Zizindikiro mu akhanda ndi kobadwa nako hypothyroidism

Munkhaniyi muphunzira:

Congenital hypothyroidism nthawi zambiri imapezeka m'mwana ndipo zomwe zimayambitsa nthawi zambiri sizisintha. Komabe, mlingo wosankhidwa wa levothyroxine m'malo mwake umathetseratu mavuto obwera chifukwa cha thupi.

Zoyambitsa Congenital Hypothyroidism

Mitu ikuluikulu ndi:

Kusowa / Kukula kwa chithokomiro chifukwa cha majini,
Matenda amtundu mu biosynthesis ya mahomoni a chithokomiro,
Kuperewera kapena kuyamwa kwa ayodini m'zakudya za mayi woyembekezera kungayambitse matenda obwera kumene,
Kuchuluka kwa thio ndi isocyanates, komanso cyanogenic glycosides, mu chakudya. Ndi mwambo kuzitcha zinthuzi kumalo azachipatala strumogenic ndipo zili wamba, Brussels zikumera ndi kolifulawa, canola, mpiru, mbatata zokoma ... Mndandandawu ukhoza kupitilizidwa, koma izi sizikutanthauza konse kuti panthawi yomwe ali ndi pakati zinthu izi siziyenera kuperekedwa kwa zakudya. Ndikokwanira kuti tisawawononge ochuluka.
Nthawi zambiri, kuyamwa ayodini wapakati yemwe mayi woyembekezera amapereka. Kuyambira pafupifupi masabata 10-12, chithokomiro cha fetal chimayamba kale kudziunjikira ayodini, kuphatikiza ma radioactive,
Chithandizo chocheperako komanso chochepetsetsa chobadwa nacho cha hypothyroidism ndicho matenda a chithokomiro cha chithokomiro. Pankhaniyi, pali TSH yambiri, ndi T3, ndi T4 m'magazi, koma hypothyroidism imawonedwabe. Mabanja mazana awiri okha omwe ali ndi mtundu uwu wa hypothyroidism wobadwira omwe akufotokozedwa.

Congenital hypothyroidism, ngati imakhazikitsidwa mwa mwana, imadziwika kuti cretinism. Zowonadi, kusowa kwa mahomoni a chithokomiro kumachepetsa kukula kwa malingaliro a munthu m'maganizo. Myxedema amadziwika kuti amakhala ndi vuto lalikulu la hypothyroidism, kuphatikizapo kubereka, pomwe mawonekedwe a hypothyroid kapena myxedema edema amakula.

Zizindikiro

Maonekedwe akhanda ndi odziwika bwino kotero kuti katswiri wodziwika bwino wa matenda a neonatologist akuwonetsa kuti wapeza kale matenda ake potsatira mayeso osavuta:

Kuchuluka kwa zatsopano kumakhala kwachilendo kapena kumalire ake,
Kutupa kwamiyendo, manja, nkhope zimawonedwa. Khungu lakuda la mwana likuwoneka bwino kwambiri poyerekeza ndi ana ena atsopano,
Ikakhudzidwa, kutentha kwapansi mwadzidzidzi kumamveka,
Mwana amene wabadwa ndi hypothyroidism ndi waulesi, amalira pang'ono, wogonthetsa thupi amakhala wopanda mphamvu, yemwe nthawi zambiri amasokonezedwa ndi mtima wofooka.
Komabe, mwana akayamba kukula kwambiri. Kulemera kwa thupi sikukula chifukwa cha mafuta, koma chifukwa cha kuchuluka kwa edema. Ndi kobadwa nako hypothyroidism mwa onse obadwa kumene, mwana, ndi munthu wamkulu, zinthu zomwe sizili zovulaza koma sizitha kusangalatsa kuti madzi azikhala ndi mafuta osaneneka. Chifukwa cha izi, edema yokhala ndi hypothyroidism iliyonse imakhala yothina kwambiri, khungu limawoneka lothinthwa.

Zambiri zodalirika za labotale sizingatheke kuposa masiku 4-5, chifukwa izi zisanachitike, mahomoni a amayi amatha kupezeka m'magazi a mwana wakhanda. Pali zingwe zoyeserera, dontho la magazi limayikidwa kwa iwo, omwe mwa akhanda amatengedwa kuchokera zidendene. Ngati owonjezera a TSH apezeka mwanjira imeneyi, ndiye kuti matendawo adakhazikika.

Gawo lotsatira ndikukhazikitsa chomwe chimayambitsa kubadwa kwa thupi, popeza chithandizo chimadalira m'njira zambiri. Congenital hypothyroidism, ngati "ili pakatikati," imaphatikizidwa ndi kuperewera kwa adrenal kusakwanira. Izi ndichifukwa choti vutoli lili mu hypothalamus (gawo laubongo, dongosolo lamanjenje lamkati), lomwe matendawa salimbikitsa gren adrenal kapena gland ya chithokomiro. Pankhaniyi, ndikwabwino kupatsa mahomoni a chithokomiro, koma TSH, komanso mosakanikirana ndi mahomoni a adrenal, omwe amaperekedwa koyamba. Mwamwayi, kubereka kwapakati pa hypothyroidism ndikosowa kwenikweni.

Losabadwa kobadwa nako hypothyroidism

Zikuwoneka kuti zonse ndizophweka: mawonekedwe a mwana, kuwunika komanso kuthandizidwa. Koma ochulukirapo ndi mitundu ina ya kubadwa kwatsopano kwa ubongo, komwe sikophweka kukhazikitsa. Zizindikiro izi mwa akhanda, zimakhalapo, koma ndizofooka kwambiri, sizigwira ntchito ndipo nthawi zambiri zimawonedwa, ndipo mwana samachiritsidwa. Chochulukitsa chomwe chimayambitsa kubadwa kwa chithokomiro cha khungu ndicho kuphatikizika kwa chithokomiro, ndipo pamenepa, pakhale matenda oopsa kwambiri.

Mwana amakula moopsa komanso modabwitsa, thupi lake limakhala losalala, ndipo nthawi zambiri limasiyidwa likukula. Izi zimachitika chifukwa cha kulepheretsa kukula kwaubongo. Kukula kwakuthupi kumachepetsedwa: fontanelles pambuyo pake kutsekeka, mano oyamba amaphulika. Chizolowezi chodzimbidwa, chotupa chodziwika bwino chimadziwika ndi ana otere. Edema amafikira mpaka pamphuno, ndipo nthawi zambiri mwana amapumira pakamwa. Mtundu wa nkhope ya adenoid umapangidwa ndi chibwano chaching'ono komanso pakamwa kosalekeza. Thandizo lakumvera limakhudzidwanso, ndipo kumva kumadodometsa.

Zizindikiro mu akulu zimafanana, koma mavuto amtima amawonjezeredwa: atherosulinosis imawoneka koyambirira komanso CHD yotsatira. Tsitsi limagwa, misomali imasweka, munthu amakonda kupsinjika, koma kuyesa kudzipha nkosowa. Nthawi zambiri, kuchepa kwa magazi m'thupi kumawonjezeredwa ndi gawo ili la kubadwa kwa hypothyroidism. Chifukwa chake, kupindika kwa munthu ndi mtundu wamtambo wachikasu chifukwa kuphatikiza kwa kuchepa kwa magazi m'thupi ndi kutupa kofupika.

Mayeso a mahomoni okha ndi omwe angasonyeze kuzindikira koyenera. TSH imachulukitsidwa kwambiri, ndipo mahomoni a chithokomiro amachepetsedwa. Ngati muchita ma ultrasound, mutha kuwona kuchepa, kusintha kwa mawonekedwe a chithokomiro.

Zizindikiro za conothyital hypothyroidism zimayimitsidwa bwino ndi kukhazikitsidwa kwa mahomoni a chithokomiro, ndipo chithandizo sichiyenera kuyamba pasanathe masiku 5 mpaka 17 munthu atabadwa.

Ponena za ana omwe ali ndi mochedwa subclinical hypothyroidism, mikhalidwe yawo imayankha mwachangu chithandizo choyenera. Akatswiri azachipatala amatcha izi "kuchira koopsa." Kutupa kumatha msanga, mwana amayamba kugwira ntchito, chidwi chimakula, chitukuko chimachitika mwachangu. Zonsezi zimachitika patangopita masiku, ngakhale mahomoni pakuyezetsa magazi sanakhale achilendo.

Chovuta chakuthandiza ana ndi mahomoni a chithokomiro ndikuti akamakula, kufunikira kwa iwo kumasintha ndipo mlingo, motero, umasankhidwa kachiwiri. Koma kwa achikulire, mankhwalawa nthawi zambiri amafanana, Mlingo umasintha kawirikawiri (kubereka, kupsinjika kwakukulu, kusamba, ndi zina zotere), ndipo zotsatira zake zimakhala zodziwikiratu. Pazaka zambiri, njira yothandizirana imalumikizana, adokotala amayenera kusankha mankhwala omwe amaphatikizidwa ndi mahomoni a chithokomiro omwe nthawi zonse amakhala ofunikira, omwe ndi ofunikira kwa munthu ndipo sanathe.

Masiku ano, sodium levothyroxine ndiyodziwika kwambiri, koma kuphatikiza (T3 + T4 kapena T3 + T4 + iodine) nthawi zina kumayankhidwa. Mlingo woyambira umakhala wocheperako nthawi zonse (50-150 μg / tsiku kwa munthu wamkulu, 5-15 μg / kg kwa mwana wakhanda komanso osachepera 2 /g / kg kwa mwana), umachulukitsidwa pang'onopang'ono mpaka umunthu woyenera. Endocrinologist amayang'ana mulingo wa TSH: ngati ichulukitsidwa, ndiye kuti mlingo uyenera kuchuluka, ndipo ngati utachepetsedwa, ndiye kuti bongo ndi mankhwala osokoneza bongo. Ngati munthu ndi wamkulu kuposa 55, ndiye kuti amawongolera kolesterol ndi mtima ntchito, pali mawonekedwe a kusankha kwa mankhwalawa (onani tebulo).

Akuluakulu, TSH imayang'aniridwa 1-1, 3-1 ndi miyezi 6 pambuyo pa kubadwa kwake, ndiye pazaka zochepa zoyambirira, mayesowa amabwerezedwa miyezi isanu ndi umodzi iliyonse, kenako osatha chaka. Ana amachitapo kanthu ndi chithandizo cha matenda a TSH mwachangu - kale masabata awiri. Ngati TSH si yachilendo pakupenda kamodzi, ndiye kuti kusankha mankhwalawa kuyambanso.

Congenital hypothyroidism nthawi zambiri imafuna mankhwala osatha, osakhalitsa. Komabe, mulingo woyenera wa mahomoni a chithokomiro omwe adalembedwa ndi adokotala muyezo woyenera amakhudza nthawi yayitali komanso moyo.

Kukhazikika kwa mahomoni a chithokomiro mu mlingo woyenera kumapangitsa kuti mwana azitha kuthamanga chimodzimodzi ndi anzawo.

Zambiri

Hypothyroidism mwa ana ndi mkhalidwe wamatumbo wodziwika ndi kuperewera kwathunthu kapena pang'ono kwa mahomoni a chithokomiro: thyroxine (T4), triiodothyronine (T3) ndi thyrocalcitonin. M'masabata oyambilira a mwana wosabadwayo, mahomoni a chithokomiro amayamba kugwira ntchito pa mwana wosabadwayo, koma pofika sabata la 10, 10 England chithokomiro chimayamba kugwira ntchito mwa mwana wosabadwayo. Kupanga kwa mahomoni a chithokomiro kumachitika m'maselo a gland - maselo a chithokomiro, omwe amatha kugwira mwachangu ndi kudziunjikira iodine yaulere m'madzi a m'magazi. Madzi a chithokomiro amakhala ndi gawo lofunikira kwambiri pakukula koyenera kwa mwana, makamaka pakubala kwa sabata loyamba ndi nthawi yobereka. Madzi a chithokomiro amawongolera kayendedwe ka embyogenesis: kusiyanitsa kwa minofu ya mafupa, mapangidwe ndi kugwira ntchito kwa hematopoietic, kupuma komanso chitetezo cha m'thupi, kusinthika kwa kapangidwe kazinthu zama ubongo, kuphatikizapo ubongo.

Kuperewera kwa mahomoni a chithokomiro mwa ana kumayambitsa zotsatira zoyipa kwambiri kuposa achikulire, ndipo mwana akadali wamng'ono, hypothyroidism yowopsa imakhala yathanzi lake komanso moyo. Hypothyroidism mwa ana imabweretsa kuchepa kwa chitukuko chakuthupi ndi chamaganizidwe (kukula, kutha msinkhu, luntha), kuphwanya mitundu yonse ya kagayidwe kazinthu kofunikira (mapuloteni, mafuta, chakudya, calcium) ndi kayendedwe ka thermoregulation.

Gulu la hypothyroidism mwa ana

Hypothyroidism mwa ana imatha kubereka kapena kutengedwa. Ndi kobadwa nako hypothyroidism, ana amabadwa ndi vuto la chithokomiro. Kuchulukana kwa kubereka kwa ubongo, malinga ndi endocrinology ya ana, pafupifupi 1 peresenti ya 4-5,000 akhanda (atsikana ndi ochulukirapo kuposa anyamata).

Malinga ndi kukula kwa mawonetseredwe, hypothyroidism mwa ana imatha kukhala yochepa (yochepa), yaying'ono, yowonekera. Kutengera ndi kuchuluka kwa kusokonezeka pakupanga mahomoni a chithokomiro, chachikulu (chithokomiro), sekondale (pituitary) ndi tertiary (hypothalamic) hypothyroidism mwa ana amasiyanitsidwa.

Zimayambitsa hypothyroidism ana

Hypothyroidism mwa ana imayamba ndi zovuta zosiyanasiyana pakuchitika kwa dongosolo la hypothalamic-pituitary-chithokomiro. Mu 10-20% ya milandu, zomwe zimayambitsa kubereka kwa ana zimatha kukhala zovuta zamtunduwu pomwe majini osinthika amatengedwa ndi mwana kuchokera kwa makolo awo, koma nthawi zambiri matendawa amakhala osachiritsika.

Kwenikweni, ana amakhala ndi matenda oopsa a chithokomiro omwe. Chomwe chimayambitsa matenda a hypothyroidism mwa ana ndi kusokonezeka kwa chithokomiro, kuwonetsedwa ndi aplasia (kusowa), hypoplasia (underdevelopment), kapena dystopia (kusamutsidwa) kwa chiwalo. Zotsatira zoyipa zachilengedwe (radiation, kusowa kwa ayodini mu chakudya), matenda amkati mwa intrauterine, kumwa mankhwala ena (thyreostatics, tranquilizer, bromides, lithiamu salt), kukhalapo kwa autoimmune chithokomiro, komanso matenda obwera chifukwa cha matendawa kumatha kuyambitsa kuwonongeka kwa chithokomiro cha fetal. Mu 10-15% ya milandu, hypothyroidism mwa ana imakhudzana ndi kuwonongeka kwa mahomoni a chithokomiro, kagayidwe kake kapena kuwonongeka kwa minofu yolandirira zomwe zimayambitsa chidwi cha minofu pazomwe zimachita.

Hypothyroidism yachiwiri komanso yapamwamba mwa ana imatha kukhala chifukwa cha kubadwa kwa pituitary ndi / kapena hypothalamus kapena vuto la chibadwa pakupanga kwa TSH ndi thyroliberin, yomwe imayang'anira chinsinsi cha mahomoni a chithokomiro. Achilengedwe operewera kwa ana amatha kuonongeka ndi chithokomiro cha chithokomiro kapena chithokomiro chifukwa chotupa kapena njira yotupa, kuvulala kapena opaleshoni, komanso kuchepa kwa ayodini.

Zizindikiro za hypothyroidism mwa ana

Hypothyroidism mu wakhanda imakhala ndi mawonekedwe owerengeka azachipatala, omwe amaphatikizapo kutha kwa kubereka (masabata 40-42), kulemera kwakukulu kwa mwana (woposa makilogalamu 3.5-4), kutupa kwa nkhope, eyel, lilime (macroglossia), zala ndi zala kupumira kwakanthawi komanso kupumira kwambiri, kulira pang'ono, kulira. Mu makanda obadwa kumene omwe ali ndi hypothyroidism, jaundice wa nthawi yayitali, machiritso ochedwa a umbilical bala, umbilical hernia, chiwonetsero chofooka chofooka.

Zizindikiro za hypothyroidism zimakula pang'onopang'ono ndipo zimayamba kuonekera mwana akamakula, sazindikira kwenikweni pakamayamwa chifukwa chobwezera ndi mahomoni a chithokomiro cha amayi. Ali m'mimba mwa ana omwe ali ndi hypothyroidism, zikuwoneka kuchepa kwakanthawi ndi ma psychomotor: kuwonda kwambiri, kugona, minyewa, kuwonda komanso kulephera kuchita masewera olimbitsa thupi, kukula ndi kutsekeka kwamphamvu, kuwonjezeka kwa kukula komanso kutsekera kochedwa kwa fontanel, kuchepa kwakachetechete, kusowa kwa luso (khalani mutu, tembenuzani , khalani, imani).

Ndi hypothyroidism mwa ana, bradypsychia amakula - kusayang'anira zakunja ndi kachitidwe kochepa kamalingaliro ndi kamvekedwe: mwana samayenda, satchula mawu amodzi payekha, samasewera palokha, samalumikizana ndi ena. Pali zizindikiro zowonongeka pamisempha ya mtima, kuchepa chitetezo chokwanira, khungu lowuma, tsitsi losalala, kutentha pang'ono kwa thupi, kuchepa magazi.

Kukula kwa zizindikiro za kobadwa nako kwa hypothyroidism mwa ana zimadalira pa etiology ndi kuopsa kwa matendawa. Kuopsa kwa kutayika kwa mahomoni a chithokomiro kumayambiriro kwa chitukuko cha intrauterine ndikuphwanya kosagundika kwa chitukuko cha dongosolo lamkati la mwana, zomwe zimayambitsa matenda a dementia komanso chikhulupiliro cham'mbuyo kwambiri, kufooka kwa mafupa, kuchepa kwa thupi, kusokonekera kwa psyche, kumva komanso kuyankhula.

Ndi mawonekedwe ofatsa, zizindikiro za hypothyroidism mwa ana mkati mwa nthawi ya neonatal amatha kuzimiririka ndikuwoneka pambuyo pake, ali ndi zaka 2-6, nthawi zina nthawi yakutha msinkhu. Ngati hypothyroidism imachitika mwa ana opitilira zaka 2, sizimayambitsa kusokonezeka kwamalingaliro. Mwa ana okulirapo ndi achinyamata, hypothyroidism imatha kukhala limodzi ndi kunenepa kwambiri, kunenepa kwambiri, kukula kwambiri komanso kutha msinkhu, kusakhazikika maganizo, kuganiza pang'onopang'ono, ndi kuchepa kwa magwiridwe asukulu.

Chithandizo cha hypothyroidism mwa ana

Chithandizo cha kubereka kwa hypothyroidism mwa ana ziyenera kuyambika koyambirira atatha kuzindikira kuti sanazindikire (asanadutse milungu iwiri pambuyo pobadwa) pofuna kupewa matenda osokonezeka m'maganizo a mwana.

Nthawi zambiri wobadwa mwatsopano ndi kupeza hypothyroidism ana, moyo wonse m'malo ndi kupanga chithokomiro timadzi analogue, sodium levothyroxine, ndikofunikira. Mankhwala ali mu koyamba mlingo wa 10-15 μg / kg thupi patsiku pafupipafupi kusanthula kwamphamvu kwa mwana ndi magawo am'mweya wosiyanasiyana kuti asankhe mulingo woyenera wa mankhwalawa. Zowonjezeredwa ndi mavitamini (A, B12), mankhwala a nootropic (hopantenic acid, piracetam), zakudya zabwino, kutikita minofu, masewera olimbitsa thupi.

Ndi subclinical mtundu wa hypothyroidism mwa ana, chithandizo sichingafunikire, mwanjira imeneyi kuyang'aniridwa kwa achipatala kokwanira kumasonyezedwa. Ndi chitukuko cha cretinism, kuchiritsa kwathunthu ndikosatheka, kutenga levothyroxine wa sodium pang'ono bwino kumayambitsa matendawa.

Kuneneratu komanso kupewa kwa hypothyroidism mwa ana

Kukula kwa hypothyroidism mwa ana kumatengera mtundu wa nthendayo, zaka za mwana, nthawi yoyambira chithandizo, komanso mlingo woyenera wa levothyroxine. Monga lamulo, munthawi ya chithandizo cha hypothyroidism mwa ana, vutoli limalipiridwanso msanga, kenako zizindikiritso zabwinobwino za kukula kwamthupi ndi m'maganizo zimawonedwa.

Kusakhalapo kapena kuyamba mochedwa kwa matenda a hypothyroidism kumabweretsa kusintha kwakukulu komanso kosasintha m'thupi ndi kulumala kwa ana.

Ana omwe ali ndi hypothyroidism amayenera kuyang'aniridwa pafupipafupi ndi dokotala wa ana, endocrinologist wa ana, kuwunika kwawoko ndi kuwunika pafupipafupi mawonekedwe a chithokomiro.

Kupewa kwa hypothyroidism mwa ana kumakhala ndi kuchuluka kwa ayodini ndi mayi wapakati wokhala ndi chakudya kapena mawonekedwe a mankhwala, makamaka zigawo za kusowa kwa ayodini, kuzindikira koyambirira kwa kuchepa kwa mahomoni a chithokomiro mwa amayi oyembekezera ndi akhanda.

Kodi matenda ndi chiyani?

Chithokomiro cha chithokomiro ndi gawo lofunikira kwambiri lomwe limalowa m'thupi la endocrine. Imagwira ntchito zambiri zofunika kuti mwana akule bwino. Ubongo umalandira chidziwitso chonse kuchokera kunja kudzera mu kuzindikira kwa mawu, kununkhira, kuwala. Thupi laumunthu limagwira ntchito mothandizidwa ndi mahomoni - zinthu zam'magazi. Dongosolo la neuroendocrine limagwira ntchito ngati mkhalapakati pakati pa ubongo ndi thupi.

Zida zazikulu zomwe zimapanga chidziwitso chonse ndi pituitary ndi hypothalamus. Amapatsa chithokomiro “lamulo” lonena za mtundu wa mahomoni omwe thupi limafunikira.

Palibe chovuta kulingalira kuchuluka kwa zinthu zachitsulo zomwe amapatsidwa. Akuluakulu ndi awa:

kuwongolera kutentha kwa thupi ndi kagayidwe kachakudya,
kapangidwe ka vitamini A m'chiwindi,
kutenga nawo gawo pakukula kwa luntha,
cholesterol yotsika
kusangalatsa kwa kukula kwa ana,
malamulo a calcium kagayidwe, komanso mafuta, chakudya ndi mapuloteni.

Chifukwa chake, chiwalo ichi chimathandizira kukula kwathunthu kwa thupi la mwana. Komanso, pakupanga kwamanjenje ndi mafupa, amasewera limodzi mwamagawo ofunikira. Chitsulo chathanzi chimapanga mitundu iwiri ya mahomoni:

thyroxine (T4),
triiodothyronine (T3).

Ingoganizirani zomwe zimachitika mthupi ngati chithokomiro cha chithokomiro chasokonekera. Inde, podziwidwa ndi ana obadwa kumene, kupangika kwa mahomoni am'munsi kumachepa. Kusowa kwawo kumakhudza kwambiri kugwira ntchito kwa thupi lonse. Kuperewera kwa mahomoni kungapangitse kulepheretsa kukula kwa malingaliro ndi thupi kwa mwana, kukula kumachepetsedwa. Mwanayo akulemera kwambiri, ali ndi vuto lotopa lotopa, mphamvu zimachepa, kugunda kwa mtima wake komanso kuthamanga kwa magazi kusokonezeka. Kuphatikiza apo, matumbo amagwira ntchito bwino, kufupika kwa mafupa kumachitika.

Zifukwa zazikulu

Chifukwa chiyani kubadwa kwa hypothyroidism kumachitika mwa ana? Pali zinthu zambiri zomwe zimadzetsa matendawa. Pakati pawo, madokotala amasiyanitsa zazikulu:

Choyipa. Matendawa omwe amafunsidwa amagwirizana kwambiri ndi majini. Nthawi zambiri, vuto la chithokomiro limachitika ngakhale mwana asanabadwe - panthawi ya fetal. Kuchepetsa koteroko kumalumikizidwa ndi kusintha kwa majini.
Zovuta pamapangidwe a mahomoni. Izi zimachitika chifukwa chakuchepa kwa chidwi cha chithokomiro cha chithokomiro. Nthawi zina mayendedwe amafunikira zinthu zofunikira pakupanga mahomoni amatha kusokonekera. Ndipo nthawi zina chifukwa chimakhala kuphwanya iodini wa metabolism m'thupi.
Kugonjetsedwa kwa hypothalamus. Ichi ndiye chimake cha dongosolo lamanjenje. Imayang'anira kugwira ntchito kwa chithokomiro cha chithokomiro, komanso tiziwalo timene timatulutsa endocrine. Zilonda za hypothalamus zimabweretsa zovuta za endocrine.
Kuchepetsa chidwi cha mahomoni a chithokomiro. Izi zitha kuchitika chifukwa choti mayi, pokhala ndi pakati, adamwa mankhwala a antithyroid.
Matenda a autoimmune.
Chotupa cha chithokomiro.
Kuchepetsa chitetezo chokwanira.
Mankhwala osokoneza bongo osokoneza bongo (kukonzekera kwa lithiamu, corticosteroids, vitamini A, beta-blockers).
Kuwonetsedwa pangozi.
Matenda a viral.
Kuperewera kwa ayodini.
Zomera za parasitic.
Kuchiza ndi ayodini.

Pali magwero ambiri omwe amatsogolera ku matenda obadwa nawo. Komabe, nthawi zambiri, chomwe chimayambitsa matenda m'makanda sichidziwika bwinobwino.

Mitundu yayikulu

Matendawa amadziwika ndi kuchepa kwa kupanga kwa mahomoni a chithokomiro, omwe amachititsa kuti kagayidwe kazachilengedwe kagwere. Masiku ano, hypothyroidism ndi matenda wamba. Zimasiyana m'mitundu yosiyanasiyana, magawo akukulidwe.

Vuto lalikulu ndilakuti matendawa atadwala kalekale. Ndipo izi zimabweretsa zovuta zambiri, chifukwa chamankhwala chomwe chimakhala chovuta kwambiri.

Matenda a Hypothyroidism amatha chifukwa cha zinthu zosiyanasiyana. Malinga ndi akatswiri, zomwe zimayambitsa matendawa zimatengera mtundu wa matendawa. Masiku ano, amasiyanitsidwa ndi awiri:

Congenital hypothyroidism imakonda kuperekedwa nthawi yapakati. Kuwonongeka kwa chithokomiro kumachitika. Pambuyo pobadwa kwa mwana, zinthu ngati izi zimatha kuyambitsa kukula kwa ubongo wamkati, kukhazikika m'maganizo, komanso mapangidwe olakwika a mafupa.

Acology operewera atha kumachitika ndi vuto la kuyamwa kwa ayodini, pambuyo pa opareshoni yochotsa (pang'ono kapena kwathunthu) chithokomiro cha chithokomiro. Nthawi zina matendawo amakhumudwitsa ngakhale chitetezo chanu cha mthupi, chomwe chimawononga gland yofunikira.

Kugawana kusintha kwa pathological komwe kumachitika mu chithokomiro cha chithokomiro, madokotala amasiyanitsa mitundu iyi:

hypothyroidism yoyamba
sekondale
chapamwamba

Aliyense wa iwo ali ndi zifukwa zake. Hypothyroidism yoyamba ndi matenda omwe amayambitsidwa ndi zinthu zomwe zimagwirizana kwambiri ndi chithokomiro cha chithokomiro. Izi zikuphatikiza ndi izi:

zolakwika zamtundu,
kobadwa nako pathologies a ziwalo,
Njira zingapo zotupa zomwe zimakhudza chithokomiro.
akusowa kwa ayodini m'thupi.

Kutuluka kwachiwiri kwa matendawa kumayenderana ndi kuwonongeka kwa pituitary gland, momwe imayimitsa kupanga mahomoni a TSH. Zomwe zikuluzikulu zimayambitsa matendawa pakachitika izi:

kukulira kwatsopano kwa pituitary gland,
magazi ambiri komanso pafupipafupi.
kuwonongeka kwa ubongo ndi matenda,
zotupa mu pituitary gland.

Gawo lapamwamba limayambitsa mavuto mu ntchito ya hypothalamus.

Zizindikiro zake za matendawa

Nthawi zambiri m'masiku oyamba amoyo mwana, hypothyroidism imawoneka. Zizindikiro za matendawa zimachitika pokhapokha miyezi ingapo. Pofika pano, makolo ndi madokotala onse akuona kuti mwana wakhanda akuchedwa kukula. Komabe, mu makanda ena, zizindikiro za kobadwa nako za hypothyroidism zitha kuchitika m'masabata oyamba amoyo.

Zizindikiro zodziwika bwino zimaphatikizapo:

Kulemera kwakukulu kwa kubadwa (kulemera kwa mwana ndi kupitirira 3.5 kg).
Mwana wosamutsidwa wokhala ndi zonse zomwe zimayamba chifukwa cha khungu (louma ndi khwinya, misomali yayitali, kusowa kwa mafuta).
Nkhope yowoneka bwino, milomo, matope.
Yoteteza khungu.
Ma fossa a supraclavicular atupa mwanjira yamapiritsi owonda.
Pakamwa kotseguka, lilime lokhazikika.
Kukhalapo kwa zizindikiro zakugonana.
Kutulutsa kwamphamvu kwa ndowe yoyamba.
Mawu oyipa a mwana, amakhala pansi (ndikulira).
Kuchiritsa kwakukulu kwa navel (nthawi zambiri ndi hernia).
Makona atatu a dera la nasolabial amakhala cyanotic.

Ngati chithandizo sichinayambike m'mwezi woyamba wa moyo, ndiye kuti mwana akuwoneka bwino, thupi, malankhulidwe ndi psychoemotional underdevelopment. Mankhwala, matenda amenewa amatchedwa cretinism.

Ndi chithandizo chokwanira pazaka za miyezi 3-4, zizindikiro zina zimawonekera. Amawonetsa kuti hypothyroidism ikupita patsogolo. Zizindikiro za matendawa ndi izi:

Anachepetsa chilako.
Kuphwanya njira yomeza.
Khungu.
Kudzimbidwa.
Kutentha kochepa.
Kuthetsa minofu.
Kuuma ndi kutsika kwa khungu.
Tsitsi la Brittle.

Paukalamba, matendawa amakhala ndi zizindikiro zotsatirazi:

Zovuta m'malingaliro, thupi.
Kusintha kwa nkhope.
Kuwoneka mochedwa kwa mano.
Zovuta.
Kukoka kosowa.
Kukula kwa mtima.

Zomwe Zimayambitsa Congenital Hypothyroidism

Pafupifupi 85% ya machitidwe a kubadwa kwa hypothyroidism ndi sporadic. Zomwe zimayambitsa unyinji wa izo ndi dysgenesis ya chithokomiro cha chithokomiro.

Pafupifupi 15% ya mphindi za kubadwa kwa hypothyroidism chifukwa cha kuwonekera kwa ma antibodies a mayi ku chithokomiro cha chithokomiro kapena cholowa cha matenda a T4 synthesis.

Mitundu ina ya kobadwa nako ya hypothyroidism masiku ano imakhala ndi masinthidwe amtundu omwe amachititsa kuti matendawa atukuke.

Zomwe zimayambitsa kubadwa kwa hypothyroidism

Chithokomiro dysgenesis (underdevelopment):

Njira zatsopano za T4 kaphatikizidwe:

Pendred's Syndrome.
Matenda a chithokomiro cha chithokomiro.
Matenda a sodium iodide womvera.
Matenda a thyroglobulin.
Matenda a chithokomiro a chithokomiro.

Congenital central hypothalamic-pituitary hypothyroidism.

Congenital hypothyroidism yoyambitsidwa ndi ma antibodies a amayi.

Kodi chimachitika ndi chiyani ndi hypothyroidism?

Kukula kwa m'mimba mwa mwana wosabadwayo, komwe pazifukwa zina kapamba kulibe kapena kugwira ntchito, kumachitika chifukwa cha mahomoni a chithokomiro, kulowa mkati mwa placenta.

Mwana akabadwa, kuchuluka kwa timadzi timeneti m'magazi ake kumatsika kwambiri. Pakukhazikika kwa mwana wosabadwayo, makamaka mu nthawi yake yoyambirira, mahomoni a chithokomiro amangofunikira kuti akule bwino kwa dongosolo lamkati la mwana.

Izi ndizofunikira kwambiri pamapangidwe a myelination of brain neurons.

Ndikusowa kwa mahomoni a chithokomiro panthawiyi, chitukuko chamkati mwa mwana chimapangidwa, chomwe sichingasinthe. Imadziwonekera yokha mumagulu osiyanasiyana a kubwezeretsa kwamaganizidwe kwa mwana mpaka ku cretinism.

Ngati chithandizo chamankhwala chikuyambitsidwa mwachangu (sabata loyamba la moyo), kukulira kwa dongosolo lamagetsi chapakati kumafanana ndi zofunikira. Imodzi ndi mapangidwe chilema pakati chapakati mantha dongosolo, ndi kobadwa nako hypothyroidism osalipidwa pa nthawi yake, chitukuko cha mafupa ndi ziwalo zina zamkati ndi kachitidwe zimavutika.

Nthawi zambiri, zizindikiro za matenda obadwa nazo za hypothyroidism sizimathandizira kuzindikira koyambirira. Congenital hypothyroidism mu wakhanda imatha kuganiziridwa pokhapokha pazomwe zikuwonetsa chithunzi cha 5 peresenti yokha.

Zizindikiro zoyambirira za hypothyroidism yobadwa nayo:

kutupa m'mimba
yaitali (oposa masiku 7) hyperbilirubinemia,
mawu otsika
umbilical chophukacho
fontanel zokulira,
hypotension
kukulira kwa chithokomiro,
macroglossia.

Ngati njira zochizira sizinatenge nthawi, pambuyo pa miyezi 3-4 zizindikiro zotsatirazi zimawonekera:

kuvuta kumeza
kusadya bwino
chisangalalo
kunenepa kwambiri
kuyanika ndi khungu
hypothermia,
minofu hypotension.

Pakatha miyezi isanu ndi umodzi ya moyo, mwana amawonetsa kuchepa kwakuthupi, m'maganizo komanso kukula kosawerengeka: hypertelorism, mphuno yotentha, kutsekeka mochedwa kwa mafonti onse (onani chithunzi).

Chidziwitso chitha kukhala chothandiza, ndi ziti zomwe zimawonetsa komanso chithandizo cha hypothyroidism mwa amayi, chifukwa matenda obadwa nawo amakhalabe ndi wodwalayo moyo wonse.

Kuchiza matenda

Kuthandizira kwa uchembere wabwino kuyenera kuyang'ana kuthamanga kwa T4 m'magazi, kutsatiridwa ndi kusankha kwa L-T4, komwe kumatsimikizira kukhazikika kwa T4 ndi TSH.

Mulingo woyenera wovomerezeka wa L-T4 ndi 10,5 mcg / kg thupi patsiku. Kupitanso apo, kuwunikira ndi kuyeserera pafupipafupi kuyenera kusankha mlingo wokwanira wa L-T4.

Kutsogolo kwa kobadwa nako hypothyroidism

Kukula kwa matendawa makamaka kumatengera nthawi yoyambira L-T4 yothandizira. Ngati mungayambitse milungu iwiri yoyambirira ya moyo wakhanda, kuphwanya kwamphamvu kwakuthupi ndi kwamaganizidwe kumatha.

Ngati nthawi yoyambira m'malo mwamankhwala yaphonya, ndipo siyiyamba, chiopsezo cha matenda opitilira muyeso chikukula, mpaka oligophrenia ndi mitundu yake yoopsa.

Chithandizo cha hypothyroidism ndi chothandiza kwambiri ndi kukonzekera kwa mahomoni a chithokomiro. Mankhwala odalirika kwambiri a hypothyroidism amawonedwa kuti ndi mahomoni a chithokomiro omwe amapezeka synthetical (mwangozi).

Chokhacho chothandizira kuchiritsa mankhwalawa ndi mankhwalawa ndi kupita kwa dokotala pafupipafupi, omwe ayenera kusankha kuchuluka kwa mankhwalawo ndikusintha pakumwa.

Zizindikiro za hypothyroidism zimayamba kutha, makamaka sabata yoyamba ya mankhwalawa. Kutha kwawo kwathunthu kumachitika pakatha miyezi yochepa. Ana mu chaka choyamba cha moyo ndipo atakalamba amangofunika chithandizo. Okalamba komanso odwala ofooka amayambiranso kutenga pang'onopang'ono mankhwalawo.

Ngati hypothyroidism idayamba chifukwa cha kusowa kwa chithokomiro, matenda a Hashimoto, kapena radiation chithandizo, ndiye kuti mankhwalawa atha kukhala amoyo wonse. Zowona, pali zochitika zina pomwe, ndi Hashimoto's chithokomiro, ntchito ya pancreatic inabwezeretsedwa zokha.
Ngati ma pathologies ena ndizomwe zimayambitsa hypothyroidism, matenda atachotsedwa, zizindikiritso za hypothyroidism zimatha.
Chomwe chimayambitsa matenda a hypothyroidism imatha kukhala mankhwala, pambuyo poti ma chithokomiro chitafika.
Hypothyroidism mu mtundu wammbuyo wamankhwala sungafunike. Komabe, kuti asaphonye kupitirira kwa matendawa, wodwalayo amafunika kuyang'aniridwa ndi achipatala mosalekeza.

Zambiri pazamankhwala olowa m'malo mochulukitsa masiku ano sizikupezeka masiku ano, ndipo asayansi ali ndi malingaliro osiyanasiyana pankhaniyi. Zikatero, posankha mtundu wa chithandizo, wodwalayo pamodzi ndi dokotalayo amakambirana za kuchuluka kwa ndalama zomwe zimagwiritsidwa ntchito popereka chithandizo chamankhwala komanso kuopsa kwake komwe kungakhalepo ndi mapindu ake.

Tcherani khutu! Odwala omwe ali ndi matenda a mtima ndi matenda a shuga ndi makamaka matenda a shuga amafunikira mlingo woyenera wa mankhwalawa, chifukwa kuchuluka kwa mahomoni ambiri kumachitika chifukwa cha kuchuluka kwa angina pectoris kapena kusokonezeka kwa mitsempha ya mtima.

Mankhwala othandizira

Pozindikira kuti ndiwobadwa nako hypothyroidism, adotolo amatipatsa mankhwala omwe amaphatikiza ndi sodium levothyroxine, yomwe ndi yogwira ntchito:

Mankhwala ayenera kumwedwa malinga ndi malangizo ndi kusankha kwa endocrinologist. Pambuyo pa chithandizo cha miyezi 1.5-2, ndikofunikira kukaonana ndi dokotala kuti mutsimikizire kulondola kwa mlingo womwe wapatsidwa. Zikafika poti mlingo wake ndi wochepa kwambiri, wodwalayo ali ndi zizindikiro za hypothyroidism:

Ngati mulingo wapambana, zizindikiro zake ndizosiyana pang'ono:

Odwala omwe ali ndi vuto la mtima, kumayambiriro kwa chithandizo, mankhwala ochepa a levothyroxine nthawi zambiri amawayikidwa, omwe amawonjezedwa pang'onopang'ono ngati pakufunika. Ngati hypothyroidism imakhala yoopsa panthawi yodziwitsa, sizovomerezeka kuchedwetsa chithandizo.

Zofunika! Pakakhala chithandizo chokwanira, kubadwa kwa ana m'mimba kumatha kubweretsa vuto losowa, koma lomwe limawopseza kwambiri - hypothyroid coma (myxedema coma). Chithandizo cha matendawa chimachitika mchipatala, mchipinda chothandizira kwambiri pakukonzekera kwa mahomoni a chithokomiro.

Ngati ntchito yopuma imasokonekera, zida zamagetsi zothandizira kupuma zimagwiritsidwa ntchito. Wodwalayo amapita kukayezetsa kwathunthu kuchipatala kuti athe kupezeka kwa mtima wodwala. Ngati atapezeka, muyenera kulandira chithandizo choyenera.

Kupewa kwa hypothyroidism mwa mwana

Hypothyroidism pa nthawi yomwe ali ndi pakati iyenera kuthandizidwa mosamala, chifukwa ikhoza kuthana ndi chitukuko cha mwana wosabadwayo komanso imayambitsa zovuta zazikulu za kubereka.

Ndi hypothyroidism mwa mayi wapakati, chithandizo chiyenera kuyamba nthawi yomweyo.Ngati matendawa adapezeka asanatenge pakati, mayiyo ayenera kuyang'anira kuchuluka kwa mahomoni a chithokomiro ndikukwaniritsa kukonza koyenera kwa mankhwala. Mukanyamula mwana, kufunikira kwa mahomoni kumatha kuwonjezeka ndi 25-50%.
Kufunika kwamankhwala kungathenso kuchitika pambuyo poti ndi hypothyroidism. Ndi isanayambike mimba iliyonse, mkazi amayenera kupimidwa kuti adziwe ngati ali ndi matenda a mtima. Nthawi zina mtundu wa hypothyroidism pambuyo pake umatha wokha, ndipo nthawi zina, matendawa amakhala m'moyo wonse wamkazi.

Chithandizo chothandizira

Nthawi zambiri, mankhwalawa a hypothyroidism amakhala ndi moyo nthawi yayitali, kotero mankhwalawa omwe adokotala amauza adokotala amayenera kumwedwa molingana ndi cholinga. Nthawi zina kubadwa kwa hypothyroidism kumapitilira, kotero, kuchuluka kwa mahomoni nthawi ndi nthawi kumafuna kuwonjezeka, malinga ndi kuchuluka kwa chithokomiro cha ntchito.

Odwala ambiri omwe amatenga kukonzekera kwa mahomoni a chithokomiro, atachokapo, zizindikiro za hypothyroidism zimayamba ndi mphamvu zopangidwanso. Zikakhala zotere, mankhwala amayenera kuyambiranso.

Congenital hypothyroidism imatha kukhala ngati complication ya matenda opatsirana. Potere, pambuyo pa kuchiritsidwa kwa matenda oyamba, ntchito ya chithokomiro imabwezeretseka. Poyesa magwiridwe ake, kusokonezeka kwakanthawi kogwiritsira ntchito kukonzekera kwa mahomoni a chithokomiro kumachitika.

Odwala ambiri omwe achotsa izi amabweza kwakanthawi zizindikiritso zazikulu za hypothyroidism. Izi ndichifukwa chakuti thupi, ndikachedwa, limatumiza chizindikiritso ku chithokomiro cha chithokomiro zokhudzana ndikufunika kuyambiranso ntchito.

Ngati chithokomiro chikutha kudzilimira mokha mtsogolomo, chithandizo chitha. Ngati kupanga kwa mahomoni kumakhalabe kotsika, muyenera kuyambiranso kumwa mankhwalawo.

Kupanga kukonzekera kwa mahomoni a chithokomiro kumafunika kuti wodwala azichezera kuchipatala kawiri pachaka (kuti atsimikizidwe). Odwala amayesedwa mahomoni olimbikitsa a chithokomiro. Zotsatira za phunziroli zikuwonetsera kuti kutsata kwa ndende ya mahomoni ndi miyezo.

Congenital

Kuzindikiritsa kobadwa nako hypothyroidism kumachitika ngati wakhanda akangobadwa kumene wapezeka kuti ali ndi vuto la chithokomiro. Imachitika mu prenatal development ndipo imatha kukhala yoyamba, yapakati (yachiwiri, yodutsa) komanso yofalikira molingana ndi kuwonongeka kwa maselo. Zizindikiro za matendawa ndizosakhalitsa, zachikhalire, ndipo njira ya hypothyroidism ndiyosawoneka bwino kapena yowonekera, yovuta.

Hypothyroidism yotereyi imatchedwa kuti yowona kapena ya androgenic. Izi zikutanthauza kuti gawo lotsika la mahomoni a chithokomiro T4 ndi T3 limalumikizidwa ndi matenda a chithokomiro palokha.

Chapakati

Maselo achinsinsi omwe amapanga thyroxin ndi triiodothyronine amawongoleredwa ndi pituitary gland mothandizidwa ndi mahomoni othandizira a chithokomiro - TSH. Ndi kapangidwe kake kosakwanira, kupanga T3 ndi T4 kumachepa. Matendawa amatchedwa pituitary kapena sekondale. Kuphatikiza kwa pituitary gland mu "chiwongolero" chamthupi ndi hypothalamus. Pogwiritsa ntchito thyroliberin, imathandizira mapangidwe a TSH. Kuperewera kwa Hypothalamic kumatchedwa tertiary.

Osakhalitsa

Zoyambitsidwa ndi ma antibodies a amayi, omwe amapanga timadzi tambiri tothandiza ku chithokomiro cha mwana. Kutalika kwake kumakhala masabata 1-3. Njira yachiwiri yachitukuko ndikusintha kukhala fomu yokhazikika. Potere, nthawi zakusintha zimasinthana ndikuwonjezereka kwa zizindikiro, zomwe zimafunikira makonzedwe amoyo wa mahomoni kwa mapiritsi.

Kuwonekera

Kulengeza kufooka kwa mahomoni. Homoni yolimbikitsa chithokomiro ndiyachilendo, ndipo chithokomiro chimatulutsa thyroxine pang'ono. Zimayambitsa chithunzi chatsatanetsatane cha hypothyroidism, komanso kuperewera kwakuthwa kwa T 4 - zovuta. Izi zitha kuphatikizira kulephera kwazungulire, kubweza m'maganizo, kuchepa kwa thupi.

Ndipo izi ndizambiri za nodular goiter wa chithokomiro.

Amayambitsa hypothyroidism mpaka chaka

Makanda ambiri obadwa kumene (mpaka 90% ya matenda onse) amakhala ndi mawonekedwe oyambira. Itha kuyambitsidwa ndi:

zolakwika pakukula kwa limba - kusunthira kumbuyo kwa sternum, pansi pa lilime, kupangika kosakwanira (hypoplasia), nthawi zambiri kusowa kwa chithokomiro cha chithokomiro,
matenda a intrauterine,
zotupa autoimmune,
kugwiritsa ntchito mankhwala oyembekezera omwe amaphwanya chitukuko (cytostatics, lithiamu salt, bromine, tranquilizer),
kukhudzana ndi mankhwala
kuyang'anira ma radiation
kusowa kwa ayodini mu chakudya cha mayi, chithokomiro, chotupa chachikulu,
masinthidwe amitundu (nthawi zambiri amaphatikizidwa ndi vuto la mtima, mafupa a mafupa),
kuphwanya mapangidwe a mahomoni chifukwa chilema pakuphatikizidwa kwa ayodini ndi chithokomiro cha chithokomiro.
cholowa chitukuko anomaly - Pendred syndrome (ugonthi ndi kukulitsa kwa chithokomiro.

Mitundu yapakati ya hypothyroidism (yachiwiri komanso yapamwamba) imawonekera m'matenda amtundu - ma cysts, zolakwika za chitukuko, vuto loopsa kapena loipapo, kupwetekedwa panthawi yobereka, kuperewera chifukwa cha kukoka kwa umbilical chingwe.

Fomu yotumphukira imachitika pamene mapangidwe a mapuloteni a receptor atayikiridwa, omwe amakhala pazinthu za ma cell ndikuphatikizana ndi mahomoni a chithokomiro. Chomwe chimapangitsa izi ndizovuta zamtundu zopatsiridwa ndi cholowa, ndipo zotsatirapo zake ndikupanga kukana kwa mahomoni (syndrome ya kukana). Poterepa, momwe timadzi tambiri timene timapanga m'magazi ndi abwinobwino kapenanso kuwonjezera pang'ono, koma maselo samayankha T3 ndi T4.

Zomwe zimapangitsa ana kukhala ndi hypothyroidism zimatha kukhala:

zotupa za muubongo
mutu kuvulala, ntchito,
Kuperewera kwa ayodini mu chakudya ndi madzi (kuchepa kwa ayodini).

Zizindikiro zoyambira ana

Kuzindikira hypothyroidism mwana wakhanda kungakhale kovuta kwambiri. Zizindikiro zoyambirira sizimasiyana mwatsatanetsatane ndipo zimapezeka mu ma pathologies a ziwalo zamkati, zotsutsana zina za chitukuko. Zizindikiro zosatsata zingaphatikizeponso:

oyembekezera pambuyo pake (masabata 40-42),
zipatso zazikulu (kuyambira 3.5 kg),
chilankhulo chokulirapo
kutupa kumaso, makamaka m'mizere,
kutupa kwa zala m'manja ndi kumapazi,
kupuma movutikira
kulira kwakanthawi
umbilical hernia, kuchiritsa pang'onopang'ono kwa bala la umbilical,
khansa yayitali ya akhanda,
kutopa msanga pakudya,
mawonekedwe a cyanosis ndi kupuma kulephera pakamwa.

Mwana akamayamwa, ndiye kuti matendawa amayamba kufooka. Koma ana oterowo nthawi zambiri amakhala kuti sanakwanitse zaka zakubadwa kuti acepetse thupi, amakhala ndi vuto logaya chakudya - kutulutsa, kudzimbidwa, kusowa kudya. Amapeza mafupa okulira, osakwanira mafupa a chigaza, ophatikizika amisempha.

Kukula kwa psychychotor kwa ana

Zotsatira zoyipa kwambiri za hypothyroidism zimakhudza dongosolo lamanjenje. Kuyambira panthawiyi, pali zizindikiro za kupendekera kwa psychomotor development:

kufooka wamba, ulesi,
kunyalanyaza chilengedwe - mwana samayesera kupanga mawu, kuyenda, samayankha polankhula naye,
nthawi yanjala kapena yonyowa, imangokhala osayenda kwa maola ambiri,
mayendedwe ndi osowa, kufooka ndi minofu kufooka,
mochedwa ayamba kugwira mutu wake, kugudubuzika pabedi, osakhala pansi.

Ngati kubadwa kwa hypothyroidism kumachitika, ndiye kuti dementia (cretinism) imayamba, psyche, kumva ndi kuyankhula zimasokonekera. Zizindikiro zoterezi zimatha kuwoneka kale theka lachiwiri la chaka ndikuwonongeka kwakukulu kwamahomoni. Milandu yochepa kwambiri imachitika mobisa ndipo imapezeka ndi zaka zisanu ndi chimodzi ndi zisanu ndi chimodzi zokha ngakhale mutha msinkhu.

Mitundu yokhala ndi matendawa, makamaka atakwanitsa zaka ziwiri, siyowopsa. Kukula kwamalingaliro sikumavutika nawo. Mwina kunenepa kwambiri, kulephera kubwerera m'mbuyo, kutha msinkhu, ndikuchepetsa kuganiza kumawonetsedwa ndi ntchito yakusukulu.

Kupewa matenda

Kupewera kwa kubereka kwa hypothyroidism kumachitika ndi gulu kuletsa kusowa kwa ayodini m'madera akumidzi (ayodini ochepa m'madzi), komanso kuzindikira komwe kungachitike pangozi pakukonzekera kutenga pakati. Mayi woyembekezera akulimbikitsidwa:

sinthani mchere wa tebulo ndi mchere wopanda mchere (ingowonjezerani chakudya chokha),
onjezani gawo pazakudya za zinthu zomwe zimakhala ndi ayodini - nsomba zam'nyanja, nsomba zam'madzi, algae, cod chiwindi, mafuta am'madzi, nsomba zam'madzi, feijoa, kiwi, maapulo,
kuyesedwa magazi kuti muone zomwe zimapezeka mu mahomoni a chithokomiro komanso kupimidwa ndi endocrinologist,
imwani mankhwala osokoneza bongo kapena mavitamini a ayodini (Vitrum Prenatal Forte, Ma Multi Tabs Olimba, Multimax kwa Amayi Oyembekezera, Wangwiro, Pregnakea) malinga ndi dokotala.

Hypothyroidism mwa ana nthawi zambiri imabadwa. Zimayambitsidwa ndi kusintha kwa majini, kusowa kwa ayodini m'zakudya za amayi, komanso njira zopatsira ndi autoimmune. Pakubadwa, mawonetseredwe osadziwika amadziwika; akamakula, mitundu yopanda matenda imayambitsa matenda a dementia, kusinthika kwa mafupa a mafupa.

Ndipo pali zambiri za kupewa matenda oopsa.

Kuti mupeze vuto la hypothyroidism, mwana wakhanda amapangidwira khungu la chithokomiro. Kuchiza kuyenera kuyamba pomwe. Ana ndi mankhwala moyo wonse levothyroxine.

Chithokomiro cha chithokomiro chimapangidwa mwa ana mu kukula kwa fetal. Nthawi zambiri, sizisintha ma contours, ma node. Miyeso (kuchuluka, kuchepa), komanso zizindikiro zina zitha kuwonetsa kukhalapo kwa matenda (hypofunction, hyperfunction) ndi kufunika koyambitsa chithandizo.

Mu gawo loyamba, chithokomiro mu ana chimatha kukhala asymptomatic. Matenda a Hashimoto's autoimmune amawonetsedwa ndi kusakwiya, misozi. Zizindikiro za matenda osachiritsika zimatchulidwa. Kuzindikira kumangotsimikizira kuzindikira. Chithandizo chimasankhidwa potengera maphunzirowa.

Kuyambira m'masiku oyamba, mahomoni mwa ana ndi otsimikiza. Kukula, luntha, ndi ntchito ya ziwalo mwa mwana zimadalira momwe zimakhudzira msinkhu wawo. Kodi muyenera kutenga chiyani? Kodi kusokonekera kudzanenanji za (chizolowezi, bwanji chimakwezedwa, kutsitsidwa)?

Ngati panali autoimmune chithokomiro, ndipo mimba idachitika, chithandizo chamankhwala chofunikira chimafunikira kuti apulumutse mwana wosabadwayo. Kukonzekera kumaphatikizapo mayeso osiyanasiyana, chifukwa zomwe zimachitika kwa mayi ndi mwana zimakhala zachisoni kwambiri.

Nthawi zambiri kusowa kwa pituitary kumachitika mwa okalamba, koma ndi kwachuma kapena kutengedwa mwa ana, pambuyo pake. Zokwanira, zochepa, zoyambirira komanso zachiwiri zimasiyananso. Kuzindikira kwa hypopituitaritis syndrome kumaphatikizapo kusanthula kwa mahomoni, MRI, CT, X-ray ndi ena. Chithandizo - kubwezeretsa ntchito ndi mahomoni.

Mitundu ya matenda

Hypothyroidism imagawidwa pobadwa ndipo amatenga. Congenital hypothyroidism mwa ana imawonedwa pafupipafupi ya 1 kesi pa 5,000 akhanda. Zowopsa za anyamata ndizochulukirapo kawiri kuposa atsikana.

Malinga ndi kuopsa kwa zizindikiro za kusowa kwa mahomoni a chithokomiro, kuwonetsa, kufupika (kuchepa) komanso kuchepa kwa mtima kwa ana kumasiyanitsidwa.

Kutengera ndi mtundu womwe kupangika kwa mahomoni a chithokomiro, mitundu yotsatirayi ya hypothyroidism imasiyanitsidwa:

choyambilira (chithokomiro) - chifukwa cha kuwonongeka mwachindunji kwa minofu ya chithokomiro, imadziwika ndi kuwonjezeka kwa TSH (mahomoni opatsirana a chithokomiro),
sekondale (hypothalamic-pituitary) - Zimaphatikizidwa ndi kuwonongeka kwa hypothalamus ndi / kapena pituitary gland, yomwe imayendetsedwa ndi chinsinsi chosakwanira cha mahomoni olimbitsa chithokomiro komanso thyroliberin, ndikutsatira ndikuchepa kwa ntchito ya chithokomiro.

Zoyambitsa ndi Zoopsa

Zomwe zimayambitsa matenda a hypothyroidism mwa ana ndizovuta zosiyanasiyana zamagulu a dongosolo la hypothalamic-pituitary-chithokomiro. Pafupifupi 20% ya milandu, kupezeka kwa hypothyroidism mwa ana kumalumikizidwa ndi genetic anomalies yomwe imabadwa kapena imachitika mwangozi. Mwa mitundu yotsimikizika yamatenda, congenital myxedema (cretinism) imapezeka kwambiri.

China chomwe chimapangitsa kuti ana aberekenso chithokomiro cha ana ndicho kusokonezeka kwa chithokomiro cha chithokomiro (hypoplasia, aplasia, dystopia), komwe kumatha kupangitsa matenda a intrauterine, komanso zinthu zingapo zoyipa zomwe zimakhudza thupi la mayi wapakati.

Mitundu yachiwiri ya hypothyroidism yobadwa nayo mwa ana imakhudzana ndi zonyansa pakukula kwa hypothalamus ndi / kapena gland.

Wopezeka hypothyroidism ana zimawonedwa kangapo. Zifukwa zake zimachitika:

kuchuluka kwa ayodini
kuwonongeka kwa chithokomiro England kapena pituitary gland yoyambitsidwa ndi chotupa kapena kutupa, kuvulala, kapena opaleshoni.

Kuti mupeze ana obadwa kumene a ana, kumachitika pang'onopang'ono kuwunika kwa makanda onse.

Zotheka ndi zovuta

Popanda chithandizo, hypothyroidism mu ana imabweretsa zovuta zotsatirazi:

kubweza kwamalingaliro osiyanasiyana
kubweza
kunenepa
myxedema coma,
kuchuluka kwa matenda opatsirana,
megacolon:
pseudohyponatremia,
Normocytic Normochromic anemia,
hypoparathyroidism.

Ndi chithandizo choyambirira, matendawa amakhala abwino. Hormone m'malo mwake imabweretsa chindapusa mwachangu cha matenda a mwana wodwala ndipo mtsogolo, chitukuko chake cha psychomotor chimachitika molingana ndi chikhalidwe chokhudzana ndi zaka.

Ngati chithandizo chamankhwala chatsimikiziridwa pambuyo poti mawonekedwe a cretinism akhale mwa mwana, zimangoletsa kupitilizabe kwawo. Zikatero, mwana amasintha kwambiri ndipo amamuchititsa kukhala wolumala.

Ana omwe ali ndi vuto la hypothyroidism amayang'aniridwa mosalekeza ndi endocrinologist, dokotala wa ana, neuropathologist. Osachepera kamodzi kotala, ayenera kudziwa kuchuluka kwa mahomoni omwe amalimbikitsa chithokomiro m'magazi.

Hypothyroidism mwa ana imayambitsa mavuto akulu kwambiri kuposa akulu. Mwana akadali wakhanda, ndiye kuti vuto lake lalikulu ndi kuchepa kwa mahomoni a chithokomiro chifukwa amakhala athanzi.