Cov thyroid nodules: cov cim qhia thiab kev kho mob

Cov txheej txheem:

Cov thyroid nodules: cov cim qhia thiab kev kho mob
Cov thyroid nodules: cov cim qhia thiab kev kho mob

Video: Cov thyroid nodules: cov cim qhia thiab kev kho mob

Video: Cov thyroid nodules: cov cim qhia thiab kev kho mob
Video: Qhia kev ua neeg zoo yuav ua li cas(choj neeb thoj) 2024, Hlis ntuj nqeg
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Thyroid nodules yog ib qho teeb meem tshwm sim hauv endocrinology. Ib qho laj thawj tseem ceeb rau nws qhov tshwm sim yog qhov tsis muaj iodine hauv lub cev. Qhov no pathology tshwm sim los ntawm kev cuam tshuam ntawm endocrine system thiab zoo li kev hloov pauv pathological cuam tshuam rau cov thyroid caj pas. Yog tias tsis ua raws li kev kho mob raws sijhawm, cov txheej txheem nodular tuaj yeem ua rau muaj ntau yam kab mob.

Tus kab mob no nyuaj heev, nrog rau kev tsim ntawm ib lossis ntau qhov ntawm qhov sib txawv thiab cov tsos mob, nrog rau cov kab mob sib txawv thiab cov kab mob benign. Cov txheej txheem zoo li no yuav muaj cov tshuaj ntsiav lossis kua. Feem ntau cov nodular tsim ntawm txoj cai lobe ntawm cov thyroid caj pas, ib yam li sab laug, yog benign, tab sis nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas thiab kho tom ntej. Yog tias tus kab mob tsis kho raws sijhawm, nws tuaj yeem ua rau muaj ntau yam pathologies.

cov thyroid nodules
cov thyroid nodules

Cov kab mob nodular feem ntau nyob rau hauv txoj cai lobe ntawm cov thyroid caj pas, thiab nrog lub hnub nyoog, qhov kev pheej hmoo ntawm nws tshwm sim nce. Txiv neej muaj qhov nopathology muaj ntau dua li cov poj niam.

qauv ntawm cov thyroid caj pas

Ib yam tseem ceeb tshaj plaws ntawm cov kab mob endocrine yog cov thyroid caj pas. Nws tsim cov tshuaj hormones uas muaj iodine. Nws zoo li tus npauj npaim thiab nyob ntawm caj dab.

Cov thyroid caj pas muaj cov isthmus, sab laug thiab sab xis lobe. Qee tus neeg muaj lub lobe ntxiv taw qhia los ntawm isthmus. Epithelial hlwb yog tsim los ntawm cov follicles uas tsim cov tshuaj hormones. Lub follicle yog ib lub zais zis me me uas muaj kua dej nyob hauv. Nrog rau ntau yam teeb meem hauv kev ua haujlwm ntawm lub caj pas, lub hauv paus follicle overflows nrog kua, thiab vim li ntawd, nodular formations tshwm sim.

pob caus yog dab tsi thiab nws tsim li cas

Thyroid nodules yog cov ntsaws ruaj ruaj uas txawv hauv cov qauv ntawm cov ntaub so ntswg noj qab haus huv. Txhua tus neeg, paub txog qhov tsis zoo, tuaj yeem kuaj xyuas tus kheej kom pom cov neoplasms. Cov thyroid caj pas noj qab nyob zoo yog yam ntxwv los ntawm:

  • muaj tib qhov chaw yam tsis muaj kev cuam tshuam thiab kev nyuaj siab;
  • same ntom;
  • tsis mob thaum nias;
  • ob qho tib si sib luag.

Txhawm rau txiav txim siab qhov ua rau ntawm pathology, koj yuav tsum hu rau tus kws kho mob endocrinologist. Los ntawm tus naj npawb ntawm cov thyroid nodules tuaj yeem yog:

  • ib leeg, uas yog, ib leeg;
  • ntaus;
  • conglomerate, uas yog, ntau cov nodes sib koom ua ke.

Ib leeg zoo li lub pob me me thiab ua taunyob rau hauv ib qho ntawm cov lobes los yog ntawm lub isthmus. Ntau qhov kev tsim tuaj yeem cuam tshuam rau txhua qhov chaw ntawm cov thyroid caj pas. Thaum lub sij hawm, lawv loj hlob thiab tsim ib tug nodular goiter. Nws tuaj yeem nce zuj zus, ntau xyoo, lossis tshwm sim sai, hauv ob peb lub lis piam xwb.

Types ntawm cov thyroid nodules

Muaj ntau ntau hom nodular neoplasms, sib txawv hauv cov qauv thiab ntau. Nyob ntawm cov yam ntxwv ntawm cov qauv, nodular formations ntawm cov thyroid caj pas yog:

  • colloidal;
  • cyst;
  • adenoma;
  • malignant neoplasm.

Colloid nodes muaj ntau cov tshuaj hormones thiab tuaj yeem ua ib leeg lossis ntau yam. Lawv loj hlob qeeb heev thiab feem ntau kuaj tau los ntawm kev sib tsoo, vim lawv tsis ua rau muaj cov tsos mob tshwm sim. Qee lub sij hawm tej zaum yuav muaj qhov degeneration ntawm cov qog nqaij hlav mus rau hauv cov qog nqaij hlav malignant.

cov thyroid nodule
cov thyroid nodule

Ib lub cyst zoo li lub tshuaj ntsiav uas muaj kua. Nws feem ntau cuam tshuam rau cov poj niam thiab yog tus cwj pwm los ntawm kev loj hlob qeeb heev. Raws li lawv loj hlob, lawv lub plhaub ua nyias thiab koj tuaj yeem hnov qhov hloov pauv ntawm cov kua hauv lub sijhawm palpation.

Adenoma zoo li lub pob nyob hauv cov tshuaj ntsiav. Nws yog tus cwj pwm los ntawm kev loj hlob zuj zus thiab tsis cuam tshuam rau cov kabmob uas nyob ib sab. Nws feem ntau tshwm sim rau cov neeg tshaj 40 xyoo, thiab feem ntau yog cov poj niam.

Malignant neoplasms feem ntau yog ib qho ntawm cov kab mob qog noj ntshav. Ntawmqhov no neoplasm tsis muaj ciam teb meej, lub plhaub, thiab nws yog tus cwj pwm los ntawm kev loj hlob sai. Rau qhov kov nws yog tuab heev, tab sis tsis provoke mob siab.

ua rau ntawm pathology

Nws tsis paub meej tias qhov ua rau muaj qhov tshwm sim nodular ntawm cov thyroid lobe, tab sis muaj qee yam cuam tshuam rau qhov tshwm sim ntawm xws li pathology. Cov xwm txheej no suav nrog:

  • hypothermia;
  • kev nyuaj siab;
  • ib puag ncig phem;
  • tsis muaj iodine;
  • mob khaub thuas;

Thaum hypothermia tshwm sim, vasospasm tshwm sim, uas ua rau muaj kev ua txhaum ntawm qee qhov ntawm cov thyroid caj pas, vim tias kev tiv thaiv kab mob txo qis, uas ua rau muaj teeb meem ntawm kev faib cell. Yog vim li cas rau qhov tsis muaj kev tswj hwm ntawm cov tshuaj hormones yog qhov tsis zoo ecology. Qhov no tuaj yeem provoke tsim cov qog.

nodular tsim ntawm txoj cai lobe ntawm cov thyroid caj pas
nodular tsim ntawm txoj cai lobe ntawm cov thyroid caj pas

Nrog rau qhov tsis muaj iodine, cov thyroid caj pas pib nce. Nodular tsim tshwm sim vim qhov tseeb hais tias lub caj pas yog sim kom tau txais qhov ploj lawm ntawm iodine los ntawm cov ntshav. o ntawm cov thyroid lobes tuaj yeem tshwm sim thaum cov txheej txheem inflammatory, uas ua rau tsim cov nodes uas zoo li cov qog. Tsis tas li ntawd, pathology kuj tuaj yeem tshwm sim vim yog kev xeeb tub.

Kev pheej hmoo yog:

  • poj niam;
  • neeg tshaj 55;
  • neeg mob nrog lwm yam kab mob ntawm endocrine system;
  • muaj kev hloov pauv rau cov kab mob thyroid.

Cov neeg ntawm cov pawg no yuav tsum tau ua tib zoo saib xyuas lawv tus mob thiab ua ntu zus ntawm cov thyroid caj pas. Thaum muaj mob, cov ntsaws ruaj ruaj lossis qhov loj me, nco ntsoov sab laj nrog kws kho mob thiab kuaj xyuas seb puas muaj kab mob.

Cov tsos mob tseem ceeb ntawm kev tsim nodular

Cov tsos mob ntawm cov thyroid nodules feem ntau nyob ntawm qhov loj thiab qhov ntau ntawm cov tshuaj hormones tsim. Qhov tsis muaj cov tsos mob me me qhia tau hais tias lub cev cuam tshuam tsis tsim cov tshuaj hormones. Yog vim li cas cov formations ntawm thawj theem tsuas yog txiav txim tau thaum lub sij hawm ultrasound diagnostics.

Koj yuav tsum tau ceeb toom los ntawm cov cim qhia ntawm nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas xws li:

  • suab hloov;
  • nyuaj nqos;
  • ua tsis taus pa;
  • febrile mob;
  • tachycardia;
  • plab hnyuv;
  • muscle qaug zog.

Tus kab mob no tshwm sim los ntawm qhov tseeb tias nws tuaj yeem cuam tshuam rau menyuam yaus thiab cov neeg laus. Qhov txaus ntshai nyob rau hauv qhov tseeb hais tias muaj kev cuam tshuam ncaj qha rau lub cev thiab lub hlwb ntsuas ntawm kev loj hlob ntawm tus me nyuam. Cov txheej txheem ntawm kev xa cov kev kho mob tuaj yeem nyuaj heev.

Cov cim qhia ntawm nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas
Cov cim qhia ntawm nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas

Nrog rau qhov chaw retrosternal ntawm goiter, tus neeg mob tuaj yeem cuam tshuam los ntawm kev ua pa luv thiab hnov txog hauv caj pas. Yog tias koj muaj ib lossis ntau cov tsos mob ntawm tus kab mob, koj yuav tsum tau mus ntsib kws kho mob tam sim ntawd rau kev kuaj xyuas thiab kev kho mob tom ntej. Nws yog qhov yooj yim dua los tshem tawm cov kab mob hauv thawj theem dua li kev cuam tshuam nrog cov teeb meem.

Kev kuaj mob ntawm cov thyroid nodules

Yog tias cov thyroid caj pas raug cuam tshuam, kev tsim nodular hauv cov theem pib tuaj yeem kuaj pom tsuas yog tom qab kev tshuaj ntsuam xyuas. Thaum cov tsos mob tshwm sim, nco ntsoov mus ntsib kws kho mob. Rau cov neeg muaj kev pheej hmoo, nws yog ib qho tseem ceeb uas yuav tsum tau kuaj xyuas kev tiv thaiv ib ntus uas yuav pab txheeb xyuas tus kab mob nyob rau theem pib.

Thawj zaug, tus kws kho mob endocrinologist ua qhov kev kuaj pom, thiab yog tias pom muaj cov kab mob ntawm ob lub lobes ntawm cov thyroid caj pas, tom qab ntawd lawv qhov loj me, mob, ntom, txav mus los, nrog rau cov kab mob ntawm daim tawv nqaij ntawm thaj chaw. cov neoplasm raug soj ntsuam. Tom qab ntawd, tus neeg mob yuav tsum tau kuaj xyuas qhov ntsuas ntawm cov tshuaj hormones hauv cov ntshav. Txawm li cas los xij, nws tsim nyog nco ntsoov tias qhov ntsuas no cuam tshuam los ntawm ntau yam, tshwj xeeb, xws li:

  • mob siab rau lub cev ua si;
  • cev xeeb tub;
  • noj qee yam tshuaj;
  • noj zaub mov tsis muaj protein ntau.

Tsis tas li ntawd, scintigraphy kuj tau ua, uas txhais tau hais tias kev nthuav qhia cov neeg ua haujlwm muaj cov xov tooj cua iodine. Txawm li cas los xij, nws yuav tsum nco ntsoov tias txoj kev kuaj mob no yog contraindicated thaum cev xeeb tub. Ib qho ultrasound ntawm cov thyroid nodules yog qhov yuav tsum tau ua, uas tso cai rau koj los txiav txim seb tus lej thiab qhov chaw nyob ntawm neoplasms, nrog rau ntsuas qhov xwm txheej ntawm lub cev nws tus kheej.

ultrasound ntawm cov thyroid nodules
ultrasound ntawm cov thyroid nodules

Thaum ua kev kuaj mob ultrasound, qhov loj ntawm cov thyroid caj pas raug ntsuas. Cov qauv rau txhua pawg hnub nyoog yuav txawv. Txawm li cas los xij, yog tias qhov sib txawv tsis tseem ceeb, qhov no txhais tau tias yuav tsis muaj pathology. Ib qho kev sib txawv ntawm qhov sib txawv ntawm cov qauv yuav qhia tau cov kab mob xws li:

  • nodular goiter;
  • cyst;
  • cov txheej txheem mob;
  • malignant thiab benign qog.

Kev txiav txim siab cov txiaj ntsig ntawm kev kuaj mob ultrasound yuav tsum tsuas yog ua los ntawm tus kws kho mob uas tuaj yeem txiav txim siab hloov pauv hauv cov thyroid caj pas. Cov nodule nyob rau hauv cov ntaub ntawv no tej zaum yuav benign los yog malignant.

Ib qho nqaij ntuag ua tiav los txiav txim siab seb tus qog puas yog benign lossis malignant. Nws suav nrog kev sau cov ntaub so ntswg rau kev kuaj xyuas nyob rau hauv lub microscope. Tag nrho cov txheej txheem yog tswj los ntawm ultrasound diagnostics. Raws li cov txiaj ntsig ntawm kev kuaj ntshav biopsy, tus kws kho mob xaiv txoj kev kho.

Cov neeg mob neoplasms muaj lub cheeb ntawm 5-10 mm thiab cov cim qhia tsis ncaj uas cov qog yog malignant raug xa mus rau biopsy. Cov cim tseem ceeb ntawm kev muaj qog nqaij hlav yog suav tias yog:

  • dense knot sib xws;
  • kev loj hlob;
  • kis mus rau cov kabmob uas nyob sib ze;
  • vim txhaum;
  • muaj cov cim qhia ntawm ultrasound.

Yog xav tias muaj qog nqaij hlav, kev kuaj mob thiab kev kho mob yuav tsum tau ua los ntawm tus kws kho mob oncologist. Rau qhov loj mentawm cov thyroid caj pas, tomography yog ua, uas tso cai rau koj kom meej meej txiav txim siab nws contour, qauv thiab pom cov qog nqaij hlav.

Kev kho cov kab mob nodular

Yog tias tus neeg mob tau kuaj pom tias muaj qhov tsim ntawm sab laug lobe ntawm cov thyroid caj pas, kev kho mob yuav tsum ua kom nyuaj, thiab txoj kev kho yog xaiv nyob ntawm qhov nyuaj ntawm cov kab mob. Kev kho tus kheej tsis tuaj yeem lees txais, vim qhov no tuaj yeem ua rau muaj qhov tshwm sim loj thiab muaj teeb meem, yog vim li cas txhua yam tshuaj yuav tsum tau muab los ntawm tus kws kho mob endocrinologist nkaus xwb tom qab kuaj.

Ib pob txha benign muaj kev nyab xeeb kiag li thiab feem ntau tsis ua mob rau lub cev. Kev kho mob nyob rau hauv rooj plaub no yog ua los ntawm kev siv cov tshuaj thiab cov tshuaj ib txwm siv. Ib tug malignant neoplasm yuav tsum tau kev phais, vim nws loj hlob sai heev, metastases txav mus rau lwm yam kabmob, thiab qhov no tuaj yeem ua rau tus neeg mob tuag.

Yog tias cov thyroid nodule tau dhau los ua tus kab mob goiter, tom qab ntawd kev kho mob tsis tau ua tiav, thiab tus neeg mob tau pom zoo saib xyuas tas li, thiab yog tias muaj qhov xav tau rau neoplasm loj hlob, ces tus kws kho mob xaiv txoj kev. kev kho mob.

Tshuaj kho mob yog txhawm rau txo qis cov tshuaj hormones tsim. Nyob rau hauv lub xub ntiag ntawm diffuse goiter, tshuaj yog siv los tshem tawm qhov tsis muaj iodine nyob rau hauv lub cev. Hauv qhov no, cov kws kho mob feem ntau sau tshuaj Iodomarin, vim qhov no yog cov tshuaj niaj hnub zoo heev.

Yog tus neeg mob kuaj taumalignant nodular formations ntawm cov thyroid caj pas, kev kho mob yog nqa tawm tsuas yog los ntawm kev phais. Kev ua haujlwm, nyob ntawm qhov kev loj hlob ntawm tus kab mob, tuaj yeem ua tau ntau txoj hauv kev, xws li:

  • ib nrab resection;
  • kev tshem tawm ntawm qhov cuam tshuam lobe ntawm cov thyroid caj pas;
  • kev tshem tawm cov thyroid kom tiav.

Tom qab kev phais, kev kho mob radioactive iodine feem ntau ua ntxiv. Qhov no yog qhov tsim nyog kom cov seem ntawm malignant neoplasms tuaj yeem raug tshem tawm tag nrho. Tom qab ua haujlwm, tus neeg mob tsis tu ncua yuav tsum tau them nyiaj rau qhov tsis muaj iodine hauv lub cev.

nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas kho
nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas kho

Txoj kev zoo tshaj plaws ntawm kev ua haujlwm yog laser kho. Lub teeb beam muab los ntawm laser heats lub qog thiab rhuav tshem cov kab mob pathogenic. Tom qab ntawd cov ntaub so ntswg caws pliav tshwm sim. Xws li kev ua haujlwm tsuas yog ua tau yog tias qhov loj ntawm neoplasm tsis ntau tshaj 4 cm.

Tiv thaiv cov thyroid nodules

Kom tsis txhob muaj teeb meem nrog cov thyroid caj pas, nws yog ib qho tsim nyog yuav tsum tau ua qee yam kev tiv thaiv, xws li:

  • siv zaub mov muaj iodine;
  • pab kom txaus pw thiab so;
  • keep active;
  • tswj cov qib tshuaj hormones;
  • mus kuaj mob raws sij hawm.

Nws txwv tsis pub noj tshuaj uas muaj iodine ntawm koj tus kheej yam tsis muaj kws kho mob sau ntawv, vim qhov no yuavua rau muaj kev phiv loj heev.

Txoj kev noj haus thiab kev noj haus

Kev kho cov thyroid nodule yuav tsum ua ke nrog kev noj qab haus huv thiab noj zaub mov tshwj xeeb. Qhov tseem ceeb tshaj plaws yog qhov txaus iodine nkag mus rau hauv lub cev txhua hnub. Kev noj zaub mov txhua hnub yuav tsum suav nrog:

  • seafood;
  • seaweed;
  • kiwi;
  • qe;
  • rye bread.

Koj tuaj yeem siv ntsev iodized thaum ua noj. Nws tseem yog ib qho tseem ceeb los ntxuav lub cev ntawm co toxins, thiab rau qhov no koj yuav tsum tau haus cereals, legumes, beets, txiv apples, freshly squeezed kua txiv, haus dej kom ntau. Koj kuj yuav tsum txwv tsis pub noj zaub mov tsis zoo, cov khoom noj rog thiab kib, khoom qab zib, khoom noj khoom haus. Ua raws li kev noj zaub mov yuav pab kom lub cev muaj txiaj ntsig zoo thiab tiv thaiv qhov pib ntawm tus kab mob.

Cov teeb meem ntawm cov thyroid nodules

kho tsis tau sijhawm thiab tsis muaj kev tiv thaiv kab mob tuaj yeem ua rau muaj teeb meem. Nyob rau hauv lub xeev tsis saib xyuas, qhov nodular tsim ntawm sab laug lobe ntawm cov thyroid caj pas, ib yam li txoj cai, tuaj yeem ua ke rau hauv cov kab mob goiter multinodular.

diffuse hloov pauv hauv cov thyroid caj pas
diffuse hloov pauv hauv cov thyroid caj pas

Sijhawm dhau mus, lub benign neoplasm tuaj yeem hloov mus rau qhov tsis zoo, thiab nws txoj kev kho yuav xav tau kev phais thiab kev kho mob nyuaj. Yog tias kev kho tsis tau raws sijhawm, nws tuaj yeem ua rau tus neeg mob tuag. Tsis tas li ntawd, nodules tuaj yeem ua rau:

  • ua txhaum cov txheej txheem metabolic hauv lub cev;
  • nyuaj nqos;
  • squeezing paj hlwb xaus;
  • choking.

Yog tsis muaj kev kho mob raws sijhawm, tus neeg tsis tuaj yeem tiv nrog tus kab mob uas twb muaj lawm ntawm nws tus kheej, yog vim li cas ntawm thawj cov tsos mob ntawm pathology, koj yuav tsum nrhiav kev pab los ntawm kws kho mob.

Pom zoo: