Pākuʻi nodular ʻona

Pili ka goular nodular goiter i ka hoʻonui ʻia o ka gland thyroid. Aia i loko o ka gland nā wahi i hoʻonui i ka nui a me nā nodule. Hoʻokahi a ʻoi paha o kēia mau nodule e hoʻohua i ka nui o ka hormone thyroid.

Hoʻomaka ka goular nodular goiter mai kahi goiter maʻalahi o kēia manawa. Kū pinepine ia i nā mākua makua. ʻO nā kumu pilikia me ka wahine a ma luna o 55 mau makahiki. Kākaʻikahi kēia maʻi i nā keiki. ʻO ka hapa nui o ka poʻe e hoʻomohala iā ia i kahi goiter me nā nodule no nā makahiki he nui. I kekahi manawa hoʻonui nui ʻia ka pona thyroid, a ʻaʻole i ʻike ʻia ka goiter.

I kekahi manawa, e hoʻomohala nā kānaka me nā goiter multinodular ʻona i nā kiʻekiʻe kiʻekiʻe o ka thyroid no ka manawa mua. Kū kēia ka hapanui ma hope o ka lawe ʻana i ka nui o ka iodine ma o ke aa (intravenously) a i ʻole ma ka waha. Hoʻohana ʻia ka iodine i ʻokoʻa no ka CT scan a i ʻole ka catheterization puʻuwai. ʻO ka lawe ʻana i nā lāʻau i loko o iodine, e like me amiodarone, hiki ke alakaʻi ʻia i ka maʻi. Ke neʻe nei mai kahi ʻāina me ka iodine hemahema i kahi ʻāina me ka nui o iodine i ka papaʻai hiki ke hoʻolilo i kahi goiter maʻalahi i goiter ʻona.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• Ka luhi
• ʻO ka neʻe pinepine ʻana o ka ʻōpū
• Ka hoʻomanawanui wela
• Hoʻonui i ka makemake
• Hoʻonui sweating
• ʻO ka wā menstrual maʻamau (i nā wahine)
• Pākuʻi kaʻiʻo
• Weliweli
• Hoʻomaha ʻole
• Kaumaha emi

Loaʻa paha i nā mākua ʻelemakule nā ​​hōʻailona ʻoi aku ka kikoʻī. Pākuʻi ʻia kēia mau mea:

• Nāwaliwali a luhi hoʻi
• Palpitations a me ka ʻeha o ka umauma a i ʻole kaomi
• Nā loli i ka hoʻomanaʻo a me ke ʻano

ʻAʻole hiki i ka nodular goular goiter ke kumu i nā maka ʻōhū e hiki ke loaʻa me ka maʻi Graves. ʻO ka maʻi Graves kahi maʻi autoimmune e alakaʻi i kahi gland thyroid overactive (hyperthyroidism).

Hōʻike kahi hoʻokolohua kino i hoʻokahi a i ʻole mau nodule i loko o ka thyroid. Hoʻonui pinepine ʻia ka thyroid. Loaʻa paha kahi wikiwiki o ka puʻuwai a i ʻole kahi haʻalulu.

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• Nā pae hormone thyroid serum (T3, T4)
• Serum TSH (thyroid stimulate hormone)
• Lawe ʻia ka thyroid a scan a i ʻole lawe iodine radioactive
• ʻO ka ultrasound thyroid

Hiki i nā beta-blockers ke kaohi i kekahi o nā ʻōuli o hyperthyroidism a hiki i ke kaohi ʻia ʻana o nā kiʻekiʻe o ka hormone thyroid i loko o ke kino.

Hiki i kekahi mau lāʻau ke pale a hoʻololi paha pehea e hoʻohana ai ka gland thyroid iodine. Hiki ke hoʻohana ʻia kēia mau mea e kaohi ai i ka gland thyroid overactive i kekahi o nā hihia aʻe:

• Ma mua o ke kaha ʻana a i ʻole ka radioiodine therapy
• Ma ke ʻano he lāʻau lōʻihi

Radioiodine therapy hiki ke hoʻohana. Hāʻawi ʻia ka iodine radioactive e ka waha. Hoʻopili ia a laila i ka nui o ka pepa thyroid a hana i nā mea i hōʻino ʻia. I nā hanana kakaʻikahi, pono ka hope thyroid ma hope.

Hiki ke hana i kahi ʻoki e wehe i ka thyroid ke:

• ʻO ka goiter nui loa a i ʻole kahi goiter ke hana nei i nā hōʻailona ma ka hana ʻana i ka paʻakikī e hanu a ale paha
• Aia ka maʻi ʻaʻai thyroid
• Pono ka mālama wikiwiki

Toxic nodular goiter ka maʻi nui o nā mākua. No laila, pilikia nā olakino olakino ʻē aʻe i ka hopena o kēia ʻano. ʻAʻole hiki i kahi makua makua ke hoʻomanawanui i ka hopena o ka maʻi ma ka puʻuwai. Eia naʻe, hiki ke mālama pinepine ʻia ke ʻano me nā lāʻau.

Nā pilikia puʻuwai:

• Hewa puʻuwai
• Kuʻi naʻau kaulike (atrial fibrillation)
• Helu puʻuwai wikiwiki

Nā pilikia ʻē aʻe:

• ʻO ka nalo o ka iwi e hiki ai i ka osteoporosis

ʻO ka pilikia o ka thyroid a i ʻole ka ʻino kahi maʻi nui loa o nā ʻōuli hyperthyroidism. Kū paha ia me ka maʻi a i ʻole ke koʻikoʻi. Hiki i ka pilikia thyroid ke kumu:

• Abdominal eha
• Hoemi i ka makaʻala noʻonoʻo
• Fiva

Pono nā poʻe me kēia ʻano e hele koke i ka haukapila.

Komo paha nā pilikia o ka loaʻa ʻana o kahi goiter nui loa i ka hanu ʻana a me ka ale ʻana. ʻO kēia mau pilikia ma muli o ke kaomi ma ke alaloa e hele ai (trachea) a i ʻole esophagus, e moe ana ma hope o ka thyroid.

Kāhea i kāu mea mālama ola inā loaʻa nā ʻōuli o kēia maʻi i helu ʻia ma luna. E hāhai i nā ʻōkuhi a ka mea hāʻawi no nā kipa ukali.

I mea e pale aku ai i ka goular nodular goiter, mālama i ka hyperthyroidism a me ka goiter maʻalahi e like me ka mea a kāu mea e hāʻawi ai.

Toxic multinodular goiter; Maʻi Plummer; Thyrotoxicosis - nodular goiter; ʻO ka nui o ka thyroid - goiter nodular ʻona; Hyperthyroidism - ʻona nodular goiter; Toxic multinodular goiter; MNG

• Hoʻonui ka thyroid - scintiscan
• Kelepaʻi thyroid

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Ke hana kūʻokoʻa nei ʻo Kopp P. i kāu nodules thyroid a me nā kumu ʻē aʻe o thyrotoxicosis. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 85.

ʻO Ritter JM, Flower R, Henderson G, Loke YK, MacEwan D, Rang HP. ʻO ka thyroid. I: Ritter JM, Flower R, Henderson G, Loke YK, MacEwan D, Rang HP, eds. ʻO Rang a me Dale's Pharmacology. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 35.

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