Pehea ka maʻi o nā Graves i nā maka

Anter

• He aha ka maʻi ʻo Graves?
• He aha nā hōʻailona o Graves 'ophthalmopathy?
• He aha ke kumu o ophthalmopathy a Graves?
• Pehea i ʻike ʻia ai ka lāʻau ophthalmopathy o Graves?
• Pehea e mālama ai i nā ophthalmopathy o Graves?
• He aha ke kuanaʻike?

He aha ka maʻi ʻo Graves?

ʻO ka maʻi ʻo Graves kahi maʻi autoimmune nāna e hoʻokumu i kāu gland thyroid e hana i nā mea ʻoi aku ka nui ma mua o ka mea e pono ai. Kapa ʻia ka thyroid ʻoi loa a hyperthyroidism.

Ma waena o nā hōʻailona kūpono o ka maʻi ʻo Graves ka puʻuwai kūlohelohe ʻole, ka hoʻohaʻahaʻa ʻana i ke kaumaha, a me kahi gland thyroid (goiter) hoʻonui ʻia.

I kekahi manawa, hoʻouka ka ʻōnaehana pale i nā mākala a me nā mākala a puni nā maka. ʻO kēia kahi kūlana i kapa ʻia ʻo ka maʻi maka thyroid a i ʻole Graves 'ophthalmopathy (GO). Hoʻomaʻamaʻa ka mumū i nā maka e huhū, hoʻomaloʻo, a hoʻonāukiuki hoʻi.

Hiki i kēia ʻano ke hoʻohālikelike i kou mau maka.

Hoʻopili ka maʻi maka o Graves ma waena o 25 a 50 pākēneka o ka poʻe i loaʻa i ka maʻi Graves.Hiromatsu Y, et al. (2014). ʻO Graves 'ophthalmopathy: Epidemiology a me ka mōʻaukala kūlohelohe. DOI:
10.2169 / internalmedicine.53.1518 Hiki iā ia ke hana i ka poʻe i loaʻa ʻole ka maʻi ʻo Graves.

E hoʻomau i ka heluhelu ʻana e aʻo hou aʻe e pili ana i nā maʻi maka o Graves, ka lāʻau lapaʻau, a me nā mea hiki iā ʻoe ke hana e hōʻoluʻolu i nā ʻōuli.

He aha nā hōʻailona o Graves 'ophthalmopathy?

ʻO ka hapa nui o ka manawa, pili ka maʻi maka o Graves i nā maka ʻelua. Ma kahi o 15 pākēneka o ka manawa, hoʻokahi wale nō maka i pili.Hiromatsu Y, et al. (2014). ʻO Graves 'ophthalmopathy: Epidemiology a me ka mōʻaukala kūlohelohe. DOI:
10.2169 / internalmedicine.53.1518 ʻAʻohe pilina ma waena o nā ʻōuli o kou maka a me ke koʻikoʻi o kāu hyperthyroidism.

Pākuʻi ʻia paha nā ʻōuli o GO:

• maka maloʻo, grittiness, hoʻonāukiuki
• puʻe maka a ʻeha hoʻi
• ʻulaʻula a me ka pehu
• ʻōniu maka eyulids
• ʻōhū o nā maka, i kapa ʻia he proptosis a i ʻole exophthalmos
• ʻālohilohi kukui
• hihio pālua

I nā hihia koʻikoʻi, pilikia paha ʻoe i ka neʻe ʻana a i ʻole ke pani ʻana i kou mau maka, ulceration of the cornea, and compression of the optic nerve. Hiki iā GO ke alakaʻi i ka nalo o ka hihiʻo, akā kākaʻikahi kēia.

Hoʻomaka ka hoʻomaka ʻana o nā ʻōuli ma kahi o ka manawa like me nā ʻōuli ʻē aʻe o ka maʻi ʻo Graves, akā ulu mua kekahi poʻe i nā ʻōuli o ka maka. Kākaʻikahi loa ʻo GO e hoʻolālā lōʻihi ma hope o ka mālama ʻana no ka maʻi o Graves. Hiki nō ke hoʻomohala iā GO me ka loaʻa ʻole o ka hyperthyroidism.

He aha ke kumu o ophthalmopathy a Graves?

ʻAʻole maopopo ke kumu pololei, akā he hui pū paha ia o nā genetical a me nā mea pili i ke kaiapuni.

ʻO ka palaho a puni ka maka ma muli o kahi pane autoimmune. ʻO nā ʻōuli ma muli o ka pehu a puni ka maka a me ka hoʻi ʻana o ka maka maka.

Kū pinepine ka maʻi maka o Graves i ka hui pū me hyperthyroidism, akā ʻaʻole mau. Hiki iā ia ke hana inā ʻaʻole paʻa nui kāu thyroid i kēia manawa.

ʻO nā kumu pilikia no GO me:

• hoʻohuli kūlohelohe
• puhipaka
• iodine therapy no hyperthyroidism

Hiki iā ʻoe ke hoʻomohala i ka maʻi ʻo Graves i kēlā me kēia makahiki, akā ʻo ka hapa nui o ka poʻe ma waena o nā makahiki 30 a me 60 i ka hōʻoia ʻana. Hoʻopili ka maʻi Graves ma kahi o 3 pākēneka o nā wahine a me 0.5 pākēneka o nā kāne.Maʻi ʻo Graves. (2017).
niddk.nih.gov/health-information/endocrine-diseases/graves-disease

Pehea i ʻike ʻia ai ka lāʻau ophthalmopathy o Graves?

Ke maopopo mua iā ʻoe he maʻi ʻo Graves, hiki i kāu kauka ke hana i ka hōʻailona ma hope o ka nānā ʻana i kou mau maka.

Inā ʻole, e hoʻomaka paha kāu kauka ma ka nānā pono ʻana i kou mau maka a nānā i kou ʻāʻī e ʻike inā hoʻonui ʻia kāu thyroid.

A laila, hiki i kou koko ke nānā ʻia no ka thyroid stimulate hormone (TSH). TSH, kahi hōmona i hana ʻia i loko o ka pituitary gland, hoʻonāukiuki i ka thyroid e hana i nā hormones. Inā loaʻa ʻoe i ka maʻi ʻo Graves, e haʻahaʻa kou pae TSH, akā e loaʻa iā ʻoe nā kiʻekiʻe o nā homone thyroid.

Hiki ke hoʻāʻo ʻia kou koko no nā mea ʻino o Graves. ʻAʻole pono kēia hōʻike e hana i ke kuhi, akā hana ʻia nō paha. Inā maikaʻi ʻole ia, hiki i kāu kauka ke hoʻomaka e ʻimi i kahi hōʻailona ʻē aʻe.

Hiki i nā hoʻokolohua kiʻi e like me ultrasound, CT scan, a i ʻole MRI ke hāʻawi i kahi kikoʻī i ka nānā ʻana i ka gland thyroid.

ʻAʻole hiki iā ʻoe ke hana i nā homone thyroid me ka ʻole o ka iodine. ʻO ia ke kumu e makemake ai kāu kauka e hana i kahi hana i kapa ʻia ʻo radioactive iodine uptake. No kēia hoʻāʻo, e lawe ʻoe i kahi iodine radioactive a ʻae i kou kino e omo iā ia. Ma hope, hiki i kahi kāmela mākaʻikaʻi kūikawā ke kōkua i ka hoʻoholo ʻana i ka maikaʻi o ka lawe ʻana o kāu thyroid i iodine.

I ka 20 pākēneka o ka poʻe me hyperthyroidism, ʻike ʻia nā ʻōuli o ka maka ma mua o nā ʻōuli ʻē aʻe.Hiromatsu Y, et al. (2014). ʻO Graves 'ophthalmopathy: Epidemiology a me ka mōʻaukala kūlohelohe. DOI:
10.2169 / internalmedicine.53.1518

Pehea e mālama ai i nā ophthalmopathy o Graves?

ʻO ka mālama ʻana i ka maʻi o Graves e pili ana i kekahi mau hoʻoponopono e mālama i nā pae hormonone ma waena o ka pae maʻamau. Pono ka maʻi maka o Graves i kāna lāʻau ponoʻī, ʻoiai ʻo ka mālama ʻana i ka maʻi o Graves ʻaʻole kōkua mau me nā ʻōuli o ka maka.

Aia kekahi manawa o ka mumū hana kahi e hoʻonui ai nā ʻōuli. Hiki i kēia ke hala i ʻeono mau mahina a ʻoi. A laila aia kahi manawa hana ʻole kahi e hoʻopaʻa ai nā ʻōuli a hoʻomaka paha e hoʻomaikaʻi.

Aia kekahi mau mea hiki iā ʻoe ke hana iā ʻoe iho e hōʻoluʻolu i nā ʻōuli, e like me:

• Kulu ka maka e hoʻoheheʻe a hoʻomaha i nā maka maloʻo, hoʻonāukiuki. E hoʻohana i nā kulu maka i loaʻa ʻole nā ​​mea ʻulaʻula a me nā mea hoʻomalu. Hiki ke kōkua pū i nā gel lubricating i ka manawa hiamoe inā ʻaʻole paʻa kou mau lihilihi āpau. E nīnau i kāu kauka i nā huahana e kōkua paha me ka ʻole o ka hoʻonāukiuki hou ʻana i kou mau maka.
• Pākuʻi anuanu e hoʻomaha iki i ka huhū. ʻOluʻolu paha kēia ma mua o kou hiamoe ʻana a i kou ala mua ʻana i ke kakahiaka.
• Maka aniani e kōkua ai i ka pale ʻana mai ka ʻike māmā. Hiki i nā aniani ke pale aku iā ʻoe mai ka makani a i ʻole nā ​​makani mai nā peʻa, ka wela pololei, a me ka lewa. ʻOi aku paha nā mea kōkua ma waho o nā aniani puni.
• Makaaniani kuhikuhi me nā prisma hiki ke kōkua i ka hoʻoponopono ʻana i ka ʻike pālua. ʻAʻole lākou e hana no nā mea āpau.
• Hiamoe me kou poʻo i hāpai ʻia e hoʻemi i ka pehu ʻana a hoʻōla i ke kaomi o nā maka.
• Corticosteroids e like me ka hydrocortisone a i ʻole prednisone hiki ke kōkua i ka hōʻemi ʻana i ka pehu. E noi i kāu kauka inā pono ʻoe e hoʻohana i nā corticosteroids.
• Mai puhi, e like me ka puhi paka ʻana i hiki ke hoʻonui i ka hihia. Inā puhi ʻoe, e nīnau i kāu kauka e pili ana i nā polokalamu hoʻomaha puhipaka. E hoʻāʻo hoʻi ʻoe e hōʻalo i ka uahi o ka lua, ka lepo, a me nā mea ʻē aʻe e hiki ai ke hoʻonāukiuki i kou mau maka.

E mālama pono i kāu kauka inā ʻaʻohe mea e hana ana a hoʻomau ʻoe i ka ʻike pālua, hoʻoliʻiliʻi i ka ʻike, a i ʻole nā ​​pilikia ʻē aʻe. Aia kekahi mau hana ʻoki kino i hiki ke kōkua, e like me:

• ʻOki kino hoʻohaʻahaʻa orbital e hoʻonui i ka maka o ka maka i hiki i ka maka ke noho i kahi kūlana ʻoi aku ka maikaʻi. Hoʻopili kēia i ka wehe ʻana i kahi iwi ma waena o ka maka o ka maka a me nā lawehala e hana i kahi no nā mea pehu.
• ʻOki kino o ka maka e hoʻihoʻi i nā lihilihi i kahi kūlana kūlohelohe.
• ʻOki kino mākala e hoʻoponopono i ka ʻike pālua. Hoʻopili kēia i ka ʻoki ʻana i nāʻiʻo i hoʻopili ʻia e nā ʻili maka a hoʻopili hou iā ia i hope.

Hiki i kēia mau kaʻina hana ke kōkua i ka hoʻomaikaʻi ʻana i ka ʻike a i ke ʻano o kou mau maka.

Kākaʻikahi wale nō, ka radiation radiation, a i ʻole ka radiotherapy orbital, e hoʻohana ʻia e hōʻemi i ka pehu ma nā mākala a me nā aʻa a puni nā maka. Hana ʻia kēia i loko o kekahi mau lā.

Inā pili ʻole nā ​​ʻōuli o kou maka i ka maʻi o Graves, kūpono paha nā lāʻau ʻē aʻe.

He aha ke kuanaʻike?

ʻAʻohe ala e pale loa ai i ka maʻi o Graves a i ʻole nā ​​maʻi maka o Graves. Akā inā he maʻi ʻo Graves a me ka uahi, ʻo ʻoe he 5 mau manawa e hoʻomohala i nā maʻi maka ma mua o ka poʻe puhipaka ʻole.ʻO Draman MS, et al. (2017). TEAMeD-5: Hoʻonui i nā hopena i ka maʻi o ka maka thyroid.
endocrinology.org/endocrinologist/125-autumn17/features/teamed-5-improving-outcome-in-thyoid-eye-disease/ ʻOi aku ka maʻi o ka maka i nā mea puhipaka.

Inā loaʻa iā ʻoe kahi hōʻailona o ka maʻi ʻo Graves, e noi i kāu kauka e kānana iā ʻoe no nā pilikia o ka maka. Kūpono ʻo GO e hoʻoweliweli i ka ʻike ma kahi o 3 a 5 pakeneka o ka manawa.Hiromatsu Y, et al. (2014). ʻO Graves 'ophthalmopathy: Epidemiology a me ka mōʻaukala kūlohelohe. DOI:
10.2169 / internalmedicine.53.1518

Hoʻopaʻa mau nā ʻōuli o ka maka ma hope o ʻeono mau mahina. Hoʻomaka paha lākou e hoʻomaikaʻi koke a noho paʻa paha no hoʻokahi makahiki a ʻelua paha ma mua o ka hoʻomaka ʻana e hoʻomaikaʻi.

Hiki ke mālama maikaʻi ʻia nā maka maka o nā lua kupapaʻu, a hoʻomaikaʻi pinepine ʻia nā ʻōuli me ka ʻole o ka lāʻau.