Matumbu eGyroid: Vanachiremba Vanoshanda Rini Uye Vanomirira Rini?

Mapundu ethyroid akajairika. Vanhu vakuru vanosvika 50–60% vanogona kunge vaine mapundu ethyroid anoonekwa pa ultrasound, asi 5–10% chete ndivo vane kenza. Mubvunzo mukuru hausi wekuti bundu riripo here, asi kuti harina njodzi here kana kuti harina kuipa, kuti riri kukonzera zviratidzo here, uye kuti riri kukura here. Sarudzo yekurapa inoenderana nezvakawanikwa pa ultrasound, mhedzisiro ye biopsy (FNAC), zviratidzo, uye kukura nekufamba kwenguva.

1. Vanachiremba "vanomirira vachitarisa" rini?

Mapundu mazhinji e thyroid haadi kuvhiyiwa nekukasika.

Kucherechedza kunokurudzirwa kana:

• Kusveta netsono diki (FNAC) kunoratidza bundu risina njodzi (Bethesda II).
• Pundu iri diki (<2–3 cm), harikonzeri zviratidzo, uye rine zviratidzo zveultrasound zvisina njodzi.
• Hapana kumanikidzwa papombi yemhepo kana pombi yechikafu.
• Mahormone ethyroid akajairika kana kuti anorapwa zvakakodzera.
• Murwere anonzwa akasununguka nekuongororwa nguva nenguva.

Kutevera kunowanzo sanganisira:

• Ultrasound mwedzi yega yega 6-18 pakutanga.
• Dzokorora FNAC kana bundu rikawedzera zvakanyanya (rinopfuura 20% muzvikamu zviviri) kana kuti rikaita zviratidzo zvinofungidzirwa zve ultrasound

• Kuvhiyiwa kunokurudzirwa rini?
• Kuvhiyiwa kunorayirwa kana chimwe kana kupfuura chezvinotevera zviripo:
• Kunyumwa kana kuongororwa gomarara
• FNAC inoratidza kenza yethyroid (Bethesda V kana VI).
• Mapundu asina kujeka ane chekuita nemasero kana zviratidzo zvekiriniki.
• Zviwanikwa zvinofungidzirwa zve ultrasound zvakaita se:
• Miganhu isina kurongeka
• Microcalcifications
• Chimiro chakareba kupfuura upamhi
• Kuwedzera kwekunze kwethyroid
• Manodhi elymph asina kujairika

B. Mapundu makuru ane zviratidzo zvisina njodzi

Kunyangwe kana pasina njodzi, kuvhiyiwa kunokurudzirwa kana murwere aine:

• Dambudziko kukumedza
• Kufema zvakaoma
• Kuchinja kwezwi nekuda kwekudzvanywa
• Kusagadzikana kwemutsipa kana kurwadziwa
• Kuzvimba kwerunako kunoonekwa

C. Mapundu anoshanda zvakanyanya ("anopisa")

Kana bundu richiburitsa mahormone ethyroid akawandisa uye zvichikonzera hyperthyroidism, kuvhiyiwa (kana radioiodine mune dzimwe nguva) kungave kwakakodzera.

D. Kukura Kunofambira Mberi

Bondo rinokura nekukurumidza, kunyanya kana richibatanidzwa nezviratidzo zvekumanikidzwa kana zvine chekuita nemifananidzo, zvinoda kuongororwa kwakawedzerwa uye kuvhiyiwa kazhinji.

Chiremba anogara achisarudza kuti murwere awane mushonga wake asi kazhinji vanotevedzera gwara rekurapa

• Mapundu madiki: Kuongororwa, Kubviswa kweRadiofrequency (RFA), kana kubviswa kwehemithyroid kana zvichidikanwa kuvhiyiwa.
• Mapundu ari pakati nepakati (2–4 cm): Kazhinji kubviswa kwehemithyroid.
• Mapundu makuru (>4–5 cm): Kubviswa kwemasero emudumbu kana akavharirwa paganda rimwe chete; kubviswa kwemasero emudumbu kana ganda rese riripo kana kuti kenza iripo. 

Basa reRadiofrequency Ablation (RFA)

RFA mushonga usinganyanyi kukuvadza mapundu asina zviratidzo. Uchishandisa ultrasound, kupisa kunoiswa netsono diki kuti mapundu aderere, kudzivirira vanga remutsipa uye kuchengetedza mashandiro mazhinji ethyroid. 

Basa Riri Kukura reRobotic Thyroid Surgery

Imwe yenzira dzakakosha dzekuvhiya thyroid ndeye robotic thyroidectomy, iyo inobvumira vanachiremba kubvisa thyroid kuburikidza nemachekwa akavanzika, anowanzoiswa muhapwa, kumashure kwenzeve, kana kuburikidza nedzimwe nzira dzinosvika kure, nokudaro vachidzivirira vanga rinooneka pamberi pemutsipa. Robhoti harishande roga; rinodzorwa zvizere nachiremba uye rinopa kuona kwakakura kwe3D, kunyatsojeka, uye kufambisa michina zviri nani. Kuvhiya kwerobhoti kunonyanya kukwezva varwere vadiki, nyanzvi, uye vanhu vane hanya nezve cosmesis yemutsipa. Yakakodzera zvakanyanya kune maronda madiki kusvika pakati nepakati uye kenza yethyroid yakasarudzwa ine njodzi shoma muvarwere vakasarudzwa nokungwarira. Kunyange zvazvo zvingatora nguva yakareba yekushanda uye mitengo yakakwira, inopa mhedzisiro yakanaka yekushongedza pasina kukanganisa kuchengetedzeka kwekuvhiya kana ichiitwa nachiremba ane ruzivo rwe thyroid uye robotic. Ko nezve robotic surgery?

Shoko guru

Chinongedzo che thyroid hachisi chinhu chinongoerekana chaonekwa kuti chine kenza uye hazvisi zvinongedzo zvese zvinoda kuvhiyiwa. Dzimwe nguva kurapwa kwakanakisa hakugone kuitwa nekunyatsotevera. Kurapa kwemazuva ano kwechinongedzo che thyroid kunotarisa pakuongororwa kwakarurama, kurapwa kwakagadzirirwa munhu, uye kuchengetedza mashandiro echinongedzo che thyroid uye zvizoro pese pazvinogoneka.