Hypothyroidism mu Mimba

Munkhaniyi muphunzira:

Hypothyroidism ndi mimba sizoyenderana kwambiri, chifukwa matendawa amakhumudwitsa kubereka, koma kubereka ndikotheka. Ngati matenda a hypothyroidism apezeka pa nthawi yomwe ali ndi pakati, zotsatirapo za mwana zimatha kukhala zoyipa kwambiri, chifukwa kumayambiriro kwa mapangidwe a mwana wosabadwayo kumadalira kwathunthu mahomoni a mayi. Ngati mahomoni sakwanira, kukula kwa mwana kumalephereka, chifukwa, kubadwa kwa mwana komwe kumakhala ndi vuto lamkati la mitsempha komanso kubwezeretsa m'maganizo ndikotheka.

Kodi chimayambitsa matenda a hypothyroidism nthawi yapakati ndi chiyani?

Monga tafotokozera pamwambapa, hypothyroidism pa nthawi yomwe mayi ali ndi pakati sichimachitika kawirikawiri, chifukwa chimodzi mwazotsatira za matendawa ndi kukula kwa kubereka. Koma nthawi zina, amayi amatha kukhala ndi pakati, makamaka ngati matendawa adalandiridwa ndi chithandizo chamankhwala.

Zomwe zimayambitsa hypothyroidism ndikuphwanya kapangidwe ka chithokomiro cha chithokomiro, ngakhale zitakhala zatsopano kapena zinaonekera pambuyo pake. Zomwe zimayambitsa kuphwanya izi zingaphatikizeponso:

• kufooka kwa ayodini
• Kulandila kwa wayodini wa ayodini pochiza matenda ena,
• kobadwa nako
• kukhalapo kwa autoimmune kapena pambuyo pake
• kukula kwa chotupa mu chithokomiro
• kuchotsa pang'ono kapena kwathunthu chithokomiro.

Palinso chifukwa china chopezeka cha hypothyroidism, chomwe chimakhudzana makamaka ndi pakati. Chowonadi ndi chakuti pa nthawi ya pakati, kusintha kwa thupi kumachitika m'thupi la mkazi, zomwe zimakhudza chithokomiro cha chithokomiro. Nthawi yapakati, thupi la mkazi limafunikira mahomoni ambiri a chithokomiro kuti agwire ntchito, ndipo chithokomiro chimawapatsa. Koma kupanga mahomoni ambiri kumabweretsa vuto lalikulu la ayodini, zomwe zimapangitsa kuti ayodini asamayende bwino. Izi zimapangitsa kupititsa patsogolo kwa subclinical hypothyroidism.

Subclinical hypothyroidism pa nthawi yapakati

Pa nthawi ya pakati, kukulira kwa subclinical hypothyroidism ndizowopsa kwambiri kwa mayi komanso kwa mwana. Choyambitsa chiwopsezo ndi zomwe zingachitike kwa mwana, chifukwa subclinical hypothyroidism palibe chizindikiritso chake, motero nkovuta kuzizindikira pakapita nthawi ndikupanga maphunziro ake. Njira yokhayo yodziwira molondola subclinical hypothyroidism panthawi yoyembekezera ndikuyesa mayeso a labotale munthawi yake.

Zizindikiro za matendawa zimawonetsedwa ndi nseru, ulesi, kugona kwambiri, kutupa kwa khungu ndi kufooka, komwe nthawi zambiri kumadziwika kwa amayi athanzi panthawi yapakati. Komanso, zizindikilo zotere sizikuwonetsedwa. Ichi ndichifukwa chake kuyesa kwelebhu kumayambiriro kwa mimba ndikofunikira kwambiri.

Zotsatira za kukula kwa subclinical hypothyroidism kwa mayi woyembekezera ndikukhazikitsidwa kwa nthawi isanakwane, zovuta zingapo. Zotsatira zake kwa mwana nazonso ndizovuta, kuthekera kwa kubadwa kwa hypothyroidism kumapeto kwake ndikokwera kwambiri, ndipo matenda a chithokomiro angachitike.

Kodi chikuwonetsa chiyani chitukuko cha hypothyroidism pa nthawi yapakati?

Ma mahomoni a chithokomiro amagwiritsidwa ntchito ndi minofu yambiri yamthupi, motero, ndipo chidziwitso cha matendawa chimakhala chosiyanasiyana ndipo chimadalira kwambiri mwadongosolo lakusowa kwawo komanso kutalika kwa matendawa. Popeza mahomoni amachepa m'matupi onse, njira zopangira metabolic kumapeto kwake zimayamba kuchepa. Zotsatira zake, azimayi omwe ali ndi pakati pamatenda amtundu amayamba kumva kupweteka, kugona, kugwira ntchito zamtunduwu kumakhala kotopetsa, ndipo kusayang'anira kumawonekera. Izi ndi zizindikiro zomwe zimagwirizanitsidwa ndi thanzi la wodwalayo.

Kuphatikiza pa kuwonongeka kwa thanzi labwino, wodwalayo amakhala ndi khungu lowuma, tsitsi limasweka, misomali yokhala ndi brittle, popeza izi zimakhala zoyamba kumva zonse chifukwa cha kuchepa. Ziwalo zamkati zimavutika, kudzimbidwa kumawonedwa mwa odwala. Kuphwanya metabolic njira kumabweretsa kukulira pang'onopang'ono m'thupi.
Kuperewera kwa mahomoni kumapangitsanso kuchepa kwa mphamvu yomwe imapangidwa ndi thupi, chizindikiro cha izi ndi kuchepa kwamphamvu kwa kutentha kwa thupi.

Mavuto amtundu wa metabolism amathandizanso minyewa edema, yomwe imayambitsa kupweteka mutu komanso kupweteka. Izi ndichifukwa choti zotupa zimakhala kuti zimalimbitsa mapeto am'mitsempha, chifukwa chake ululu.

Kuzindikira matendawa

Kuthekera kwa kuzindikira kwa hypothyroidism m'magawo oyambilira kumalephereka ndi mawonekedwe osachedwa amomwe matendawa ndi osiyanasiyana, ndipo kupezeka kwa matendawa kwa amayi apakati kumakhala kovuta kwambiri. Zizindikiro zonse za matendawa zimawonedwa mwa mayi wathanzi, chifukwa amadziwika ndi pakati. Chifukwa chake, chofunikira kwambiri ndichidziwitso cha mayeso a labotale molumikizana ndi deta ya maphunziro akuthupi ndi othandizira.

ECG, ultrasound ya chithokomiro England ndi mtima - thandizani kudziwa momwe chithokomiro chimagwirira ntchito

Choyamba, adokotala amafotokoza mbiri ya wodwala, yomwe imatenga deta ya matenda a chithokomiro, njira zochizira, njira zamankhwala, komanso kukhalapo kwa matendawa.

Pakuwunika kwakuthupi, kumawunika wodwalayo kumachitika, mkhalidwe wa chithokomiro komanso kuchuluka kwa thupi kumayeza.

Popima ma labotale, chofunikira kwambiri ndikusanthula kwa mahomoni, ndiye amene amapereka zotsatira zolondola kwambiri za boma komanso kuchuluka kwa mahomoni m'thupi. Kuphatikiza apo, zowunikira zotsatirazi zimachitika:

• kuwunika kuchuluka kwa ayodini amene amaphatikizidwa ndi mapuloteni,
• kusanthula kwa magazi
• kusanthula kwa kuchuluka kwamwazi wamagazi,
• kusanthula kwamankhwala.

Maphunziro a zida amachitika mu mawonekedwe a ECG, ultrasound ya chithokomiro chamtima ndi mtima. Zotsirizazo zimapangitsa kuti pakhale kupatula kukhalapo kwa matenda ena okhala ndi zizindikiro zofananira ndikuwonetsa momwe mawonekedwe a chithokomiro amapangira.

Kodi mankhwalawa amachitika bwanji?

Cholinga chachikulu cha chithandizo cha hypothyroidism panthawi yoyembekezera ndikuchotsa zotsatira zake kwa mwana. Ngati matendawa adapezeka mu gawo loyamba la kubereka, kusokonezeka ndikulimbikitsidwa. Ngati ndizosatheka kusokoneza kapena ngati mukufuna kupulumutsa mwana, chithandizo chamankhwala chimachitika, cholinga chake ndikubwezera hypothyroidism. Substitution chithandizo ndiye chithandizo chachikulu, njira zina, zomwe sizigwiritsa ntchito mankhwala sizigwiritsidwa ntchito.

Kuti mwana akule bwino, makamaka magawo oyamba a kubereka, mwana wosabadwayo asanakhazikitse chithokomiro, ndikofunikira kusankha kuchuluka kwa mahomoni a chithokomiro. Miyezo yapano ya L-thyroxine ndi TSH imatsimikiza kugwiritsa ntchito mayeso a mahomoni. Mlingo wotere wa L-thyroxine amasankhidwa kuti akwaniritse kuchuluka kwa 50 mcg patsiku.

Kusintha kwa Mlingo ndi kuyang'anira kuchuluka kwa mahomoni kumachitika miyezi iwiri iliyonse.
Ndi chizindikiritso cha panthawi yake cha mayi amene ali ndi pakati komanso kulandira chithandizo chokwanira, palibe zotsatira zoyipa kwa mwana.

Mitundu ndi zoyambitsa chitukuko

Hypothyroidism ndi yoyamba (99% ya milandu) ndi sekondale (1%). Yoyamba imachitika chifukwa cha kuchepa kwa kupanga kwa mahomoni a chithokomiro, omwe amachititsa kuchepa kwa magwiridwe ake. Choyambitsa chachikulu cha hypothyroidism ndizonyansa mu gland palokha, ndipo yachiwiriyo ndi kuwonongeka kwa pituitary kapena hypothalamus.

Hypothyroidism yoyamba imagawidwa kukhala yaying'ono komanso kuwonekera. Subclinical imatchedwa pamene mulingo wa TSH (mahomoni opatsirana a chithokomiro) ukuwonjezeka m'magazi, ndipo T4 (thyroxine) ndiyabwinobwino. Ndi mawonekedwe - TSH ichulukitsidwa, ndipo T4 yafupika.

Mitundu ya mahomoni m'magazi:

• chithokomiro chotulutsa chithokomiro (TSH): 0.4-4 mIU / ml, pa nthawi ya pakati: 0.1-3.0 mIU / ml,
• thyroxine yaulere (T4): 9.0-19.0 pmol / L, panthawi yoyembekezera: 7.6-18.6 pmol / L,
• triiodothyronine yaulere (T3): - 2.6-55.6 pmol / L, panthawi yapakati: 2.2-55 pmol / L.

Hypothyroidism imagawidwanso m'magulu obadwa nawo komanso kutengedwa.

Zoyambitsa hypothyroidism:

• kusokonezeka kobadwa nako komanso zonyansa za chithokomiro.
• Matenda omwe chithandizo chake chimayambitsa matenda a iodine (kuphatikiza poyizoni),
• chithokomiro (autoimmune, postpartum) - kutukusira kwa England
• chithokomiro (ntchito yochotsa chithokomiro cha chithokomiro),
• zotupa za chithokomiro,
• kuchepa kwa ayodini (ndi zakudya kapena mankhwala azamankhwala),
• kobadwa nako hypothyroidism,
• chithokomiro cha chithokomiro kapena mankhwala a ayodini.

Zizindikiro za Hypothyroidism

Ndi hypothyroidism m'thupi, momwe machitidwe ena amapangidwira amachepa chifukwa chosowa mahomoni a chithokomiro opangidwa ndi chithokomiro cha chithokomiro. Kukula kwa matendawa kumatengera kuchuluka kwa matendawa. Zizindikiro zimatha kuchitika payekhapayekha komanso motsatana. Izi zikuphatikiza:

• kuyiwala
• anachepetsa chidwi
• kuchepa tsitsi komanso kutsika kwake,
• mawu osokosera (kubowola usiku kumatha kuchitika chifukwa cha kutupa kwa lilime ndi larynx)
• minofu kukokana
• kutupa kwa pakhungu
• kufooka wamba (ngakhale m'mawa),
• kupweteka kwa molumikizana
• Kukhumudwa
• kuchepetsa kulumala
• kunenepa
• kutsika kwamphamvu ya kupuma komanso kugunda kwa mtima (chimodzi mwazizindikiro zazikulu kwambiri, kugunda kwa mtima kungakhale kosakwana 60 kugunda / mphindi),
• khungu lowuma
• kutsitsa kutentha kwa thupi (izi zimayambitsa kumva kukhala oyera),
• dzanzi m'manja (chifukwa cha kukakamira kwa mathero amanjenje ndikutupa kwa minofu m'chiuno),
• masoka osamva, kumva, kulira m'makutu (ziwalo zam'mimba zimakhudzidwa chifukwa cha kutupa kwa minofu).

Kukula kwa hypothyroidism pa nthawi yapakati

Amayi oyembekezera omwe ali ndi hypothyroidism ali ndi gawo limodzi. Ndi chitukuko cha mimba, Zizindikiro zitha kuchepa. Izi zikuchitika chifukwa cha kuwonjezeka kwa zochitika za chithokomiro cha mwana wosabadwayo komanso kuchuluka kwa mahomoni ake kwa mayi ngati chindapusa.

Ndi mphamvu yofooka ya mahomoni a chithokomiro pa chitetezo chathupi, chizolowezi chofala pafupipafupi chimawonekera.

Kuti Zizindikirozi zisapitirire patsogolo, muyenera kufunsa dokotala, kuyesa mayeso onse ofunika ndikuyamba chithandizo msanga.

Chithandizo cha hypothyroidism pa nthawi yapakati

Chithandizo cha hypothyroidism pa nthawi yoyembekezera chimachitika ndi endocrinologist pamodzi ndi obstetrician.

Mu trimester yoyamba, kuzindikira kwa prenatal (prenatal) kwa kuphwanya kwa mwana wosabadwayo ndikofunikira. Ndi hypothyroidism yopanda kulipidwa, kuchotsa mimba kumasonyezedwa pazifukwa zamankhwala. Koma ngati mayi akufuna kupitilirabe kubereka, ndiye kuti amachira mankhwala ndi sodium levothyroxine (L-thyroxine). Hypothyroidism yolipiridwa (yokhala ndi kukula kwa mtundu wa TSH) sikuti kuphwanya pakati, momwemonso chithandizo chimachitika.

Asanakhale ndi pakati, L-thyroxine m'malo mwake ndim 50-100 mcg / tsiku. Pambuyo pa kuyambika kwake, mlingo umachulukitsidwa ndi 50 μg, palibe chiopsezo cha mankhwala osokoneza bongo mopambanitsa, kuchuluka kwa mahomoni a chithokomiro m'magazi a mwana wosabadwayo amachepa. Nthawi zina zimachitika kuti mwa amayi ena apakati kuyambira sabata la 20 atatha kupimidwa kwa mahomoni, pakufunika kuwonjezeraku. TSH panthawi yothandizira iyenera kukhala pansi pa 1.5-2 mIU / L.

Sodium Levothyroxine imapezeka m'mapiritsi a 50 ndi 100 μg (mwachitsanzo, Eutirox). Mankhwala amatengedwa m'mawa theka la ola musanadye, ngati pali toxosis, ndiye bwino kumwa pambuyo pake.

Ndi hypothyroidism, kupanga mahomoni ndi chithokomiro cha chithokomiro sikubwezeretsedwa, kotero, mankhwalawa amayenera kupitilizidwa, kwa moyo wonse.

Kupereka

Amayi ambiri oyembekezera omwe ali ndi hypothyroidism, opatsidwa chindapusa chonse, amabereka nthawi komanso popanda zovuta. Gawo la Kaisareya limachitika kokha molingana ndi zisonyezo zaubeteri.

Ndi hypothyroidism, zovuta pakubala kwa mwana nthawi zina kumachitika, monga kugwira ntchito yofooka. Kupititsa mu nkhaniyi kumatha kukhala kudzera munjira zachilengedwe, komanso mothandizidwa ndi gawo la cesarean (kutengera zisonyezo).

Pakadutsa nthawi yobereka, pamakhala ngozi yotaya magazi, motero kupewa ndikofunikira (kuyambitsa mankhwala omwe amachepetsa chiberekero).

Zovuta za hypothyroidism za mayi ndi mwana wosabadwayo

Pali chiopsezo chopanga kobadwa nako hypothyroidism mu fetus. Ngati matendawa apezeka munthawi yake, ndiye kuti amatha kuwongolera mosavuta mothandizidwa ndi chithandizo chamankhwala.

• kusokonekera (30-35%),
• preeclampsia
• ntchito yofooka
• kutaya magazi pambuyo pake.

Zovuta zomwe zingachitike ndi hypothyroidism:

• matenda oopsa, preeclampia (15-20%),
• placental abrupt (3%),
• postpartum hemorrhage (4-6%),
• kulemera kochepa kwa mwana wosabadwayo (10-15%),
• kusintha kwa fetal (3%),
• mwana wosabadwa wa mwana wosabadwayo (3-5%).

Ndi chithandizo cha panthawi yake komanso chokwanira, chiopsezo cha zovuta ndizochepa. Kwa njira yabwino yokhala ndi pakati komanso kubereka kwa fetal, chithandizo chamankhwala chimafunikira nthawi yonse ya pakati. Ndi kubereka kwa hypothyroidism mwa mayi wapakati, kufunsa majini ndikofunikira.

Zambiri zomwe zatengedwa patsamba la Federal Medical Library (dissertation: "Krivonogova M.E., mkhalidwe wa Fetal mwa amayi apakati omwe ali ndi matenda operewera kwa ayodini")

Maphunziro ena pa nthawi yomwe ali ndi pakati

Mimba ndi hypothyroidism: ndi ngozi ziti zomwe zingakhalepo?

Hypothyroidism ndi matenda omwe amayamba chifukwa cha kuchepa kwa mahomoni a chithokomiro. Chiwopsezo cha matenda amiseche pakati pa azimayi obala mwana chikufika 2%. Mimba yokhala ndi hypothyroidism imafunikira kuyang'aniridwa mosamala kuchipatala, chifukwa kulephera kuwongolera izi kumachitika ndi zovuta pa mwana wosabadwayo.

Chithokomiro cha chithokomiro ndi gawo limodzi la dongosolo la endocrine lomwe limayendetsa mwachindunji kapena mosazungulira pafupifupi machitidwe onse a thupi. Pazifukwa izi, ndikofunikira kudziwa momwe hypothyroidism ingakhale yoopsa panthawi yapakati. Kuti mumvetse momwe mungapangire kukula kwa vuto la kuchepa kwa chithokomiro, zomwe zimayambitsa ziyenera kuganiziridwa.

Kutengera ndi zomwe zidapangitsa kutsika kwa mahomoni a chithokomiro, mitundu ingapo ya hypothyroidism imasiyanitsidwa.

Zina mwa izo ndi:

Amapanga 95% yamitundu yonse ya hypothyroidism. Amayambitsa kuwonongeka mwachindunji kwa chithokomiro cha chithokomiro. Nthawi zambiri timalankhula za kuwonongeka kwa minofu ya ziwalo kapenanso kuchepa kwa ntchito yake.

Izi zitha kubweretsa:

• Autoimmune chithokomiro. Ndi matenda a chithokomiro otupa. Autoimmune hypothyroidism imakonda kupezeka nthawi yapakati.
• Zotsatira za opaleshoni. Hypothyroidism imatha kukhazikika pambuyo pochotsa chithokomiro chonse cha chithokomiro, kapena gawo limodzi.
• Anomalies of development. Tikulankhula za agenesis (kubadwa kwina) ndi dysgeneis (malfform) a chithokomiro.
• Matenda opatsirana. Mavuto a ARVI nthawi zambiri amabweretsa kutupa.
• Matenda a ayodini. Ntchito pa nkhondo yolimbana ndi neoplasms.
• Osakhalitsa hypothyroidism. Nthawi zina amakula chifukwa cha chithokomiro cha pambuyo pake.

Hypothyroidism ina yoyambirira imakhala yochepa kwambiri panthawi yomwe mayi ali ndi pakati ndipo amayamba chifukwa cha kusokonekera kwa kapangidwe ka mahomoni a chithokomiro.

Zifukwa:

• Zakudya za poizoni wa thyrotropic mthupi, kugwiritsa ntchito mankhwala ena.
• Kuphwanya kwatsopano kwa ntchito yopanga chithokomiro.
• Kusowa kwambiri kapena ayodini wowonjezereka m'thupi (pachifukwa ichi, Iodomarin yokhala ndi hypothyroidism yokhazikika pakulimbikitsidwa imayenera kutengedwa pokhapokha ndi chilolezo cha adokotala.

Matendawa amayamba chifukwa cha kuwonongeka kwa pituitary gland.Chingwe chakunja cha gland iyi ya endocrine, yomwe ili muubongo, chimapangitsa chithokomiro cha chithokomiro cha chithokomiro. TSH imagwira ntchito monga chothandizira kutulutsa chithokomiro. Kupsinjika kwa pituitary gland kumapangitsa kuchepa kwa mahomoni a chithokomiro. Werengani zambiri za TSH pa nthawi yomwe muli ndi mimba →

Pathology imayambika chifukwa cholephera kugwira gawo lina la endocrine system - hypothalamus, yomwe ilinso mu ubongo. Chipinda chamitsempha ichi chimakhala ndi mphamvu yolimbikitsa pakubisika kwa TSH ndi gitu pituitary pamasula mahomoni a thyrotropin-kumasula. Mphamvu yochepetsera ya hypothalamus imatha kubweretsa kulephera kwa chithokomiro.

Hypothyroidism yotereyi panthawi yomwe mayi ali ndi pakati pamafunika kupenda mosamala, chifukwa imatha kukhala chimodzi mwazizindikiro zazikulu zowonongeka kwamphamvu mu ubongo. Kusowa kwa mahomoni a chithokomiro komanso sekondale kumatchedwa hypothyroidism yapakati.

Nthawi zambiri osowa mtundu wamtunduwu amalembedwa mma fomu a mabanja. Mimba mu vuto la kubereka hypothyroidism mufunso liyenera kukonzedwa ndikuyang'aniridwa pang'onopang'ono kwa endocrinological. Peripheral hypothyroidism imachitika chifukwa chakuchepa kwa chidwi chathupi lathupi kuma mahomoni a chithokomiro. Pankhaniyi, pali kusowa kwa kuphwanya kwakukulu mu chithokomiro cha chithokomiro, hypothalamus ndi gitu.

Njira yachipatala ya hypothyroidism imatengera nthawi yayitali komanso kutha kwa chithokomiro cha chithokomiro. Nthawi zambiri, matenda am'mimba amachitika mwachinsinsi. Chifukwa chake, subclinical hypothyroidism siyimayambitsa madandaulo panthawi yobereka komanso pambuyo pobereka.

Matenda a mahormone olimbitsa thupi pang'ono komanso owopsa amawonekera mu mawonekedwe a "masks" a matenda osiyanasiyana. Mwachitsanzo, zomwe zimachitika chifukwa cha hypothyroidism yopanda kufotokozedwa zitha kukambidwa pakakonzedwa, komwe sikugwirizana kwenikweni ndi kuwonongeka kwa mtima.

Hypndroidism Syndromes:

Ndi mtundu wobisika kwambiri wamavuto. Subclinical hypothyroidism sizimavutitsa mkazi nthawi yapakati, chifukwa chake zovuta zake zimakhala zazikulu chifukwa chazindikira mochedwa. Kukula kwa kusalinganika kwa mahomoni, pamapeto pake, kumabweretsa mawonekedwe azachipatala, koma sikunena mwachindunji.

Subclinical hypothyroidism panthawi yoyembekezera imatha kupezeka pogwiritsa ntchito mayeso a labotale. Chizindikiro chachikulu ndikuwonjezeka kwa TSH motsutsana ndi kumbuyo kwa mulingo wabwinobwino wa T4 (tetraiodothyroxine). Izi zimachitika chifukwa cha kukondoweza kwa chithokomiro cha chithokomiro.

Subclinical hypothyroidism sichiri chifukwa chokhala ndi nkhawa panthawi yoyembekezera: zotsatira za mwana wobadwa mosiyana ndi mbiri yake, monga lamulo, sizowopsa pamoyo. Mu 55% mwa anthu, mwana wabwinobwino amabadwa. Mavuto amatha kuchedwa, mwachitsanzo, ngati chitetezo chochepa.

Kutupa kwa chithokomiro cha chithokomiro nthawi zambiri kumapezeka pakati pa amayi omwe ali ndi mwana wosabadwa. Gulu lamavuto limaphatikizapo omwe ali mwana asanachitike nthawi yobereka. Kukula kwakukulu komwe kukufotokozedwa ndi kunyamula kwa ma antibodies kupita ku chithokomiro cha chithokomiro mwa 10-20% ya amayi apakati.

Autoimmune chithokomiro, choyambitsidwa ndi autoantibodies, chimayambitsa hypothyroidism, yomwe imatha kusokoneza kutenga pakati, popanda chithandizo choyenera, imakhudza mwana wosabadwa. Matendawa amapitilira mu mawonekedwe a hypertrophic ndi atrophic. Poyamba, ndikuwonjezeranso kukula kwa chithokomiro, chachiwiri - kulowererapo kwa malo omwe akhudzidwa ndi minofu yolumikizidwa.

Kukhalapo kwa hypothyroidism sikuyenera kunyalanyazidwa mukakonzekera kutenga pakati. Kuchepa kwa mahomoni a chithokomiro kungayambitse kusabereka. Chithandizo cha hypothyroidism yomwe idakhazikitsidwa kale iyenera kuchitika pasadakhale: kutenga pakati, ngakhale zitachitika, kuopsa kochotsa mimbayo kapena kuphwanya kwakukulu pakukhazikitsa kwa mwana wosabadwayo.

Amayi omwe sanadwalepo ndi hypothyroidism amalangizidwanso kuti awone mawonekedwe awo a chithokomiro pakukonzekera kutenga pakati. Ichi ndichifukwa chakutha kubereka mwana ndi matenda amisala. Ngati vuto la mahomoni silinadziwike mwana asanabadwe, ndiye kuti zizindikiro za hypothyroidism zomwe zimadzachitika pambuyo pake zitha kuzindikirika pakhungu.

Kuperewera kwa mahomoni a chithokomiro kungakhale ndi vuto lililonse kwa mayi woyembekezera komanso kwa mwana wosabadwayo. Pathology ndiyowopsa makamaka mu trimester yoyamba, pamene kuyika kwa ziwalo ndi machitidwe a mluza kumachitika.

Hypothyroidism yosafupikitsidwa panthawi yapakati imatha kuyambitsa kwambirimavuto kwa mwana:

• Kunenepa pang'ono.
• Zambiri mu thupi ndi m'maganizo.
• Anomalies a kapangidwe kake.
• Congenital hypothyroidism.

Hypothyroidism yayikulu imabweretsa mavuto pa mimba ndipo imatha kukhala yowopsa kwa mkazi. Kukula kwa matendawa kumafotokozedwa ndikugwiritsira ntchito mahomoni a chithokomiro cha amayi akuchikazi mwa mwana woyamba kubadwa.

Mavuto omwe angakhalepo:

• Kuchotsa modzipereka.
• Kukhazikika kwa placenta ndi magazi kwambiri.
• Ntchito zofooka.
• Chuma choperewera magazi.

Ndi dokotala uti yemwe ndiyenera kulumikizana ndi hypothyroidism pa nthawi yapakati?

Kuwongolera kwa nthawi yonse yoyembekezera ndi hypothyroidism kumachitika moyang'aniridwa ndi endocrinologist ndi obstetrician-gynecologist. Katswiri woyamba amawongolera kusayenerana kwa mahomoni ndikuwunika zotsatira, pomwe wachiwiri akuwunikira zokhudzana ndi prenatal ndikuwona momwe mayiyo angakhalire. Izi zimakuthandizani kuti muchepetse zoopsa zomwe zingachitike poyembekezera mayi woyembekezera ndi mwana wake.

Hypothyroidism, yolipiridwa molondola pa nthawi yomwe mayi ali ndi pakati, sizikhala ndi zotsatira zoyipa kwa mwana ndi mayi. Maziko a chithandizo ndi chithandizo chamankhwala. Monga mankhwala, mankhwala omwe ali ndi sodium levothyroxine ndi: Eutirox, L-thyroxine, Bagothyrox.

Mlingo watsimikiza ndi endocrinologist ndipo umachokera ku 50 mpaka 150 mcg patsiku. Mankhwala amatengedwa m'mawa theka la ola musanadye. Sodium ya Levothyroxine sabwezeretsa ntchito ya chithokomiro, koma imangosintha ntchito yake.

Maphikidwe a folks omwe amakupatsani mwayi kuti mupeze levothyroxine kunyumba sapezeka. Mimba yomwe imachitika nthawi ya hypothyroidism ya chithokomiro chimafunikira chisamaliro chapadera komanso salola kudzipatsanso mankhwala. Kumwa kwa mankhwala aliwonse kuyenera kuvomerezana ndi adokotala.

Maphikidwe ambiri otchuka amayang'ana pa kugula zinthu zomwe zimakhala ndi ayodini. Komabe, kudya kwambiri mu thupi kungakulitse hypothyroidism komanso kungawononge pathupi. Njira zotetezera kuperewera kwa ayodini zimaphatikizapo kumwa mozama zakudya zam'nyanja.

Zitsanzo za maphikidwe osindikizidwa omwe amagwiritsidwa ntchito pa intaneti omwe sayenera kutumizidwa:

• Apulo cider viniga wa ayodini mkati. Njirayi sidzangothandiza kuchiritsa matenda a hypothyroidism panthawi yomwe mayi ali ndi pakati, komanso imayambitsa mavuto owopsa: poyamba, mutha kupsa, kenako, poyizoni wokhala ndi ayodini.
• Juniper ndi Batala Mafuta. Zina zilizonse zakunja pazitsamba za chithokomiro sizabwino. Izi zimakhala choncho makamaka milandu ikapezeka kuti ilipo.

Njira zodziwika zopewera sizinapangidwe. Njira zikuluzikulu ndizolinga zakukonzanso panthawi yake zakuphwanya komwe kulipo.

Pofuna kupewa hypothyroidism pa nthawi ya pakati komanso kupewa zovuta zake, malangizowa akuyenera kuonedwa:

• Kuwunikira kuchuluka kwa mahomoni a chithokomiro pakukonzekera pakati.
• Kumwa mankhwala okhala ndi ayodini monga momwe dokotala wanenera.
• Kuganizira mawonekedwe a achire regimens mukamagwiritsa levothyroxine.
• Kupewa matenda opatsirana, kupatula kukhudzana ndi poizoni.

Ndikofunikira kukumbukira kuchuluka kwa hypothyroidism komwe kumakhudza pakati. Kunyalanyaza kufunika kwa "chaching'ono" cha endocrine gland kumatha kubweretsa zotsatirapo zowopsa kwa mwana ndi amayi. Chinsinsi cha mimba yabwinobwino ndikupempha kwakanthawi kwa endocrinologist ndi gynecologist, komanso kukhazikitsa malingaliro awo.

Zomwe zimayambitsa ndi zotsatira za hypothyroidism pa nthawi yapakati

Hypothyroidism pa nthawi yapakati ndi mawonekedwe osakwanira a mahomoni a chithokomiro, omwe, pomwe ali ndi pakati, mwana asanapange dongosolo lake la endocrine, amakakamizidwa kuti awapatse thupi la amayi ndi mwana.

Ma mahomoni a thyroxine ndi triiodothyronine omwe ali ndi zotsika kwambiri angawononge thanzi la amayi ndi makanda.

Hypothyroidism pa nthawi yapakati ndi yamitundu iwiri:

Choyamba ndi chifukwa chakugwira ntchito bwino kwa chithokomiro cha chithokomiro pachokha ndipo chitha kupezedwa kapena kukhala ndi chikhalidwe chamkati. Imadziwonetsa mu kuchepa kwa kuchuluka kwa minofu yogwira yomwe imatulutsa mahomoni, ndikulemala mu biosynthesis ya mtundu wa mahomoni a chithokomiro. Hypothyroidism yachiwiri imachitika motsutsana ndi kumbuyo kwa mphamvu yochepa ya chithokomiro cha chithokomiro, komanso kumasula mitundu ya hypothalamus.

Pozindikira matenda a hypothyroidism munjira yachipatala, zomwe zili zowonjezera za TSH zimasiyanitsidwa ndikuyang'ana kumbuyo kwa nthawi yayitali yaulere T3 ndi T4 (hypentroidism yotsala kapena subclinical hypothyroidism panthawi yapakati) komanso kuchuluka kwa TSH motsutsana ndi maziko a kuchepa kwaulere T3 ndi T4 (yowonetsa hypothyroidism).

Ngati thupi la mayi wapakati limasinthasintha pazinthu zochepa za T3 ndi T4, ndiye kuti fomu yolumikizidwa ndikuchotseredwa imapezeka. Woopsa, ndi hypothyroidism yovuta, azimayi omwe ali ndi pakati amatha kudwala. Kukhalapo kwa matendawa kwadzola zizindikiro, choncho mayi woyembekezera ayenera kuyang'aniridwa ndi dokotala pafupipafupi.

Zizindikiro zamankhwala za chiwonetsero cha matenda a hypothyroidism ndi:

• kumva kufooka kwathupi lathupi,
• Kuchepetsa magwiridwe
• kupweteka kwa m`malo olumikizirana mafupa,
• kutopa,
• Zizindikiro zakhumudwitsa
• Kuchepetsa kukumbukira ndi chidwi,
• onenepa kwambiri
• mtima ndi mtima.
• khungu lowuma ndi tsitsi,
• mavuto ndi m'mimba thirakiti
• kusintha mamvekedwe a mawu.

Zotsatira za matendawa ndizomwe zimayendetsedwa mu njira zonse za metabolic. Chifukwa cha izi, mutha kuwona kuyera nthawi zonse ndikuchepetsa kutentha kwa thupi. Kuperewera kwa mahomoni a chithokomiro kumapangitsa kuti chitetezo chamthupi chisayambike bwino, chomwe chimayambitsa matenda opatsirana pafupipafupi. Kumva kufooka ndi kutopa kumadziwika ngakhale m'mawa. Vutoli limatsatiridwa ndi kupweteka kwa mutu, dzanzi m'manja ndi kutupa.

Kutupa kwa minofu kumakhudza mphamvu, kumangika zingwe zam'mawu, kumachepa masomphenyawo, makutu akumveka. Matenda am'mimba amayankhidwa ndi kudzimbidwa. Poyerekeza ndi vuto la chithokomiro, matenda amtima amayamba, cholesterol m'magazi imatuluka, mtima wamatenda, matenda amitsempha yamagazi.

Hypothyroidism ndi kusabereka ndi malingaliro amalire. Mwa akazi, pali kusokonezeka kwa msambo, komwe kumatenga mafomu otsatirawa ndi hypothyroidism: kusamba kumachitika kwambiri, kwa nthawi yayitali, ndipo nthawi zina kumatha kusiyiratu. Chifukwa chake, zimakhala zosatheka kukhala ndi pakati ndi hypothyroidism.

Hypothyroidism mwa amayi apakati ndiwopseza kwambiri kwa mwana wosabadwayo. Zotsatira zoyipa zomwe zingakhalepo kwa mwana ndi izi:

• Kukula kwa mitsempha yake yapakati imadwala matenda a mayi.
• Mu gawo loyambirira la pakati, pali kusowa konse kogwira ntchito kwa chithokomiro cha chithokomiro cha mwana wosabadwayo. Kuphatikiza apo, khungu lake lamanjenje limayamba chifukwa cha zovuta za mahomoni a amayi.
• Ndi hypothyroidism mwa akazi, mwana wosabadwayo amatha kudwala hypoxia, yomwe imatsogolera mwana kulemera pang'ono.
• Matendawa ndi oopsa chifukwa mwana wosabadwayo angafe m'mimba.

Mu theka lachiwiri, mphamvu ya mahomoni azimayi ikhoza kukhala yamphamvu kwambiri ndipo imalipilira kuchepa kwa mahomoni a chithokomiro mwa mwana.

Pambuyo pobadwa mwana, ngati matenda obadwa nawo atapezeka pa nthawi yake, matendawa amatha kuchiritsidwa ndikuthira mankhwala, ndipo mwana wosabadwayo sangakhale ndi vuto la m'maganizo. Mimba yokhala ndi hypothyroidism ya amayi imatsogolera kuti kuyika kwa dongosolo lamkati la mwana kumaganizira kuchepa kwa mahomoni a chithokomiro, zomwe zikutanthauza kuti njira zosasinthika ndizotheka.

Mpaka posachedwapa, hypothyroidism panthawi yoyembekezera inali ndi zovuta zambiri, kuphatikizapo pambuyo pobereka. Masiku ano, kuwunika matendawa ndi matendawa ndi kupeza nthawi yake komanso kulandira chithandizo moyenera kumathetsa zovuta. Kafukufuku womwewo wa labotale akuti kupatuka panjira yokhala ndi mahomoni a chithokomiro kumakhala kowopsa pakukula kwa mwana kuposa thanzi la mayi.

Hypothyroidism ndi kutenga nthawi imodzi kumayambitsa thanzi la mayi. Izi zikuwonetsedwa mu izi:

• Trimester yoyamba imayendera limodzi ndi toxosis yayikulu, ingachititse kuti pakhale kunja kwa mimba.
• Kuopseza pathupi kupitirirabe kwa nthawi yonse yoyembekezera.
• Madeti omalizira amasokonezeka ndi gestosis.
• Zotsatira za hypothyroidism pa nthawi ya pakati zimaphatikizira kuchepa kwa magazi m'thupi, kutulutsa magazi ku uterine pambuyo pobadwa.

Mwa amayi nthawi yapakati, matendawa amapezeka mwa amodzi mwa khumi. Nthawi zambiri, hypothyroidism siziwonetsa.

Kafukufuku wa Laborator pamenepa amaulula ma antibodies omwe amayang'aniridwa ku chithokomiro cha chithokomiro. Kukhalapo kwa ma antibodies kumabweretsa kuwonongeka kwa maselo a chithokomiro, pomwe kuphatikiza kwa mahomoni kumachepetsedwa.

Ngakhale TSH ikakhalabe yachilendo, ndikukula kwa mwana wosabadwayo panthawi yapakati, pali kuchepa kwa mahomoni a chithokomiro, ndipo chifukwa chake, hypothyroidism imayamba.

Opaleshoni yokhudzana ndi chithokomiro cha chithokomiro imathandizanso matendawa. Gawo la minofu yake likachotsedwa, kuchuluka kwa maselo omwe amapanga timadziwo kumatsika. Izi ndizomwe zimayambitsa kusowa kwa mahomoni panthawi yoyembekezera.

Matendawa amachititsa kusintha kwa magwiridwe antchito a chithokomiro. Zolakwika izi zikukhudza mfundo izi:

• kuchuluka kwa minofu ya tinyezi,
• kuchuluka kwa globulin m'chiwindi,
• zotupa za ayodini
• kuzindikira kwa mahomoni a gulu la chithokomiro mu placenta.

Zizindikiro za hypothyroidism pa nthawi yomwe mayi ali ndi pakati nthawi zambiri zimasonyezera kuchepa kwa ayodini, chifukwa matendawa amakhudzana ndi kufunika kwakuchulukirapo kwamahomoni a chithokomiro.

Chimodzi mwazomwe zimachitika ndi matendawa ndikuwonekera mu theka lachiwiri la mimba ya tachycardia motsutsana ndi kumbuyo kwa matenda a matenda a gland hyperfunction. Izi ndichifukwa cha kuchuluka kwa mahomoni kuchokera kwa mwana wosabadwa. Kuperewera kwa mahomoni a chithokomiro kumabweretsa kutupa kwa khungu, ziwalo zamkati ndi mucous nembanemba.

Gestational hypothyroidism imabweretsa kuti mwana wosabadwayo nthawi zambiri amatha kufa ndi vuto la oxygen panthawi yobereka. Pambuyo pake, azitha kutenga matenda opatsirana pafupipafupi.

Postpartum hypothyroidism imachititsanso mavuto azimayi.

Mayi woyembekezera amayenera kuwonedwa ndi obstetrician-gynecologist ndi akatswiri othandizira odwala. Akatswiri awa nthawi zonse amatchera khutu ku zizindikiro za hypothyroidism. Ngati pali kukayikira kocheperako, ndiye kuti kuyesa kwa mahomoni kumayikidwa nthawi yomweyo.

Phunziroli limatsimikizira kupezeka kwa magazi a mahomoni a chithokomiro (T4) ndi mahomoni a pituitary, omwe amalamulira kapangidwe ka T4 (TSH). Ndi kuchepetsedwa koyamba kwa woyamba komanso wachiwiri, kuwunika kumapangidwa - hypothyroidism yoyamba, ndiye kuti ichi ndi chizindikiro cha vuto la chithokomiro. Ndi chizindikiro chochepetsedwa cha mahomoni onse awiri, hypothyroidism imapezeka ndikuphwanya ntchito za pituitary ndi hypothalamus.

Ngati kuwunika kumawonetsa kusintha kwachilengedwe mu hypothyroidism yoyamba, madokotala amapereka kuyesedwa kowonjezera magazi kupezeka kwa ma antibodies. Kusanthula kwabwino kumawonetsa kuwonongeka kwa maselo okhala ndi ma antibodies awo.

Komanso, moyang'aniridwa ndi akatswiri, kukonzekera pakati kungachitike.

Musanayambe chithandizo, chifukwa chimakhazikitsidwa. Izi zitha kukhala kusowa kwa ayodini kapena kuwonongeka kwa ndulu. Chithandizo chikhazikitsidwa ndi potaziyamu iodide. Kuchulukitsa kwa mankhwalawa kunapangidwa kuti kuthetsere matenda. Woopsa mawonekedwe, kutha kwa mimba ndikotheka. Ngati mayi adasankha kupitiriza kutenga pakati, ndiye kuti mankhwala a mahomoni amaperekedwa, zomwe zimatenga nthawi yochulukirapo pambuyo pobadwa.

Kuperewera kwa mahomoni kumalipidwa ndi levothyroxine, mlingo womwe umasankhidwa payekha kutengera kuyesedwa kwa magazi ndi mkhalidwe wa mkazi. Mlingo woyambirira ndi 50 mcg. Mlingo watsiku ndi tsiku umatha kuwonjezeredwa ndi 25 mcg kamodzi pakatha masiku atatu ndikusinthidwa kukhala 175 mcg.

Ngati hypothyroidism idayikidwa asanabadwe, ndiye kuti mlingo umakulitsidwa ndi 25 mcg patsiku. Mwa amayi apakati oterowo, amawunikira chithokomiro mosalekeza. Kuzindikira koyambirira kumathandizira kuchitira chithandizo mwachangu, zomwe zikutanthauza kuti kuchira kumabwera posachedwa. Ndi chithandizo choyenera, mkazi amatha kupirira mwana wathanzi popanda mavuto.

Popewa matendawa, pofuna kupatula kusowa kwa ayodini m'thupi, mkazi ayenera kupimidwa asanakonzekere kutenga pakati. Pakuwunika kosautsa, kukhala ndi pakati ndikwabwino kuchedwetsa.

1. Matenda a chithokomiro. - Moscow: Engineering, 2007. - 432 c.
2. Petunina, N. A. Matenda a chithokomiro. / N.A. Petunina, L.V. Trukhina. - M: GEOTAR-Media, 2011 .-- 222 p.
3. Kubwezeretsa kwa Chithokomiro - Ushakov A.V. - Chithandizo cha Odwala
4. Sinelnikova, A. A. 225 maphikidwe a za chithokomiro. / A.A. Sinelnikova. - M: Vector, 2012 .-- 128 p.
5. Uzhegov, G.N. Matenda a chithokomiro: Matenda osiyanasiyana, Chithandizo cha mankhwala achikhalidwe, achire / G.N. Kuwotcha. - Moscow: Russian State Humanitarian University, 2014 .-- 144 p.

Ольга Melikhova Olga Aleksandrovna - dokotala endocrinologist, wazaka 2.

Amathandizira kupewa, kuzindikira komanso kuchiza matenda a endocrine system: chithokomiro cha chithokomiro, kapamba, “adrenal gland, gland pituitary, gland gland”, gathy ya parathyroid, gland.

✓ Nkhani yoyesedwa ndi dokotala

Mtsikana akagwira chithokomiro cha chithokomiro nthawi yapakati komanso mahomoni (chithokomiro) amapangidwa moperewera, ndiye kuti matendawa amayamba kuwonjezereka. Mu zoterezi, mzimayi amatha kukumana ndi mavuto osiyanasiyana.

Ngati thupi la mkazi nthawi yoyembekezera silingatulutse kuchuluka kwama mahomoni ena, ndiye kuti imakhala yodzala ndi mwana wosabadwayo. Zotsatira zake, mwana amatha kubadwa ndi kukumbukira kwakumbuyo, mavuto mumitsempha, kusakwanira kwamlingo waluntha. Zoterezi ndizowopsa kwa thanzi la mayi, popeza kusala kwazogonana komanso kusabereka kwina sikuyenera. Mzimayi akatsimikizira kuti ali ndi matenda a hypothyroidism, ndi kotheka kukhala ndi pakati, koma pankhaniyi, makolo amtsogolo amafunika kudziwa zonse zomwe zingachitike.

Subclinical hypothyroidism pa nthawi yapakati

Mahomoni a chithokomiro opangidwa ndi thupi lachikazi ndiofunika kwambiri panthawi yapakati, chifukwa amathandizira pakukhazikika kwa mwana. Ngakhale kufunikira kwamagulu am'magazi kwa mwana (magawo oyambirira a moyo, mwana wosabadwayo alibe chithokomiro), mahomoni a chithokomiro ndiofunikanso kwa amayi, popeza pali zovuta zambiri:

• kusokonekera sikusiyidwa,
• hypothyroidism imatha kupezeka mwa mwana
• mwana amabadwa ndi nzeru zamisala,
• pakubadwa, mwana adzakhala ndi thupi lonyansa,
• mwa mkazi pamene ali ndi pathupi, kutulutsa khunyu sikungosiyidwa,
• matenda oopsa mwa mayi woyembekezera,
• chitukuko cha chithokomiro
• Kutha kwa mwana wosabadwa
• magazi ochulukirapo atabereka,
• malformations wamanjenje mu mwana.

Yang'anani! Ngati mayi atenga pakati ndi matenda a subclinical hypothyroidism, ndiye kuti ndikofunikira kukonzekera chiopsezo chakufa kwa perinatal.

Mawonekedwe a chithokomiro

Kwenikweni, hypothyroidism imayamba ngati matenda oyamba, omwe amayamba chifukwa cha chotupa cha chithokomiro kapena ngati chitetezo cha m'thupi chayipa.

Dera la hypothalamic-pituitary limawonedwa kale ndi hypothyroidism yachiwiri. Izi zikufotokozedwa ndi kukhalapo kwa matenda kapena neoplasm mwachindunji mu chithokomiro cha chithokomiro.

Subclinical hypothyroidism itha kuchepetsa mwayi wokhala ndi pakati. Izi zikufotokozedwa ndi kuperewera kwa msambo ndi kuchepa kwa msambo. Chifukwa chake, kusabereka kungayambitse. Popewa mavuto ndi kutenga pakati ndikukhazikika kwa mwana, ndikofunikira kuti mayi aziyang'anira nthawi zonse momwe thupi limayendera komanso kuchuluka kwa mahomoni, ngati pali zovuta zilizonse mu chithokomiro cha chithokomiro, ndiye gwiritsani ntchito mankhwala apadera kuti muchepetse kusintha kwa mahomoni. Zotsirizazi ndizofunikira osati kwa mkazi yekha, komanso pakukula kwathunthu kwa mwana. Kupanda kutero, ngati mwana wapezeka ndi vuto lina lokhala ndi pakati, ndiye kuti kumwalira kwa mwana kudzera mu mimbayo sikungalephereke.

Mimba komanso subclinical hypothyroidism

Zotsatira za hypothyroidism pamimba

Ndikofunikira kwambiri pakukonzekera kuti muwone zodwala mu chithokomiro cha chithokomiro. Zowonadi, masabata oyambilira atatenga pakati, TSH imayamba kukhazikika mthupi, zomwe zimatsimikiziridwa ndikuwonekera kwa zosowa zatsopano m'thupi. Chizindikiro chachikulu cha TSH chimatsimikiziridwa patsiku lachiwiri mutabadwa mwana.

Tcherani khutu! Ngati thupi la mzimayi silikufuna ayodini, ndiye kuti kupangika kwa timadzi timeneti kumakhalabe komweko.

Pamene kusowa kwa ayodini kumawonedwa, kaphatikizidwe ka TSH kamachepetsedwa - ichi ndichizindikiro chosayenera pakukula kwa mwana. Woyamba kubereka atatenga pathupi, mwana wosabadwayo amadalira kwathunthu timadzi tating'onoting'ono ta mayi. Pakakhala vuto la kuchepa kwa mahomoni, makulidwe abwinobwino a mwana wosabadwa angachitike.

Izi ndizofunikira! Asanachotsedwe kwa mwana wakhanda ayenera kusanthula mwapadera kuti awonetse matenda - zam'tsogolo. Kusanthula kumachitika mwa kutenga magazi kuchokera kwa mwana kuchokera chidendene.

Kuti muchepetse ziwopsezo kwa mwana komanso mayi, mankhwala a mahomoni amaperekedwa, omwe amakhudzana ndi kukhazikitsidwa kwa L-thyroxine. Pankhaniyi, mlingo wa mankhwalawa umatsimikiziridwa ndi adokotala okha, ndipo mankhwala omwe amadzipaka okha amalephera. Munthawi ya kumwa mankhwala a mahomoni, mkazi amayenera kupereka magazi kuti awone kuchuluka kwa mahomoni pakapita milungu isanu ndi itatu iliyonse.

Malingaliro a subclinical hypothyroidism

Chifukwa chake, sikoyenera kuthana ndi matenda a subclinical hypothyroidism, ndibwino kukonza vutoli pasadakhale mwa kumwa thyroxine. Kulandila kwa mahomoniwa kumatha kokha pakubala. Chifukwa chake, ndikotheka kukhalabe ndi chitukuko cha mwana wosabadwayo. Ngati mayi yemwe ali ndi vutoli adaganiza zodzithandizira payekha, ndiye kuti chithandizo chotere sichingapereke zotsatira zilizonse ndipo pambuyo pake kubereka kudzakhala koopsa.

Gulu

Malinga ndikuvuta, mitundu itatu ya hypothyroidism imasiyanitsidwa:

1. SUBCLINICAL. Amadziwika ndi kusapezeka kwa zizindikiro ndi zizindikiro za matendawa. Magazi amatha kukhala ndi mahomoni abwinobwino a chithokomiro, koma nthawi zonse amakhala okwera kwambiri a TSH. Njira yokhayo ya hypothyroidism imakhudza osaposa 20% ya akazi.
2. ZOLEMAWA KAPENA ZINA. Nthawi zonse limodzi ndi thanzi labwino. Mlingo wa mahomoni m'magazi umatsitsidwa, koma TSH imakwezedwa.
3. KUMWAMBA. Amadziwika ndi nthawi yayitali ya matendawa pakalibe chithandizo chokwanira. Monga lamulo, zotsatira zake zimakhala zovuta.

Hypothyroidism pa nthawi yapakati ndiomwe imayambitsa kuchepa kwa metabolism. Popeza ma receptor a mahomoni a chithokomiro amapezeka pafupifupi thupi lonse, pali kusokonezeka komwe kumagwira ntchito ziwalo zambiri ndi machitidwe. Kukula kwake kumadalira kuchuluka kwa kuchepa kwa mahomoni. Ndi chifukwa chaichi kuti matendawa ndi ovuta kukayikira koyambirira, ndipo ndikofunikira kuti mwana wosabadwayo azitha kupeza kuchuluka kwa mahomoni a chithokomiro m'milungu 12 yoyambirira ya mimba, panthawi yopanga ziwalo zamkati.

Kuwongolera kwa amayi apakati omwe ali ndi hypothyroidism

Ngati mayi woyembekezera ali ndi matenda a chithokomiro, amapatsidwa dongosolo loyendetsera pakati:

1. Nkhani yokhudza kukhalabe ndi pakati ikuyendetsedwa.
2. Mzimayi amawonedwa ndi othandizira limodzi ndi endocrinologist.
3. Upangiri wabadwa umayikidwa, nthawi zambiri amniotic madzimadzi amatengedwa kuti awunikidwe kupatula kubadwa koyipa kwa mwana wosabadwayo.

1. Chithandizo chimayikidwa ngakhale mitundu yofatsa komanso ya asymptomatic.
2. Amayi onse omwe ali ndi nthawi yoyamba kubereka amalimbikitsidwa kuti azikonzekera ayodini.
3. Panthawi yonse yoyembekezera, kuchuluka kwa mahomoni kumayesedwa kangapo.
4. Amayi amapita kuchipatala cha amayi kukonzekera kuti akathetse vuto la njira yobala mwana, yomwe nthawi zambiri imakhala isanakwane. Pambuyo pobadwa, mwana amayenera kupatsidwa uphungu wa chibadwa.

Kodi zotsatira zake zingakhale chiyani kwa mwana?

Madzi a chithokomiro amakhala ndi chofunikira kwambiri pakupanga komanso kusasinthika kwa ubongo wa wakhanda. Palibe mahomoni ena omwe ali ndi vuto lofananalo.

Zotsatira zoyipa za hypothyroidism panthawi yoyembekezera

• chiopsezo chachikulu chochotsa mimbayo,
• kubereka
• kusokonekera kwa mtima,
• kusamva
• squint
• kubadwa kwa maliseche a ziwalo zamkati.
• kobadwa nako hypothyroidism, yomwe imayamba mwa ana obadwa kwa amayi omwe ali ndi hypothyroidism yosasinthika. Izi ndizotsatira zoyipa kwambiri kwa mwana wosabadwa, ndiye chifukwa chachikulu chokhazikitsidwa ndi cretinism. Cretinism ndimatenda omwe amayamba chifukwa cha hypothyroidism. Imawoneka ngati kuchedwa kwakula kwamaganizidwe ndi thupi, kuchedwa kuvala, kutsekeka bwino kwa mafelemu, nkhope yake imakhala yofanana ndi mbali zowoneka bwino, ziwalo zamthupi sizofanana, njira zolerera za mwana zimavutika

Pambuyo pozindikira kuti mwanayo wapezeka, mwana amamuika mankhwala kwa nthawi yayitali kuti athetse mankhwala omwe amalocha mahomoni a chithokomiro. Mankhwala atangoyambitsidwa kumene kwa mwana, ndiye mwayi waukulu wamaganizidwe ake. Ndipo, kotala lililonse la chaka, chithandizo chimayang'aniridwa - mwana amayesa kutalika, kulemera, kukula konse ndi kuchuluka kwa mahomoni.

WOPERESITSA HYPOTHYROIDISIS. Matenda osakhalitsa a ana obadwa kumene, omwe amadutsa palokha popanda kufufuza. Zimakhala zofala kwambiri m'magawo okhala ndi vuto la ayodini, mwa ana akhanda, ngati mayi adamwa mankhwala osokoneza bongo wa chithokomiro cha chithokomiro. Pankhaniyi, mwana amamulembera chithandizo monga hypothyroidism, ngati atafufuza mobwerezabwereza matenda akewo sanatsimikizike, onse amalephera.

Mawonekedwe a kayendetsedwe ka zinthu

Kuyambira kuyambira tsiku loyambirira, mayi wapakati amayenera kuwunika magazi pafupipafupi kuti awone kuchuluka kwa mahomoni. Thupi limayenera kupanga zinthu zokwanira, kotero kuti thupi la munthu wamkulu komanso mwana wosabadwayo ndi lokwanira. Ma mahomoni opangidwa ndi chithokomiro ndikofunikira kuti mapangidwe azovuta ndi kukulira kwa mluza.

Mimba yokhala ndi chithokomiro chokhala ndi chithokomiro ndimkhalidwe wofala kwambiri, matendawa amapezeka mwa amayi ambiri oyembekezera, nthawi zambiri amakhala woopsa. Madokotala ambiri sawona kuti ndizofunikira kumuchiza konse, poganiza kuti ndizokwanira kuyang'anira wodwalayo komanso kuyezetsa magazi pafupipafupi. Nthawi yomweyo, zotsatirapo za kubereka ndi hypothyroidism zimatha kukhala zoyipa kwambiri ngati vutoli likupita. Ngati pali zisonyezo, simungazengereze ndi kusintha kwachipatala kuchuluka kwamapangidwe a mahomoni.

Zoyambitsa, zotsatira zake

Pa nthawi ya pakati, magwiridwe antchito a chithokomiro amakwiya chifukwa chobala mwana wosabadwayo - nthawi yayitali ya thupi la mkazi imakhala yovuta kwambiri. Nthawi zina, chifukwa chake sichikhala momwe akazi aliri, koma mthupi, chizolowezi cha chithokomiro. Matendawa amatha kuchitika ngakhale asanakhale ndi pakati, koma musayang'anidwe kwa zaka. Mwanjira iliyonse yomwe mungasankhe mukabereka mwana, izi zimatha kukhala zotsatirapo zosasangalatsa kwambiri.

Ma mahomoni omwe amapangidwa ndi chithokomiro cha chithokomiro amakhudza kukula kwa machitidwe osiyanasiyana ndi ziwalo za mluza. Subclinical hypothyroidism pa nthawi ya pakati kumatha kubweretsa zosowa pakugwira ntchito kwamanjenje. Amadziwika kuti mwa ana omwe adwala kale ndi matendawa, azimayi, pafupifupi, amakhala ndi nzeru zapamwamba pang'ono kuposa omwe amabadwira kwa amayi athanzi. Kuphatikiza apo, kukhudzidwa kwa mwana wosabadwayo wa hypothyroidism panthawi yoyembekezera kumapangitsa kuti chithokomiro chikule. Mwana akhoza kukhala ndi mavuto chifukwa chogwira ntchito kuyambira atabadwa.

Chithunzi cha kuchipatala

Ndi zovuta zazing'ono, hypothyroidism imawonetsedwa makamaka machitidwe ndi kusintha kosinthika. Kusakhazikika kwamaganizidwe kwamphamvu kumamveka, nthawi zina malingaliro ofunikira amavutika, zochitika zimatsika kwambiri. Ngati matendawa ali olimba, izi zimakhudza mkhalidwe wamavuto, zomwe zimayambitsa kukhumudwa, nkhawa, mantha komanso kuzengereza.

Kungoganiza matenda komanso mavuto omwe mwana angakhale nawo pa nthawi ya hypothyroidism pa nthawi yomwe ali ndi pakati, muyenera kudziwa bwino za momwe mzimayi angadziwire kuti mukuwonetsetsa zomwe zikuchitika. Mahomoni T3, T4 ndi ofunika kwambiri. Nthawi zambiri, kuchuluka kwa mitundu yoyamba ya mahomoni kumacheperachepera, pomwe lachiwiri limasungidwa bwino.

Yang'anirani mkhalidwewo

Amakhulupirira kuti njira yofunikira kwambiri pakubala ndi kukonzekera mwana pasadakhale. Izi zimaphatikizapo kuwunika kwathunthu kwa zomwe zikuwonetsa, kuphatikizapo ntchito yogwira gland. Izi zimakuthandizani kuzindikira zovuta zilizonse ndikuwonetsa pasadakhale mtundu wanji wa chindapusa chofunikira chothandizira kupewa zotsatira za mwana wosabadwayo. Hypothyroidism pa nthawi ya pakati imatha kukhala cholepheretsa chizolowezi. Komabe, mawonekedwe owopsa kwambiri ndi omwe amapanga pambuyo poti wabereka.

Zokhudza mwana wosabadwayo wa hypothyroidism pa nthawi yomwe ali ndi pakati zimatha kuyambitsa chitukuko cholakwika, chotsika. Amadziwika kuti odwala omwe ali ndi matendawa ana omwe alibe thanzi, owonda kwambiri nthawi zambiri amabadwa. Komabe, kutali ndi vuto lalikulu kwambiri lomwe likufotokozedwa. Zotsatira zamkati wamanjenje zimakhala zoyipa kwambiri.

Zovuta: chiyani

Zotsatira zotsatirazi za hypothyroidism panthawi yobereka kwa mwana zimadziwika:

• onenepa pobadwa,
• kusakhazikika, kutulutsa koyamba kwa placenta,
• luntha lotsika
• kulakwitsa
• mitundu yayikulu ya toxicosis,
• kusokonekera
• kubadwa kwa mwana wakufa
• matenda obadwa nawo a chithokomiro.

Kubala mwana ndi zovuta

Zotsatira za hypothyroidism panthawi yobereka kwa mwana ndi amayi ndizosasangalatsa kwambiri. Amadziwika kuti ndi matendawa pamakhala kuthekera kwakukulu kwa kutulutsa magazi koopsa kwa mzimayi amene akubereka. Zinthuzi ndizowopsa kotero kuti zikuwopseza moyo wa amayi ndi mwana. Njira yokhayo yochepetsera zoopsa ndikuyambitsa kulipira kwakanthawi mimbayo itatha.

Pofuna kupatula zovuta za hypothyroidism pa nthawi yomwe mayi ali ndi pakati, ndikofunikira kuti nthawi zonse muzipita kukakumana ndi katswiri pakukonzekera kwa mwana komanso panthawi ya bere, kuyang'anira zizindikiro, idyani moyenera ndikusamalira nokha. Nthawi yokhayo yolowerera pachipatala imathandizira kwambiri kuti athe kupewa mavuto azaumoyo.

Hypothyroidism: ngozi kwa mayi

Zotsatira za hypothyroidism panthawi yoyembekezera kwa mwana zawoneka kale pamwambapa. Kwa mayi, amatha kukhala oyipa kwambiri, kuphatikizaponso mwayi woti afe. Ma mahomoni opangidwa ndi chithokomiro ndiofunika kwambiri pa thanzi la munthu, ndipo zimawonekera makamaka mwana akabadwa. Ndikusowa kwa zinthu zomwe zimapangidwa ndi gland, maselo amafuta amadzikundikira m'chiwindi, zomwe zimapangitsa kuti mafuta a magazi a magazi azizungulira. Izi, zimakwiyitsa atherosulinosis, mitsempha yamagazi imavutika, ndipo chiopsezo cha stroko chikuwonjezeka.

Hypothyroidism, yokhala ndi hypothermia kapena kuthamanga kwambiri, imabweretsa vuto la hypothyroid. Kupanikizika kumachepa, zimachitika kuti zimachitika pang'ono, mkaziyo amasiya kuzindikira. Izi zikuopseza moyo. Komanso matendawa amatha kupangitsa kuti mwana azigwira ntchito mopitirira muyeso.

Hypothyroidism ndi chiwopsezo kwa mwana wosabadwayo

Ngati matendawa awonekera munthawi yoyamba kubereka, kuopsa kwa khanda kumakula kwambiri. Izi ndichifukwa choti mahomoni omwe amapangidwa ndi chithokomiro cha chithokomiro ndi chimodzi mwazinthu zazikulu zomwe zimapangira makina azinthu zazing'ono. Kuperewera kwa mahomoni kumakhudza dongosolo lamanjenje. Popita nthawi, mwana amatha kuwonetsa matenda amitsempha, kuthekera kwa zodwala zam'mutu ndizambiri. Izi zitha kupewedwa ndi chiphuphu chamankhwala choyang'aniridwa ndi dokotala.

Nthawi zambiri hypothyroidism imadzetsa kuchepa kwamphamvu kwa mluza m'mbelekero. Ndikosatheka kuneneratu kuti ndi ati omwe adzavutike ndi izi. Ngati chithokomiro chodwala, ndiye kuti m'tsogolo mwana adzamwa mankhwala a mahomoni moyo wake wonse.

Hypothyroidism: mawonetseredwe

Mutha kulingalira za matendawa ngati mawonedwe otsatirawa azindikirika:

• kufooka
• miyendo yam'manja
• kutupa kwa kamwa
• kusintha kwa mawu
• kutentha kwachilendo
• zovuta za chopondapo.

Ndi chithokomiro chosakwanira, mtima ndi mitsempha yamagazi imavutika kwambiri, kumatulutsa, kuwonongeka kwa magazi ndikotheka. Mulibe okosijeni wokwanira mu placenta, palibe michere ina yokwanira kuti apange chiwalo chatsopano.

Pathology: mawonekedwe

Ngati mawonekedwe akuthamanga apezeka, zotsatira zoyipa zaubongo ndizotheka, mapangidwe abwinobwino omwe amasokonezedwa ndi kusowa kwa mahomoni m'magazi. Kuphatikiza apo, matendawa amakwiya:

• myelination of neurons,
• apoptosis
• makanema ojambula
• kuyenda kwa mahomoni.

Ndi chitukuko cha hypothyroidism pakadali pano, mwayi wokhala wolakwika, kuchotsa mimbayo, komanso kubadwa kwa mwana wakufa, ukuwonjezeka. Komabe, ngakhale mwana atapulumuka, kwanthawi yayitali machitidwe ake amkati ali pachiwopsezo ndipo sangathe kukula bwino.

Mphamvu yamanjenje imavutika: chiyani ndipo motani?

Ndi hypothyroidism, mwayi wokhala ndi endros cretinism ndiwambiri. Kuphwanya uku nthawi zambiri kumawonetsedwa ndi zochitika zotsatirazi:

• kulephera kuyankhula
• ugonthi
• kubweza m'maganizo
• kusokonekera kwamaso (squint),
• diplegia yapamwamba.

Nthawi zina, izi zimakwiyitsa kwambiri. Njira yokhayo yopulumutsira mwana pamavuto awa ndi kukayezetsa pafupipafupi. Komabe, ndizosatheka kutsimikizira kusowa kwathunthu kwa ma pathologies, mutha kungochepetsa chiwopsezo cha kupezeka kwawo.

Moyang'aniridwa ndi dokotala

Malangizo oyamba akangotulutsidwa, tifunika kufunsa katswiri. Madotolo amayang'ana mayeserowo ndikuwongolera momwe zinthu ziliri. Kuti muchepetse zotsatira zosasangalatsa, ndikofunikira kuti pakhale zochitika zoyenera kwa mayi wapakati, zomwe ndi zomwe chipatala chimachita.

Kuti mupeze mawonekedwe a matendawa, muyenera kupanga ma anamnesis, kuphatikizapo kuphunzira za kubadwa kwa makolo - munthawi zina, kukonzekera zamtunduwu ndizomwe zimayambitsa matenda a chithokomiro. Kufufuza kwakuthupi kumachitika.

Dongosolo: chiyani ndipo motani?

Choyamba, adokotala amawunika wodwalayo akubwera, akumaganizira ngakhale zinthu zomwe zimawoneka ngati zazing'ono. Unikani maonekedwe, chekeni khosi, phunzirani momwe mafuta osakanikira amapangidwira. Onetsetsani kuti mukufufuza madera omwe ali pafupi ndi chithokomiro cha chithokomiro ndi zala zanu. Kenako wodwalayo akumumvetsera, akuyang'ana kukoka kwake, kukula kwa kugunda kwa mtima, mulingo wa kukakamizidwa.

Mavuto azaumoyo amatha kuonekera ngakhale ndikomwe mayiyo amawona. Monga lamulo, hypothyroidism imawonetsedwa ndi kutupa, kutupa kwa nkhope, kudzimbira. Khungu limasunthika, ma mota amagwira ntchito ngati kanema wapaulendo. Matchulidwe amphwanyidwa, liwiro la kulankhula limatsika, wodwalayo amalankhula ndi hoars. Matenda amisala amathanso kutha.

Kuti muwone zomwe zimayambitsa matendawa, muyenera kuchita mayeso a labotale. Choyamba, amayang'ana magazi, kuwulula kuchuluka kwa mahomoni, coagulability, kuchuluka kwa ayodini. Kuunika kwamomweku kumafunika. Kenako, kafukufuku wothandiza amachitika, pomwe wodwalayo amatumizidwa kuti adzagwiritse ntchito ultrasound, electrocardiogram. Ngati mimba idakonzedweratu, matenda osiyanasiyana ndi oyenera. Kuchiza kwa mayi woyembekezera kumatheka pokhapokha kuyang'aniridwa ndi dokotala. Sizovomerezeka kuti mupatseni nokha mankhwala, sankhani Mlingo kapena musinthe chithandizo chomwe dokotala mwasankha.

Chifukwa chiyani subclinical hypothyroidism imayamba?

Chifukwa chachikulu chomwe matendawa amakulira ndi njira ya pathological mu chithokomiro cha chithokomiro. Nthawi zina, imatha kukhazikika pang'onopang'ono kuwonongeka kwa pituitary gland.

Zoyambitsa matenda oopsa:

1. Matenda obadwa nawo.
2. Autoimmune chithokomiro.
3. Kuperewera kwa ayodini m'thupi la mkazi.
4. Khansa ya chithokomiro.
5. Kupezeka kwa neoplasms mu chithokomiro cha chithokomiro.
6. Tizilombo timene timakhudzidwa ndi radiation.
7. Chithokomiro.

Yang'anani! Ngati pa nthawi ya pakati mtsikana wapezeka ndi subclinical hypothyroidism, ndiye kuti, choyambirira, chithandizo cholowa m'malo chimadziwika.

Hypothyroidism yoyamba komanso yachiwiri

Subclinical hypothyroidism imakhala ndi zofooka zochepa, zomwe zimadziwonetsera zokha mwa mawonekedwe osokoneza bongo, omwe amayamba kudziwonetsa ngati kukhumudwa. Kuphatikiza apo, mwa mayi yemwe akudwala matendawa, zochita zimachepetsedwa ndipo malingaliro operewera amawonekera. Chifukwa chake, ngati mkazi ali ndi vuto lachilendo kwa iye, ndiye kuti chithokomiro chimayesedwa kaye.

Mtundu wa subclinical wa pathology umadziwika ndi kuwonjezeka kwakukulu kwa T3, ngakhale kuti T4 imakhalabe mkati mwa mtundu wamba. Njira yachipatala ya hypothyroidism imapezeka mosavuta kuposa subclinical (pafupifupi asymptomatic). Matenda obisika oterewa amatha kuonekera mwa zochita za mkazi:

• kusokonekera, komwe kumadziwoneka kawirikawiri,
• malankhulidwe oletsedwa
• kusayenda kwamayendedwe,
• mkhalidwe wopsinjika
• maonekedwe onenepa kwambiri
• kusokoneza kwamtima.

Zizindikiro zonse pamwambazi ndizovuta kutengera chiwonetsero cha matenda oopsa, chifukwa chake, kutsimikizika kumatsimikiziridwa pokhapokha kuyesedwa kwathunthu komanso, chidziwitso cha chithokomiro.

Hypothyroidism pa nthawi yapakati - zomwe mtsikana aliyense ayenera kudziwa

Hypothyroidism pa nthawi yapakati si chinthu chosowa komanso chowopsa. Ichi ndi matenda a endocrine omwe amayamba chifukwa cha kuchepa kwamphamvu kwa mahomoni a chithokomiro. Pali zinthu zosiyanasiyana zomwe zimayambitsa matenda.

Matenda a chithokomiro mwa akazi ndi ochulukirapo ka 10-15 kuposa amuna. Vuto lalikulu la matendawa ndikuphwanya kwa kubereka kwa azimayi, ngakhale atakhala ndi matendawa. Hypothyroidism imapezeka mwa amayi atatu aliwonse omwe ali ndi vuto losabala.

Dziwani kuti nthawi zina kukhala ndi pakati kumatha kuyambitsa matenda a chithokomiro, nthawi zambiri izi zimachitika m'magawo a ayodini.

Zifukwa zonse zitha kugawidwa m'magulu awiri - yoyamba komanso yachiwiri.

Hypothyroidism yoyamba. Poterepa, chomwe chimayambitsa matendawa ndi chithokomiro cha chithokomiro.

• kuwonongeka kwa chithokomiro
• yotupa, kuphatikizapo autoimmune chithokomiro. Poyamba, autoimmune thyroiditis imakhala asymptomatic, ndiye kuti zizindikiro za hypothyroidism zimawonekera,
• kuphwanya kapangidwe ka gland pambuyo poyambira ayodini
• neoplasms
• zotheka pambuyo pa ntchito - matendawa amakula chifukwa cha kuchepa kwa kukula kwa chiwalo.

Hypothyroidism yachiwiri. Ndizovuta zamatenda a chiwalo china, pomwe chithokomiro palokha chimakhala chathanzi. Zomwe zimayambitsa yachiwiri ya hypothyroidism ndimatenda amisala, omwe amachititsa kuti pakhale kuchuluka kosakwanira kwa mahomoni opatsirana a chithokomiro (TSH), kapena chithokomiro chowonjezera cha chithokomiro, chomwe hypothalamus imayang'anira kupanga kwa TSH.

• zotupa
• kusokonezeka kwa magazi,
• opaleshoni kuwonongeka kapena kuchotsedwa kwa gawo la pituitary gland,
• malisidwe obadwa nawo a pituitary gland,

• chithandizo cha nthawi yayitali ndi glucocorticoids (waukulu Mlingo wa dopamine).

Malinga ndikuvuta, mitundu itatu ya hypothyroidism imasiyanitsidwa:

1. SUBCLINICAL. Amadziwika ndi kusapezeka kwa zizindikiro ndi zizindikiro za matendawa. Magazi amatha kukhala ndi mahomoni abwinobwino a chithokomiro, koma nthawi zonse amakhala okwera kwambiri a TSH. Njira yokhayo ya hypothyroidism imakhudza osaposa 20% ya akazi.
2. ZOLEMAWA KAPENA ZINA. Nthawi zonse limodzi ndi thanzi labwino. Mlingo wa mahomoni m'magazi umatsitsidwa, koma TSH imakwezedwa.
3. KUMWAMBA. Amadziwika ndi nthawi yayitali ya matendawa pakalibe chithandizo chokwanira. Monga lamulo, zotsatira zake zimakhala zovuta.

Hypothyroidism pa nthawi yapakati ndiomwe imayambitsa kuchepa kwa metabolism. Popeza ma receptor a mahomoni a chithokomiro amapezeka pafupifupi thupi lonse, pali kusokonezeka komwe kumagwira ntchito ziwalo zambiri ndi machitidwe. Kukula kwake kumadalira kuchuluka kwa kuchepa kwa mahomoni. Ndi chifukwa chaichi kuti matendawa ndi ovuta kukayikira koyambirira, ndipo ndikofunikira kuti mwana wosabadwayo azitha kupeza kuchuluka kwa mahomoni a chithokomiro m'milungu 12 yoyambirira ya mimba, panthawi yopanga ziwalo zamkati.

Ngati mayi woyembekezera ali ndi matenda a chithokomiro, amapatsidwa dongosolo loyendetsera pakati:

1. Nkhani yokhudza kukhalabe ndi pakati ikuyendetsedwa.
2. Mzimayi amawonedwa ndi othandizira limodzi ndi endocrinologist.
3. Upangiri wabadwa umayikidwa, nthawi zambiri amniotic madzimadzi amatengedwa kuti awunikidwe kupatula kubadwa koyipa kwa mwana wosabadwayo.

1. Chithandizo chimayikidwa ngakhale mitundu yofatsa komanso ya asymptomatic.
2. Amayi onse omwe ali ndi nthawi yoyamba kubereka amalimbikitsidwa kuti azikonzekera ayodini.
3. Panthawi yonse yoyembekezera, kuchuluka kwa mahomoni kumayesedwa kangapo.
4. Amayi amapita kuchipatala cha amayi kukonzekera kuti akathetse vuto la njira yobala mwana, yomwe nthawi zambiri imakhala isanakwane. Pambuyo pobadwa, mwana amayenera kupatsidwa uphungu wa chibadwa.

Madzi a chithokomiro amakhala ndi chofunikira kwambiri pakupanga komanso kusasinthika kwa ubongo wa wakhanda. Palibe mahomoni ena omwe ali ndi vuto lofananalo.

Zotsatira zoyipa za hypothyroidism panthawi yoyembekezera

• chiopsezo chachikulu chochotsa mimbayo,
• kubereka
• kusokonekera kwa mtima,
• kusamva
• squint
• kubadwa kwa maliseche a ziwalo zamkati.
• kobadwa nako hypothyroidism, yomwe imayamba mwa ana obadwa kwa amayi omwe ali ndi hypothyroidism yosasinthika. Izi ndizotsatira zoyipa kwambiri kwa mwana wosabadwa, ndiye chifukwa chachikulu chokhazikitsidwa ndi cretinism. Cretinism ndimatenda omwe amayamba chifukwa cha hypothyroidism. Imawoneka ngati kuchedwa kwakula kwamaganizidwe ndi thupi, kuchedwa kuvala, kutsekeka bwino kwa mafelemu, nkhope yake imakhala yofanana ndi mbali zowoneka bwino, ziwalo zamthupi sizofanana, njira zolerera za mwana zimavutika

Pambuyo pozindikira kuti mwanayo wapezeka, mwana amamuika mankhwala kwa nthawi yayitali kuti athetse mankhwala omwe amalocha mahomoni a chithokomiro. Mankhwala atangoyambitsidwa kumene kwa mwana, ndiye mwayi waukulu wamaganizidwe ake. Ndipo, kotala lililonse la chaka, chithandizo chimayang'aniridwa - mwana amayesa kutalika, kulemera, kukula konse ndi kuchuluka kwa mahomoni.

WOPERESITSA HYPOTHYROIDISIS. Matenda osakhalitsa a ana obadwa kumene, omwe amadutsa palokha popanda kufufuza. Zimakhala zofala kwambiri m'magawo okhala ndi vuto la ayodini, mwa ana akhanda, ngati mayi adamwa mankhwala osokoneza bongo wa chithokomiro cha chithokomiro. Pankhaniyi, mwana amamulembera chithandizo monga hypothyroidism, ngati atafufuza mobwerezabwereza matenda akewo sanatsimikizike, onse amalephera.

Popeza ndizovuta kukayikira matenda kumayambiriro kwa chitukuko chake, adotolo amatsegula mbiri ya mzimayi: zovuta za chithokomiro, kutaya pathupi, kusabereka, kubereka kwatsopano kwa mwana wobadwa kale.

Kuti muwonetsetsetsetsetsetsetsetsetse, ndikokwanira kupereka magazi kwa mahomoni - kuzindikira gawo lokwera la TSH ndikokwanira, popeza TSH yokwezeka ndiye chizindikiro chovuta kwambiri cha hypothyroidism, ngakhale ndi maphunziro ake apadera.

Amayi onse amafunika kulandira chithandizo mosachedwa, ngakhale atadwala matendawa.

Kuthandizira mankhwala othandizira umuna kumachitika ndi ma analogue opanga mahomoni a thyroxine Levothyroxine. Chifukwa chakuti pakakhala pathupi kufunika kwa thupi la mkazi kukhathamiritsa kwa timadzi timeneti, mankhwalawa amawerengedwa molingana ndi zotsatira za kusanthula, poganizira kulemera kwa thupi la mkazi. Pa nthawi yomwe mayi ali ndi pakati, mayi amafunika kukhalabe ndi TSH ya 2 mU / L, T4 ndizabwino, koma bwino pamalire ake apamwamba.

Nthawi zambiri, kwa mkazi yemwe ali ndi udindo, mlingo wa mankhwalawa umachulukitsidwa ndi theka. Kenako, masabata onse a 8-12 atatenga pathupi, mayeso a mahomoni amaperekedwa, kutengera zotsatira zomwe dokotala amayang'anira kuchuluka kwa mankhwalawa. Pambuyo pa milungu 20 ya mimba, mlingo umakulanso ndi 20-50 mcg wina. Mankhwalawa amatengedwa m'mawa (ndi toxosis yomwe imasanza kwambiri, Levothyroxine amatha kusinthidwa kukhala maola a nkhomaliro). Mankhwalawa alibe mphamvu pa mwana wosabadwayo, samatha kuyambitsa bongo. Kuphatikiza apo, mkazi ayenera kutenga kukonzekera kwa ayodini (mwachitsanzo - Iodomarin).

Ngati matendawa amalipiridwa mokwanira, ndiye kuti kulera sikumaperekedwa kwa mkazi.

ZINSINSI ZA IODINE. Mankhwala omwe amadziwika kwambiri kuti abwezeretse akusowa kwa ayodini m'thupi ndi Iodomarin, amapezeka pamapiritsi okhala ndi ayodini a 100 ndi 200 mg. Mankhwalawa amatha kugwiritsidwa ntchito popewa kupewa matenda, komanso mankhwala.

Iodomarin imagwiranso ntchito popanga mahomoni a chithokomiro, ndikupereka iodination ya kutsogola kwa mahomoni a chithokomiro. Malinga ndi momwe limagwirira ntchito, imalepheretsa kapangidwe ka TSH, kuti tiletse kukula kwa chithokomiro.

ZITSANZO:

• Iodomarin yoletsa kupewa iyenera kutengedwa panthawi ya kukula kwambiri, i.e. ana, achinyamata, amayi apakati ndi oyembekezera.
• Kukonzekera kubereka.
• Pambuyo pochotsa chithokomiro, komanso njira yochizira ndi mahomoni.
• Iodomarin imaphatikizidwa mu regimen yothandizira kuperekera poyizoni, chomwe ndi chifukwa cha kuchepa kwa ayodini.
• Kuopseza kwa kuyamwa kwa ayodini.
• Kuphatikiza apo, mankhwalawa amathandizidwa ndi syphilis, matenda amkati, kutsika kwa ziphuphu ndi matupi akhungu, omwe ali ndi matenda am'mimba, monga chiyembekezo.

NJIRA YOTHANDIZA. Iodomarin imapatsidwa mapiritsi 1/2 (50 mg) kwa akhanda ndi ana opitirira zaka 12, mapiritsi a 1-2 (100-200 mg) amaperekedwa kwa achinyamata. Amayi oyembekezera komanso oyamwitsa Iodomarin amawayika 200 mg tsiku lililonse.

Tidawunikiranso ndemanga za makolo pa makolo. Amayi onse amasiya ndemanga zabwino, akumati thanzi lawo litatha kumwa mankhwalawa, amamva kuwonjezeka mphamvu ndi nyonga. Tapeza ndemanga pomwe makolo adanena kuti mutatha kumwa mankhwalawo, zotsatira za kuyesa kwa ultrasound zidawonetsa kusintha kwa mwana wosabadwayo m'njira yabwino. Palibe ndemanga zoyipa pagawo la makolo.

Timalimbikitsa amayi onse kuti athetse kusowa kwa ayodini ndi Iodomarin pa nthawi yoyembekezera komanso mkaka wa m'mawere, ndipo azimayi omwe ali ndi hypothyroidism ayenera kuyamba kulandira chithandizo.

1. 
   Efimov A.S., Bodnar P.N., Zelinsky B.A. Endocrinology, sukulu ya Vishcha - M., 2014 .-- 328 p.
2. 
   Chernysh, Pavel Glucocorticoid-metabolic theory of 2 shuga mellitus / Pavel Chernysh. - M: LAP Lambert Academic Publishing, 2014 .-- 820 p.
3. 
   Chernysh, Pavel Glucocorticoid-metabolic theory of 2 shuga mellitus / Pavel Chernysh. - M: LAP Lambert Academic Publishing, 2014 .-- 901 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka patsamba lino kuti athetse zovuta koma osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Zimayambitsa hypothyroidism

Hypothyroidism ndi kuchepa kwa mahomoni a chithokomiro mwa amayi apakati, monga lamulo, amakula pazifukwa zomwezi monga mwa anthu ena. Izi zitha kukhala:

• Kuchotsa onse kapena gawo la chindayo chifukwa cha kuwoneka ngati chotupa cha khansa kapena maselo,
• Kuchepetsa kukwiya kwa chithokomiro kapena kuchiritsa kwa chithokomiro chake cha ayodini wa radioactive,
• Matenda osiyanasiyana amthupi otupa,
• Kudziletsa
• Akusowa kwa ayodini m'madzi ndi / kapena chakudya,
• Kuphwanya kwa pituitary England.

Mu thupi la mayi wapakati pali zinthu zingapo zomwe zimayambitsa mwachindunji matenda a hypothyroidism, kapena kuchita ngati zotsogolera ku matenda awa:

1. Mthupi la mayi woyembekezera, chifukwa cha ntchito ya ma estrogens, kuchuluka m'magazi a protein ya thyroxin-binding globulin. Puloteni iyi imamangiriza mahomoni a mahomoni ndikuwongolera kuchepa kwa kufalikira kwa mahomoni aulere m'magazi, omwe amagwira ntchito machitidwe ake,
2. Kugwira ntchito kwa chithokomiro cha chithokomiro kumayendetsedwa ndi ma pituitary gland, imapangika ndi tropic hormone thyrotropin (TSH). Mukachulukitsa timadzi tambiri timene timatulutsa. Nthawi yapakati, thupi la mzimayi limatulutsa chorionic gonadotropin, yomwe imalimbikitsa kwambiri chithokomiro cha chithokomiro. Kukopa kotereku kumapangitsa kuti chithokomiro cha pituitary chichepetse kupanga kwa mahomoni opatsa chithokomiro, popeza momwe amathera. Pakutha kwa pakati, kuphatikiza kwa chorionic gonadotropin kumayima, ndipo ndulu ya pituitary silingathe kupanga TSH. Zotsatira za izi ndi kupangidwa kwa hypothyroidism,
3. Mu theka lachiwiri la pakati, kuphatikiza kwa michere yapadera ya placenta, yomwe ili ndi ntchito yayikulu, imayamba m'thupi la mkazi. Izi zingayambitse kusintha kwa mahomoni a chithokomiro kukhala mankhwala osagwira.
4. Ndikofunika kwambiri kuti mkazi nthawi yoyembekezera apeze ayodini wokwanira. Pa nthawi yobereka, thupi limayamwa mu mkodzo, ena amapatsidwa placenta. Izi zimapangitsa kuti pakhale kuperewera kwa ayodini m'thupi la mayi wapakati, chifukwa chake hypothyroidism imatha kuwoneka.

Mfundo zazikuluzikulu za chithandizo

Monga lamulo, mankhwalawa a chithokomiro hypeleloction ndikugwiritsa ntchito moyo wonse wa mahomoni a chithokomiro: levothyroxine kapena thyroxine.

Mlingo umayesedwa payekhapayekha - woyamba, dokotala amamulembera wodwalayo mlingo wochepa, kenako amadzuka sabata lililonse la 6-8 mpaka mulingo wokwanira. Amatanthawuza mfundo zomwe zidzasinthe chida chotayika cha chithokomiro.

Pa nthawi yoyembekezera, chithandizo cha hypothyroidism chimaphatikizanso kugwiritsa ntchito mankhwala othandizira ma hormone, komabe, mfundo zamankhwala ndizosiyana kotheratu. Amayi oyembekezera omwe ali ndi matenda a "hyperthyroidism", kuyambira tsiku loyamba la mankhwala, levothyroxine amawerengera mlingo woyenera.

Kuphatikiza apo, ngati mayi adawonetsa hypothyroidism ngakhale mwana asanabadwe, ndipo adatenga timadzi ta muyezo, ndiye kuti atatenga pakati ayenera kutenga nthawi yayitali kuchuluka kwa timadzi tambiri, amatenga Mlingo 9 miyezi yonse.

Mfundoyi ndiyofunika kwambiri kuti muchiritse bwino mankhwala, chifukwa theka zoyambirira zam'mimba thupi la mwana limakhudzidwa ndi chilichonse, ngakhale chosafunikira kwambiri, kuchepa kwa thyroxine.

Tchulani chinthu chimodzi chofunikira: mayi sayenera kungowonetsa ziwonetsero zoonetsa, komanso mankhwalawa panthawi yobereka.

Kuphatikiza pa kugwiritsa ntchito kwa mahomoni ake panthawi yake, hypothyroidism pa nthawi ya pakati pamafunika kusintha kwa zakudya:

1. Ndikofunikira kuchepetsa kuchuluka kwa chakudya chamafuta omwe amaperekedwa: ma muffin, chokoleti ndi mafuta a ufa,
2. Ndikofunikira kuchepetsa kuchuluka kwamafuta omwe amadya: nyama, nsomba, nyama zosuta, mafuta anyama.
3. Zikuwonetsa kuchuluka kwa mapuloteni,
4. Pazakudya muyenera kuyambitsa mkaka wopanda mankhwala,
5. Wonjezerani kudya kwanu kwamafuta ndi mavitamini.

Kuphatikiza apo, madokotala amalimbikitsa kuchepetsa kuchuluka kwa mchere womwe umagwiritsidwa ntchito patsiku, komanso kumwa madzi. Izi ndizofunikira kuchepetsa chiopsezo cha myxedema.

Kuopsa ndi zotsatira za hypothyroidism

Kwa thupi la mayi woyembekezera, mahomoni a chithokomiro ndiofunika kwambiri. Kuperewera kwa mahomoni otere kumabweretsa zotsatira zowopsa komanso zoyipa kwa iye mwini ndi mwana wake wosabadwa. Kuthekera kwa kukhala ndi matenda akulu mu wakhanda kumawonjezereka.

Zowopsa zonse za hypothyroidism kwa mayi ndi ana ake zitha kugawidwa m'magulu angapo

Mavuto omwe amawoneka mwa mayi wapakati:

• Kuchepetsedwa mu kukula kwa intrauterine kwa mwana chifukwa cha kuchepa kwa mahomoni a thyroxine,
• Kutupa kwa magazi
• Magazi oopsa - kuthamanga kwa magazi komwe kumawonekera nthawi yapakati,
• Kukhazikika kapena kuzungulira kwa chimbudzi,
• Kubadwa mwana asanabadwe kapena kulemera kochepa
• Chigawo cha Kaisareya,
• Imfa ya fetal nthawi yapakati kapena pobereka,
• Nthawi zina kuchotsa pakamodzi.

Mavuto omwe amapezeka mwa mwana yemwe ali ndi amayi omwe ali ndi hypothyroidism:

• Matenda a chitukuko cha,
• Congenital hypothyroidism,
• Mavuto akukulira kwa maluso a psychomotor, nthawi zina amakhala ndi malingaliro abwinobwino ammbuyo.

Chofunikira: ngati hypothyroidism imawoneka mwa mkazi panthawi yopanga pakati, ndiye kuti mwayi wokhala ndi pakati ndi wotsika kwambiri.

Izi zimagwirizanitsidwa ndi kuphwanya kwa dzira, nthawi zina ndi hypothyroidism mwa amayi ena osabereka.