qoob loo. Txiv hmab txiv ntoo yog xav tau los ntxiv rau lub cev nrog micronutrient reserves.
Txhua hnub koj yuav tsum noj cov zaub mov uas muaj selenium. Nws muaj nyob rau hauv seaweed, txiv lws suav, champignons, cereals. Tab sis feem ntau ntawm tag nrho cov khoom no yog nyob rau hauv Brazil txiv ntseej. Seaweed, ntxiv rau selenium, muaj lwm cov kab ke tsim nyog rau kev mob ntawm cov thyroid caj pas -iodine. Tom qab tag nrho, kev txo qis hauv kev ua haujlwm ntawm lub cev ua rau txo qis kev nqus ntawm iodine.
