甲状腺 结节 和 甲状腺肿
Overview
A goiter is an enlargement of the thyroid, the H-shaped gl和 that wraps around the front of your windpipe, just below your Adam's apple.
A goiter can be smooth 和 uniformly enlarged, called 弥散性甲状腺肿, or it can be caused by one or more nodules within the gl和, called 结节性甲状腺肿. 结节 may be solid, filled with fluid, or partly fluid 和 partly solid.
甲状腺 nodules are quite common. When examined with ultrasound imaging, as many as one-third of women 和 one-fifth of men have small thyroid nodules.
肿大的甲状腺有可能继续正常工作并产生适量的激素. In fact, most goiters 和 nodules don't cause health problems. 然而, 甲状腺肿也可能是导致甲状腺产生过多甲状腺激素(称为甲状腺激素)的某些情况的征兆 甲状腺机能亢进)或太少(叫 甲状腺功能减退).
原因
几乎所有甲状腺肿大的病例都是由以下问题之一引起的:
Inefficient production of thyroid hormone
当甲状腺不能产生足够的甲状腺激素时，它会通过变大来补偿. Worldwide, the most common cause is not enough iodine in the diet. 然而, this is rare in the United States. 其他原因包括遗传缺陷或某些药物，如碳酸锂.
Inflammation of the thyroid
甲状腺发炎的常见原因包括自身免疫性甲状腺炎(也称为桥本甲状腺炎)。, which occurs when the person's immune system attacks its own thyroid, causing swelling 和 inflammation. 桥本甲状腺炎常导致永久性甲状腺功能低下(甲状腺功能减退)。.
Another common cause is postpartum thyroiditis. 这 affects about 5 percent of women in the year after pregnancy. It usually goes away on its own without treatment.
甲状腺炎症也可能由感染或某些药物引起.
甲状腺肿瘤
甲状腺肿瘤 are usually benign, but can be cancerous. 大多数肿瘤为结节，但也可表现为腺体的全身性肿胀.
Our approach to thyroid nodules 和 goiter
UCSF offers comprehensive consultations 和 treatments for thyroid conditions, including goiter (enlarged thyroid gl和) 和 thyroid nodules. 许多甲状腺肿大和甲状腺结节是无害的，所以我们通常可以采取观望的方法. 然而, 治疗可能是必要的甲状腺肿或结节引起麻烦的症状或健康问题, such as the production of too much or too little thyroid hormone. Additionally, some cases are caused by 甲状腺癌, although this is rare.
治疗方案包括甲状腺激素药物、放射性碘治疗和手术. For patients considering surgery, 加州大学旧金山分校提供了侵入性较小的方法，既不会留下疤痕，也不会在下巴下留下小疤痕.
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迹象 & 症状
Most thyroid nodules are too small to see or feel. 它们往往是在你做影像学检查时发现的，因为其他原因.
A large nodule or goiter may cause a sense of tightness or pain in your neck, 有时会变大到干扰呼吸或吞咽.
If your thyroid function is affected, you might notice other 症状. 如果你的腺体分泌过多的甲状腺激素(甲状腺功能亢进)，你可能会经历:
- 减肥
- 失眠
- 焦虑
- 颤抖的手
- 热不宽容
甲状腺分泌甲状腺激素过少(甲状腺功能减退)的迹象包括:
- 体重增加
- 不耐冷
- 肌肉痉挛
- 思维缓慢
- 抑郁情绪
诊断
If a thyroid nodule or goiter is suspected, your doctor will examine you for signs of thyroid enlargement. 你的十大赌博平台排行榜也会检查你甲状腺附近是否有淋巴结肿大, 同时寻找甲状腺激素分泌过多或过少的迹象. 我们会询问你的病史和你经历过的任何症状.
You will likely need additional diagnostic 测试s, which may include:
- 甲状腺超声检查. 这 测试 将声波射入颈部，形成甲状腺和周围组织的图像.
- A blood 测试 for thyroid-stimulating hormone (TSH). 这种激素由脑下垂体产生，并帮助调节两种甲状腺激素的产生, triiodothyronine (T3) 和 thyroxine (T4). 的 测试 can rule in or out common causes of 甲状腺机能亢进 和 甲状腺功能减退. 如果你的TSH很低, 你可能患有良性甲状腺肿瘤，产生大量甲状腺激素. 如果你的TSH很高, you may have an underactive thyroid gl和; its enlargement may stem from inflammation caused by an autoimmune disorder.
- Radionuclide thyroid scan. 这 测试 使用放射性示踪剂——你可以吞下或注射——和一个特殊的相机来评估你的甲状腺功能.
细针抽吸. 在 这个测试十大赌博平台排行榜会用细针从结节上取下一小部分来检查是否有癌症. 如果你的TSH正常或高，你的甲状腺结节直径超过1 / 2英寸, you will likely need a biopsy.
幸运的是, 大多数活检的甲状腺结节是良性的(非癌性的)，不需要手术. 你只需要定期接受十大赌博平台排行榜的检查，以确保结节没有生长.
For all patients with nodules or goiters, our goal is to answer the following questions in our evaluation:
1. Is the thyroid (or part of the gl和) so large that it is stretching, compressing or invading nearby structures in the neck?
2. 甲状腺工作正常吗?还是甲状腺激素分泌过多或过少?
3. Is the goiter or nodule due to cancer?
这些问题的答案将决定你的最佳治疗方案.
治疗
Many goiters 和 nodules can be followed with a "watch 和 wait" approach. If they are causing bothersome 症状 or impacting your health, 然而, they will need to be treated, 通常是外科手术. 这 includes cases such as:
- 不舒服或导致呼吸或吞咽困难的大甲状腺肿.
- 多结节性甲状腺肿，尤指气管、食道或血管收缩的甲状腺肿.
- Nodular goiters causing 甲状腺机能亢进 (overactive thyroid), 如果不能使用放射性碘或抗甲状腺药物治疗.
- 甲状腺肿s or nodules that are malignant (甲状腺癌).
- 甲状腺 nodules that produce uncertain results on a biopsy.
放射性碘
这种治疗主要用于缩小甲状腺肿或结节，导致甲状腺产生过多的甲状腺激素. 的 iodine is given as a capsule or liquid. 一次吞下, it concentrates in the thyroid 和 destroys some or all of the thyroid tissue, without harming other tissues.
甲状腺 hormone medication (L-thyroxine)
这种合成形式的甲状腺激素可以帮助缩小甲状腺肿大和治疗甲状腺功能低下. 甲状腺功能减退症状通常在开始服药的第一周内开始改善, 和 disappear within a few months.
手术
如果甲状腺肿大到拉伸或压缩附近的结构, or if it has become unsightly, you may need surgery to remove all or part of the thyroid. 类似的, 大的甲状腺结节——以及你的十大赌博平台排行榜怀疑可能是恶性的结节——可能需要手术切除.
甲状腺 surgery carries a risk of affecting the voice, 因为有可能对控制声带运动肌肉的神经造成损伤. 这可以从唱歌时失去一个或两个高八度，到把声音变成耳语.
Depending on how much of the thyroid gl和 is removed, you may need to take synthetic thyroid hormone for the rest of your life.
加州大学旧金山分校健康 medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
