Cov thyroid caj pas yog ib qho tseem ceeb hauv nruab nrog cev ntawm tib neeg endocrine system. Lub plawv dhia, lub hlwb-kev xav, kev ua haujlwm ntawm cov poj niam, kev nco ua haujlwm yog nyob ntawm qhov tseeb ntawm nws txoj haujlwm.
Qhov chaw thiab qhov tshwm sim
Cov thyroid caj pas yog ib lub cev zoo li npauj npaim thiab muaj ob lub lobes, uas txuas nrog lub isthmus (lub lobes yog tis ntawm npauj npaim, thiab isthmus yog lub cev ntawm cov kab). Hauv tsib feem pua ntawm cov neeg mob, lub isthmus ntawm cov thyroid caj pas yuav tsis tuaj tag nrho.
Lub isthmus nyob rau theem ntawm lub nplhaib thib ob lossis thib peb, sib cais los ntawm cov pob txha mos cricoid.
Size
Qhov loj ntawm isthmus ntawm cov thyroid caj pas yog tus kheej rau txhua tus neeg thiab feem ntau nyob ntawm lub cev hnyav. Nrog rau qhov hnyav tshaj nyob rau hauv ib tug neeg, lub cev yog loj, uas tsis yog ib tug pathology. Cov qauv ntawm isthmus ntawm cov thyroid caj pas yog 4-8 mm.
Pathology
Lub isthmus ntawm cov thyroid caj pas yog raug cov kab mob tib yam li cov thyroid nws tus kheej. Nws ntseeg hais tias tus kab mob ntawm lub cev yuav siv sij hawm 2nd qhov chaw tom qabntshav qab zib mellitus. Raws li kev txheeb cais, tus kab mob thyroid isthmus yog 5-8 npaug ntau dua rau cov poj niam dua li cov txiv neej. Ib tug nquag pathology yog tsim ntawm nodes. Raws li txoj cai, cov nodes yuav tsis ua rau lawv tus kheej xav tau ntev, uas ua rau muaj kev noj qab haus huv loj - ob qho tib si rau isthmus ntawm cov thyroid caj pas thiab rau kev ua haujlwm ntawm tag nrho cov kab mob.
Pathological o ntawm isthmus hauv tib neeg ua rau muaj kev cuam tshuam ntawm kev ua haujlwm ntawm cov thyroid caj pas nws tus kheej. Qhov no tuaj yeem yog vim qhov hloov pauv ntawm hormonal. Thaum pom qhov loj me ntawm lub cev, cov kws kho mob tsis cuam tshuam ntau qhov tseem ceeb rau cov kab mob no. Thiab yog hais tias qhov loj ntawm lub isthmus ntawm cov thyroid caj pas nce lub sij hawm, ces qhov no twb yog thawj kos npe rau ntawm yuav tsum tau hu rau ib tug endocrinologist.
Kev faib tawm ntawm qhov hnyav ntawm pathology
Hauv cov tshuaj, kev faib tawm ib ntus ntawm kev hloov pauv pathological hauv isthmus ntawm cov thyroid caj pas yog siv:
- hloov me me, lawv yuav luag tsis pom, muaj qhov deformation ntawm caj dab cov leeg;
- nrog kev hloov pauv tseem ceeb, lub caj dab zoo li twb hloov lawm. Neoplasm tsis pub tus neeg mob ua neej nyob li qub.
nce qhov loj ntawm isthmus ntawm cov thyroid caj pas, tuaj yeem qhia txog kev loj hlob ntawm cov kab mob xws li Basedow's disease, Graves' disease, malignant tumors.
Yog vim li cas rau pob caus
Yog vim li cas rau qhov pom ntawm pob qhov rooj muaj xws li hauv qab no:
- Ib puag ncig tsis zoo.
- Kev noj haus tsis zoo.
- siv dej tsis zoo.
- Kev tsis txaus iodine hauv tib neeg lub cev (iodine yog ib qho kab mob uas nkag mus rau hauv lub cev nrog zaub mov, tab sis nyob rau ntau thaj tsam ntawm peb lub teb chaws nws tsis txaus). Ib qho tsis txaus ntawm microelement hauv tib neeg lub cev ua rau txo qis hauv kev tsim cov tshuaj hormones. Qhov tshwm sim ntawm iodine deficiency nyob rau hauv lub cev ntawm tus poj niam cev xeeb tub tej zaum yuav yog ib tug nchuav menyuam, thiab anomaly nyob rau hauv kev loj hlob ntawm tus me nyuam mos kuj tsis raug cais tawm. Thaum menyuam yaus thiab hluas, vim tsis muaj iodine, kev puas hlwb thiab lub cev tsis muaj zog tuaj yeem txhim kho.
- Kev kuaj x-ray ntau ntau.
Lub isthmus node ntawm cov thyroid caj pas muaj ib puag ncig thiab tsim nyob rau hauv cov ntaub so ntswg ntawm isthmus. Qhov no ua rau lub cev hloov pauv hauv cov ntaub so ntswg ntawm cov thyroid caj pas nws tus kheej.
Knot tsos mob:
- caj pas tsis xis nyob;
- squeezing caj pas;
- suab nrov lossis nws ploj lawm;
- muaj ib pob hauv caj pas uas nqos tsis tau;
- mob khaub thuas;
- mob ntshav siab;
- menstrual irregularities.
Cov cim qhia hauv kev loj hlob ntawm neoplasms:
- sudden hloov mus siab;
- Nyob ntawm tus ntsia thawv phaj;
- tawv hloov xim;
- ncua kua dej tawm;
- tawm hws ntau dhau;
- poob sai lossis, hloov pauv, hnyav nce;
- insomnia lossis tsaug zog;
- tachycardia lossis bradycardia;
- tshwm sim ntawm qhov qis tshaj plawsua tsis taus pa;
- faus;
- muaj kev puas siab puas ntsws.
Diagnosis
Txhawm rau txiav txim siab qhov xwm txheej ntawm isthmus ntawm cov thyroid caj pas, tus neeg mob yuav tsum tau ua cov txheej txheem kuaj mob hauv qab no:
- kuaj ntshav rau cov thyroid hormones;
- kev tshuaj xyuas siv xov tooj cua iodine;
- palpation;
- ultrasound;
- MRI lossis CT.
Thawj yam uas tus kws kho mob ua thaum kuaj tus neeg mob lub caj pas thyroid yog hnov cov thyroid caj pas los ntawm caj dab, vim nws tsis tuaj yeem pom cov kab mob. Palpation yog txoj hauv kev yooj yim tshaj plaws ntawm kev ntsuam xyuas, tab sis tsis yog ib txwm ntseeg tau.
Txoj kev tshawb fawb thib ob yog ultrasound, uas yog qhov zoo dua thiab pheej yig dua rau cov neeg mob. Ntawm ultrasound, qhov transverse thiab ntsug loj ntawm isthmus ntawm cov thyroid caj pas, cov ntshav khiav, kev hloov hauv cov qog ntshav tau txiav txim siab. Txoj kev kuaj no yooj yim vim nws tsis tas yuav muaj kev cob qhia tshwj xeeb, nws tuaj yeem ua rau cov ntxhais cev xeeb tub.
MRI thiab CT raug sau rau kev kuaj mob siab dua ntawm tus neeg mob, yog tias tus kws kho mob pom qhov txawv txav hauv isthmus ntawm cov thyroid caj pas ntawm ultrasound.
Kev kho mob
Tom qab kuaj mob, tus kws kho mob tau sau ntawv kho mob. Yog tias ib lub pob tau pom thiab nws me me, ces tus kws kho mob pom zoo kom soj ntsuam thiab kuaj ib zaug txhua 3 lub hlis. Nws tseem pom zoo kom ua ultrasound ntawm isthmus ntawm cov thyroid caj pas txhua rau lub hlis. Yog hais tias lub pob loj loj, ces tus neeg mob yuav raug xa mus rau biopsy, los yog lawv yuav muab puncture los txiav txim qhov xwm.neoplasms.
Knot classification
Yog tias muaj qhov tsis sib xws ntawm qhov loj ntawm isthmus ntawm cov thyroid caj pas mus rau qhov qauv lossis cov nodes tshwm sim, qhov no qhia tau hais tias muaj kab mob. Nyob rau hauv rooj plaub tom kawg, nws yog ib qho tsim nyog los txiav txim seb hom nodes:
- Benign qog - cov nodes tshwm sim hauv 92% ntawm cov neeg mob. Yog tias qhov tsim tsis tsim kev tsis xis nyob rau tus neeg mob, cov hlab ntsha thiab cov ntaub so ntswg uas nyob ib sab tsis tau compressed, nyob rau hauv cov ntaub ntawv no, kev kho mob tsis tas yuav tsum tau.
- Follicular qog - hauv 85% ntawm cov neeg mob, cov qog no yog qhov zoo, thiab hauv 15% malignant. Nyob rau hauv ob qho tib si, tus neeg mob tau pom zoo rau kev phais mob, tsuas yog tom qab histology, nws muaj peev xwm txiav txim siab qhov mob ntawm qog.
- mob qog nqaij hlav - nyob rau hauv cov xwm txheej zoo li no, tsuas yog kev phais yog qhia. Thaum lub sijhawm ua haujlwm, tus kws phais neeg endocrinologist txiav txim siab qhov chaw ntawm cov qog thiab txiav txim siab ntau npaum li cas ntawm isthmus ntawm cov thyroid caj pas yuav tsum tau muab tshem tawm. Cov theem tom ntej ntawm kev kho mob tom qab kev ua haujlwm tau raug sau tseg kom tau txais kev kho mob los yog hluav taws xob. Yog tias pathology tau kuaj pom nyob rau theem pib thiab kev kho mob tau ua tiav, ces txoj hauv kev rov qab los yog siab. Qhov tseem ceeb tshaj plaws yog kom paub qhov txawv ntawm cov kab mob hauv lub sijhawm, yog li cov kws kho mob muab cov lus pom zoo rau cov neeg mob hnub nyoog 45 xyoos thiab laus dua kom ua ultrasound ib xyoos ib zaug rau kev tiv thaiv.
tiv thaiv kab mob
Kev tiv thaiv kab mob thyroid tseem ceeb rau txhua lub hnub nyoog thiab suav nrog kev ua raws licov cai teev tseg:
- siv sijhawm tsawg dua hauv lub hnub (tshwj xeeb yog lub caij ntuj sov);
- noj zaub mov muaj iodine (seaweed, iodized ntsev, nqaij nruab deg, ntses, caviar, walnuts, kiwi);
- coj txoj kev noj qab haus huv (kev haus luam yeeb ua rau cov thyroid caj pas, yog li nws yog qhov zoo dua rau tso tus cwj pwm no thiab siv sij hawm ntau sab nraum zoov, cov ntxhais cev xeeb tub raug pom zoo kom noj cov vitamin complex nrog iodine).
Yog tias koj muaj kev pheej hmoo kis tus kab mob, koj yuav tsum tau kuaj xyuas tus kws tshaj lij.
