He mea mārama ka puta he āwangawanga ina kite koe i tētahi pupuhi iti i roto i tō kaki. Tērā pea ka whakaaro koe he aha te take, kua rongo rānei koe i tētahi ' goiter '. I tēnei rā, ka kōrerohia e tātou tēnei mate, e mōhiotia ana i roto i te rongoā ko te Goiter . Kaua e manukanuka—ko te whakamōhiotanga te taahiraa tuatahi nui rawa atu ka taea e koe te mahi.
He aha te Repe Tairoiro?
I mua i tā tātou tūhuratanga i te pūtake o te mate puku, me titiro tātou ki te repe kei muri: tō repe tairoi . Kei te pūtake o tō kaki, i raro noa i tō āporo Ātama, ko tō tairoi tēnei okana iti, āhua pūrerehua. Ahakoa tōna rahi iti, he mahi nui tāna hei wāhanga matua o te pūnaha endocrine o tō tinana.
He mea tino nui ngā homoni e hangaia ana e tō tairoi ki tō hauora. E rua ngā homoni e tukuna ana e ia: te thyroxine (e mōhiotia whānuitia ana ko te T4) me te triiodothyronine (e mōhiotia ana ko te T3). Ka whakahaere ēnei homoni i ētahi mahi nui i roto i tō tinana, pēnei i:
- Te tukanga pākia o tō tinana ( metabolism ) —te huri i te kai e kainga ana e koe hei pūngao.
- Te whakahaere i te pāmahana o tō tinana .
- Te awe i tō wairua me ngā taumata manukanuka.
- Te whakahaere i te tere o tō ngakau .
- Te whakahaere i tō pūnaha nakunaku .
E kite ana koe, he nui te kawenga o tēnei repe iti nei. Mēnā ka nui haere, ka nui rawa rānei, ka iti rawa rānei te homoni e whakaputaina ana, ka taea e ia te whakararuraru i te taurite o tō tinana katoa.
He momo rerekē te Goiter?
Ae, ka whakarōpūtia ngā mate puku i runga i te tipu me te pānga ki ngā taumata o ngā homoni tairoi.
I runga i te āhua o tā rātou tipu:
- Te Korokoro Māmā (Horahanga): Ka puta tēnei ina pupuhi ōrite te repe tairoiro katoa, ā, he maeneene ki te pā atu.
- Te Korokoro Pona: Koinei te wā e puta ai he puku totoka, he puku wai rānei (pona) i roto i te tairoiti, ka ahua puku te repe.
- Te Korowha Multinodular: Ka puta tēnei ina tupu ngā pona maha i roto i te repe tairoi. Tērā pea ka kitea ēnei pona mai i waho, ka kitea rānei mā te whakaahua tātaritanga.
I runga i ngā taumata o te homoni tairoi:
- Te mate pukupuku paitini: I tēnei wā, ka nui rawa te whakaputanga o ngā homoni tairoi e te tairoi nui, ka hua ake he mate tairoi kaha rawa e mōhiotia ana ko te hyperthyroidism.
- Ko te Goiter Kore-paitini: Ahakoa kua nui te tairoiti, kei te noho noa tonu ō taumata homoni. Kāore he hyperthyroidism, kāore hoki he tairoiti ngoikore (hypothyroidism). Ka kiia tēnei e ngā tākuta he āhua "euthyroid".
I ētahi wā, ka whakakotahi pea ngā tākuta i ēnei whakarōpūtanga. Hei tauira, ko te "toitini maha-nodular goiter" ko te tikanga kua whanakehia e tō tairoi he maha ngā pona e whakaputa kaha ana i ngā homoni taikaha.
Ko wai kei te tūpono ki te whakawhanake i te Goiter?
Ahakoa ka pāngia te tangata e te mate puku, he nui ake te kitea i roto i ngā wāhine. Inaa, e whā ngā wā ka nui ake te tūponotanga o te pāngia o ngā wāhine e te mate puku i ngā tāne . Ka piki ake hoki tō tūponotanga i a koe e pakeke haere ana, ā, ko te nuinga o te wā ka kitea te mate puku i muri i te 40 tau te pakeke .
Hei tāpiri, ka nui ake pea te tūponotanga o te whakawhanake i te mate pukupuku mena kei a koe tētahi o ngā āhuatanga e whai ake nei:
- Momonatanga
- Te ātete ki te insulin
- Te mate pāwera
Hei tāpiri atu, mēnā kua whiwhi koe i te rongoā irahiko i tō mahunga, i tō kaki rānei, mēnā rānei he hītori whānau tōu mō te mate tairoi , ka nui ake te tūponotanga ka pāngia koe e te mate puku.
He Pēhea te Noa o tēnei Āhuatanga?
He mea noa te mate puku. Hei tauira, i te Hononga o Amerika, e 5% o te taupori e pāngia ana e ēnei mate.
I te ao whānui, ko te korenga o te iodine te tino take o te mate puku. E kiia ana e tata ana ki te 2.2 piriona tāngata o te ao e noho ana i ngā rohe e pāngia ana e te korenga o te iodine.
Ko te tūponotanga o te whakawhanaketanga o te mate puku ka whakawhirinaki ki te kaha o te korenga o te iodine:
- I ngā rohe ngoikore ngawari o te iodine , ko te auau o te mate goiter kei waenga i te 5% me te 20%.
- I ngā rohe he ngoikore te iodine , ka piki ki waenga i te 20% me te 30%.
- I ngā rohe tino ngoikore ai te iodine , ka neke ake te reiti i te 30%.
He aha ngā tohu hei tirotiro māu?
Ka rerekē te rahi o ngā puku, mai i te pupuhi iti noa iho ki te puranga nui rawa. I te nuinga o te wā, kāore he mamae. Heoi, ki te mea nā te mate tairoiti (mumura o te repe tairoiti) te pupuhi, tera pea ka pāngia koe e te ngawari, te mamae rānei i te wāhi.
Ko ngā tohu tino kitea o te mate pukupuku ko:
- He puku, he pupuhi rānei e kitea ana i mua o tō kaki , i raro tonu i tō āporo o Ātama.
- He kare ā-roto e kikī ana i roto i tō korokoro .
- Te pāorooro , ngā panoni rānei o tō reo.
- Ngā uaua kaki pupuhi.
- Te ānini o te mahunga ina ara ake ō ringa ki runga ake i tō mahunga.
Tērā pea ka puta ētahi atu tohu kāore i te tino kitea mēnā ka pēhia e te mate pukupuku nui ngā hanganga e karapoti ana:
- Te uaua ki te manawa (te poto o te manawa) .
- Te maremare.
- He tangi whiowhio teitei i te wā e manawa ana (stridor), e puta mai ana i te pēhanga o te paipa hau.
- Te uaua ki te horomi (dysphagia), nā te pēhanga o te paipa kai.
Mena kei te hono tō goiter ki te tairoi kaha rawa (hyperthyroidism), ka pāngia pea koe e:
- Te tere o te manawa (tachycardia) .
- Te whakahekenga taumaha kāore i te whakamāramatia .
- Te korere, te nekeneke pinepine rānei o te puku.
- Te werawera nui ahakoa e okioki ana, e mātao ana rānei.
- Te wiri, te wiri rānei o ngā ringaringa.
- Te manukanuka, te mataku, te pukuriri rānei.
I tetahi atu taha, ki te hono tō goiter ki te tairoi ngoikore (hypothyroidism), ka kite pea koe i ngā tohu penei:
- Te ngenge nui, te ngenge rānei (te ngenge nui) .
- Te mate kōroke.
- Kiri maroke.
- Te pikinga taumaha kāore i te mārama .
- Ngā huringa paheketanga koretake.
He aha ngā take o te mate puku?
Ko te tikanga, ko te mate puku he urupare urutau a tō repe tairoi ki tetahi mea e whakararuraru ana i tōna kaha ki te whakaputa homoni. Ahakoa ko te korenga o te iodine te take matua o te ao, he maha atu ngā take matua ka taea te whakanui i te repe.
Ko ngā tino take o te mate pukupuku:
- Te Kore o te Iodine: Me tino hiahia tō tairoiti ki te iodine hei hanga i ngā homoni. Mēnā kāore i te rawaka te iodine i roto i tō kai, ka mahi te tairoiti i te wā roa ki te hopu i ngā mea katoa e wātea ana, ka pupuhi i a ia e whakanui ana i ngā pūtau hei whakakapi. Ahakoa koinei te tino take o te ao, he iti ake te kitea i ngā whenua kei reira te tote tēpu iodized. Ka taea e koe te tiki i te iodine mā te taiao mai i ngā kaimoana, ngā miraka, me te tote iodized. Heoi, kaua e tango i ngā tāpiringa iodine me te kore he tirotiro hauora, nā te mea ka taea e te nui o te iodine te whakaoho, te whakararu rānei i ētahi atu raruraru tairoiti.
- Te mate o Graves:He mate pūnaha ārai mate tēnei e whakaeke hē ai tō pūnaha ārai mate i te tairoi, ka nui rawa te whakaohooho. Ka nui haere te repe, ka nui rawa te homoni e whakaputaina ana, ka hua ake te hyperthyroidism, me te rongoā hauora.
- Te Mate Tairoiti o Hashimoto: Ko tētahi atu mate pūnaha ārai mate, ko te mate a Hashimoto ka puta te mumura ka kino haere tō tairoiti. Hei whakautu, ka pupuhi pea te repe hei utu mō te hekenga o te whakaputanga homoni. Ahakoa ka taea e ēnei mate pukupuku te whakakore i a rātou anō i ētahi wā, he maha ngā tūroro e hiahia ana ki te rongoā whakakapinga homoni tairoiti hei whakahaere i te ngoikore o te mahi.
- Matepukupuku Tairoiro: Ahakoa kāore i te tino kitea, ka puta pea te matepukupuku tairoiro hei pona ā-rohe, hei pupuhi rānei.
- Te hapūtanga: Ka taea e te homoni human chorionic gonadotropin (hCG), e tukuna ana i te wā e hapū ana, te whakanui ake i te repe tairoiti.
- Te mate tairoidi: Ko te mumura o te tairoidi tonu, e puta mai ana i ngā mate huaketo, i ngā huringa rānei i muri i te whānautanga, ka arahi pea ki te pupuhi me te kore whakamarie.
I ētahi wā, ka puta ngā mate puku kāore he tino take; e kiia ana ēnei he mate puku puku tūpono. Ka taea hoki e ētahi rongoā te whakararuraru i te mahi tairoi, ā, ka pupuhi, pērā i te lithium, e whakamahia ana hei rongoā i ngā mate hinengaro.
Me pēhea te tautuhi a ngā tākuta i te mate pukupuku?
I roto i te whakamātautau tinana o ia rā, ka taea e tō tākuta te kite ngāwari i te nui haere o te tairoi mā te pā noa ki tō kaki me te tono kia horomia koe. Heoi, ko te tautuhi i te mate pukupuku te taahiraa tuatahi noa iho - me whakatau hoki e tātou te take matua o te pupuhi. Hei mahi i tēnei, he maha ngā whakamātautau tautuhi ka tūtohutia pea:
- Whakamātautau Tinana: E ai ki te kōrero, ka ata whāwhā tō tākuta i tō kaki hei aromatawai i te rahi o tō tairoi, tirohia mēnā he pona, me te whāwhā mēnā he ngawari.
- Ngā Whakamātautau Toto o te Tairoiro: Ka inehia e ēnei whakamātautau ngā taumata o te homoni whakaoho tairoiro (TSH) me ngā homoni tairoiro kore utu (T4 me te T3) i roto i tō toto hei whakatau mēnā kei te mahi tika tō tairoiro, kāore i te kaha, kei te kaha rawa rānei.
- Whakamātautau Paturopi: Ka rapua e tēnei whakamātautau toto ngā paturopi motuhake e pā ana ki ngā mate tairoi ārai mate pērā i te mate a Hashimoto, te mate a Graves rānei. Ko ngā paturopi he pūmua ārai mate e aro hē ana ki ō ake kiko i ētahi wā.
- Te Whakamātautau Ira-oro o te Tairoiro: Ka whakamahia e tēnei whakamātautau whakaahua ngā ngaru oro auau teitei hei hanga tirohanga taipitopito o tō tairoiro. Mā tēnei ka taea e mātou te tirotiro i te rahi o te repe me te whakatau mēnā he pona kei roto, ā, mēnā he totoka, he wai rānei aua pona.
- Te Whakapūtanga o te Ngira Pai (Biopsy): Mena he pūngao kitea kei roto i tō tairoi, ka whakahaerehia pea e tō tākuta he biopsy. Ka whakamahia he ngira tino angiangi hei tango i tētahi tauira iti o ngā pūtau hei tātaritanga taiwhanga, ko te nuinga hei whakakore i te mate pukupuku.
- Te Tangohanga me te Matawai i te Tairoiro: Ka whakaratohia e tēnei whakamātautau rongoā karihi ngā taipitopito mō te rahi me te mahi a tō tairoiro. Kei roto ko tētahi horopeta iti, haumaru o te rauemi irahiko (ka tangohia ā-waha, ka werohia rānei) hei tirotiro me pēhea te mimiti o tō tairoiro. Ko te tikanga he mea whakarite tēnei mō te aromatawai i ngā āhuatanga motuhake pēnei i te hyperthyroidism.
- Matawai CT, MRI rānei: Mena he tino nui te puku, kua tipu rānei ki roto i te uma, ka taea te whakamahi i te matawai CT, MRI rānei hei ine i tōna rahi tika me te aromatawai i te nui o tana pēhi i ngā ara e karapoti ana.
Ka taea e te mate pukupuku te whakatau ko ia anake?
I ētahi wā, ka memeha noa iho te mate pukupuku ngawari i roto i te wā, me te kore he wawaotanga hauora.
He maha ngā mate puku, pērā i ngā mate puku maha-nodular, ka puta me ngā taumata homoni tino noa (euthyroid). Kāore pea ēnei mate puku e hiahiatia he rongoā tonu ina whakaūtia he pai. Heoi anō, me aroturuki tonu nā te mea he tūponotanga roa kei te whanake he tairoi ngoikore, he tairoi kaha rawa rānei i muri mai.
Ahakoa te iti o te ahua, ki te kite koe i tētahi pupuhi i tō kaki, he mea nui kia rapu aromatawai hauora ngaio . Nā te mea he maha ngā take taketake o te mate puku, ko ētahi me tere te maimoatanga, me te whakarite i te maimoatanga.
He aha ngā kōwhiringa maimoatanga e wātea ana?
Ko te huarahi hei rongoā i te mate puku ka whakawhirinaki katoa ki tōna rahi, ō tohu, me te pūtake. Ko ngā huarahi rongoā noa ko:
- "Tatari Mataara" (Tirotiro): Mena he iti tō puku, kāore e tipu, ā, kāore e puta he tohu ā-tinana, he koretake rānei o ngā homoni, me aroturuki tata koe i a ia mā te tirotiro me te tango i ngā ultrasound i ia wā, kaua e tīmata i te maimoatanga.
- Ngā rongoā:
- Ko te Levothyroxine (hei tauira, Levothroid®, Synthroid®) he rongoā whakakapinga homoni tairoi. Mena ko te take o tō goiter he ngoikore te mahi o te tairoi (hypothyroidism), ka tohua pea tēnei e tō tākuta hei whakatikatika i ō taumata.
- Mena he nui rawa te mahi a te tairoi (hyperthyroidism) i puta mai ai tō goiter, ka whakamahia ētahi atu rongoā pēnei i te Methimazole (hei tauira, Tapazole®) me te Propylthiouracil .
- Mena ko te mumura te tino take, ka tohua pea e tō tākuta he Aspirin , he Corticosteroid rānei hei whakaiti i te pupuhi me te mamae.
- Te Whakaora Iodine Irahiko: E whakamahia ana mō ngā tairoiti kaha rawa (hyperthyroidism), ko tēnei maimoatanga ko te tango i te iodine irahiko mā te waha. Ka haere te iodine ki te tairoiti, ā, ka whakangaro i tētahi wāhanga o te kiko kaha rawa, ka whakaiti i te goiter. Kia mahara, ka arahi pea tēnei ki te tairoiti ngoikore, ka hiahiatia he rongoā whakakapinga homoni mō te wā katoa.
- Pokanga (Thyroidectomy): Ka tūtohu pea tō tākuta kia tangohia katoatia, kia wāhanga rānei o tō tairoi. He maha ngā wā ka tohua te pokanga mēnā he nui te goiter hei pēhi i ō ara manawa, i tō korokoro rānei (ka uaua ai te manawa, te horomi rānei), mēnā rānei me tango ngā pona whakapae. Mēnā ka kitea te mate pukupuku tairoi, he mea nui te pokanga. I runga i te nui o te repe ka tangohia, me tango pea e koe ngā pire whakakapinga homoni tairoi i ia rā mō te toenga o tō oranga.
Ka taea e koe te ārai i te mate puku?
Ko te mate puku noa i puta mai i te korenga o te iodine te momo mate puku anake ka taea e koe te ārai. Ka taea tēnei mā te pupuri i tētahi kai taurite e nui ana te iodine, tae atu ki te ika, ngā hua miraka, me te tote tēpu whai iodine paerewa. Mō ētahi atu momo mate puku, kāore i te tūtohutia te tango i ngā tāpiringa iodine, i ētahi atu rongoā rānei ka hokona noa i te toa rongoā me te kore he tohutohu hauora, nā te mea ka kino ake te āhua o tō tairoi, kaua e āwhina.
He aha te matapae mō te tangata he mate puku?
Ko te tirohanga roa (matapae) mō te tangata whai mate puku ka whakawhirinaki katoa ki te momo puku me tōna pūtake.
He pai te āhua o te mate puku noa. Heoi, ki te haere tonu te rahi o te repe, kāore e āraihia, ka pēhia pea ngā whekau tata, ka uaua ai te manawa me te horomi, ka puta rānei he reo pākiki tonu.
Mena he tohu te pupuhi o tētahi atu mate pūnaha ārai mate, pērā i te mate a Graves, i te mate thyroiditis a Hashimoto rānei, ka whakawhirinaki tō tirohanga whānui ki te angitu o tā mātou whakahaere i taua mate.
Āhea koe me toro atu ki te tākuta mō te mate goiter?
Ahakoa te tātaritanga tuatahi, ki te mea kua whakapumautia tō mate pukupuku,He mea tino nui kia whakaritea he tirotiro auau me tō tākuta (kia kotahi te wā i te tau) hei aroturuki i tōna rahi me ō taumata homoni.
Ki te tīmata koe ki te kite i tētahi tohu hou, ki te kino haere rānei, whakapā atu ki tō kaiwhakarato hauora tonu atu.
He pokapū whakahaere nui tō tairoi mō tō pūnaha endocrine katoa, ā, he mana nui tōna ki tō hauora whānui. Ko te whakanui i tēnei repe he tohu whakatūpato mō tētahi raruraru tairoi kei raro iho. Ko te rongo whakamarie, he tino ngāwari te rongoā i ngā mate puku, ā, ko ētahi ka memeha noa iho. Mena ka kite koe i tētahi puku, i tētahi pupuhi rerekē rānei i mua o tō kaki, tēnā whakapā atu ki tō kaiwhakarato hauora. Ka taea e mātou te tirotiro i te pūtake o te mate, ka kitea te mahere pai rawa atu, tino whakamarie hoki māu.
Ngā Kaupapa Matua hei Maumahara
Ko te tumanako ka āwhina ēnei mōhiohio i a koe kia mōhio ake, kia marino ake hoki mō te mate puku. Anei tētahi whakarāpopototanga poto o ngā mea kua kōrerohia e mātou:
- Ko te goiter he whakanui o te repe tairoiti, ka puta pea i ngā āhuatanga hauora maha.
- Ki te kite koe i te pupuhi i tō kaki, he uaua ki te horomi, ki te manawa rānei, he rerekētanga ohorere rānei o te reo, me rapu tonu i te tohutohu hauora ngaio.
- Kāore e hiahiatia ana te rongoā mō ngā mate puku katoa, engari he mea nui te tautuhi i te pūtake me te aroturuki i te repe mō tō hauora mō te wā roa.
- Ahakoa ko te korenga o te iodine te tino take o te ao, kua iti ake te kitea o tēnei mate i roto i ngā whenua whakawhanake i ngā mahi hauora tūmatanui pēnei i te tote whai iodine.
- Kaua rawa e tīmata ki te tango i ngā homoni tairoi, i ngā tāpiringa iodine rānei, me te kore he tohutohu a te tākuta.
- Mena kua tāpaetia kei a koe te mate puku, ko te haere ki ngā whakamātautau haumanu auau te mea nui hei pupuri i tō hauora.
Kāore he take e mataku ai. Mēnā he tika te arataki hauora, he ngāwari te whakahaere i te mate puku, ā, kei konei tonu te tīma i Nirogi Lanka hei tautoko i a koe.
