ʻO ka hypenitisism kongenital e pili ana i kahi hui heterogeneous. Hōʻike ia iā ia iho me ka nele o nā hormone thyroid, e hoʻomohala ma muli o dysgenesis o ka hoʻokūkū o ka hypovisary a i ʻole nā thyroid gland.
ʻO ke kumu o ka hypothyroidism he mau congenital pathology o ke kāpili ʻana o ka nui o ka thyroid a me nā ʻano o nā mea exogenous āpau (ke pani ʻia ʻana o nā antibodies, nā mea kanu, a me nā mea hou aku).
Ma nā huaʻōlelo maʻalahi, ka hypothyroidism congenital ʻo hypothyroidism o kekahi kumu e hōʻike ana iā ia iho a loaʻa iā ia ka hānau.
Hoʻokomo ʻia nā mea nui i ka Hypothyroidism Congenital
Ma kahi o 85% o nā hanana o ka hypothyroidism congenital he sporadic. ʻO ke kumu o ka hapa nui o lākou he dysgenesis o ka nui o ka lāʻau thyroid.
Ma kahi o 15% o nā manawa o ka hypothyroidism congenital ma muli o ka hoʻolaha ʻana o nā antibodies o ka makuahine i ka aʻai kelepaʻi a i ʻole ka hoʻoilina o nā pathologies o T4 synthesis.
Eia kekahi mau ʻano congenital hypothyroidism i kēia mau lā nā hanana genetic e alakaʻi i ka hoʻomohala ʻana i ka maʻi.
ʻO nā kumu nui o ka hypothyroidism congenital
Nā maʻi thygenesis (underdevelopment):
- Hypoplasia (25-35%).
- Agenesis (23-43%).
- Dystopia (35-43%).
Nā alahele iʻike ʻia o ka T4 synthesis:
- ʻĀina Syndrome.
- Ke ala o ka thyxidase thyroid.
- Ke helehelena o ka sodium iodide opurt.
- Ke kuʻuna o ka thyroglobulin.
- ʻO ke ala nui o ka deiodinase thyroid.
ʻO ka hypnotalamic central hypothalamic-pituitary hypothyroidism.
Hoʻokomo ʻia ka congenital hypothyroidism e nā antibodies māmā.
He aha ka mea e hana ai me ka hypothyroidism?
ʻO ka hoʻomohala o ka prenatal o ka pūpū, ma muli o ke kumu i hele ʻole ai ka pancreas a ʻaʻole i hana, hele ma muli o ka hormone thyroid o ka makuahine, e komo ana i ka placenta.
Ke hānau kahi pēpē, hāʻule nui ka pae o kēia mau hormones i loko o kona koko. I ka hana o ka intrauterine o ka pūpū, ma mua o kona wā mua, e lawa pono nā hormones thyroid no ka hoʻolālā kūpono ʻana o ka pūnaehana hoʻonāukiuki o ka pēpē.
He mea koʻikoʻi kēia no nā hana o ka meelination o nā lolo neurons.
Me ka nele o nā hormone thyroid i kēia manawa, ʻano hana o kahi cortex cerebral o ke keiki, ka mea e pau ʻole ai. Hōʻike ia iā ia iho i nā pae like ʻole o ka retardation noʻonoʻo o ka pēpē a hiki i ka cretinism.
Inā hoʻomaka ʻia ka hoʻololi hoʻololi ʻana i kahi manawa kūpono (ʻo ka pule mua o ke ola) e pili ana i ka hanana ʻana o ka hanana nū o ke kikowaena olakino. Me ka hoʻolālā pū ʻana o kahi pōʻino i loko o ka kinipōpō i loko, me ka uku hoʻopihapiha i ka hypenitisism congenital.
Nā Hoʻomaka
I ka nui o nā hihia, ʻaʻole pono ka ʻona maʻi o ka hypothyroidism hopena. Hiki keʻikeʻia ka congenital hypothyroidism i kahi keiki hou ma muli o nā hōʻailona o ke kiʻi lāʻau lapaʻau i nā manawa 5% wale nō.
Nā hōʻailona mua o ka hypothyroidism congenital:
- ʻōpū māhā;
- ka lōʻihi loa (ʻoi aku ma mua o 7 mau lā) hyperbilirubinemia;
- leo haʻahaʻa;
- umbilical hernia;
- hoʻonui ʻia posterior fontanel;
- hypotension;
- hoʻonui ʻia thyroid;
- macroglossia.
Inā ʻaʻole i lawe ʻia nā hana therapeutic i ka manawa, ma hope o 3-4 mau mahina i ʻike ʻia ai kēia mau hōʻailona aʻe:
- pilikia paʻakikī;
- ʻilihune maikaʻi ʻole ʻole;
- pāhawewe;
- loaʻa ka waiwai maikaʻi ʻole;
- ka maloʻo ʻana a me ka palu o ka ʻili;
- hypothermia;
- hōʻai naʻau.
Ma hope o ʻeono mau mahina o ke ola, hōʻike ke keiki i nā hōʻailona o ka lohi i ka hoʻomohala ʻana i ka olakino, psychomotor development a me kahi ulu liʻiliʻi ʻole.
E maikaʻi nā ʻike, he aha nā hōʻailona a me ka mālama ʻana o ka hypothyroidism i nā wahine, no ka mea e noho mau kahi maʻi congenital me ka mea maʻi no ke ola.
ʻO ka maʻi maʻi
Pono e kuhikuhi pono i ka hana hoʻohālikelike me ka wikiwiki o ka hoʻohana ʻana i ka T4 i ke koko, a laila lilo ke koho ʻana i kahi momona o L-T4 e ukali ana, ʻo ia ka mea e hōʻoia ai i ka hoʻomau mau o ka ʻike paʻa ʻana o ka T4 a me TSH.
ʻO ka paipai mua o ka momona o L-T4 e like me 10-15 mcg / kg kino kino i kēlā me kēia lā. E hana hou ʻia ka nānā ʻana a me ka nānā ʻana no ke koho ʻana i kahi wai kūpono o ka L-T4.
ʻO ka hoʻomaikaʻiʻana no ka hypothyroidism congenital
Ka hilinaʻi nui ʻana o ka maʻi i ka timeliness o ka hoʻomaka ʻana o ka hoʻōla hoʻololi L-T4. Inā ʻoe e hoʻomaka i nā ʻelua pule o ka ola hou o ka male hou ʻana, nalowale loa nā hewa ʻana o ka hoʻomohala kino a me ka psychomotor.
Inā hoʻomaka ʻia ka manawa hoʻomaka o ka hānō o ka honi ʻana, a hoʻomaka ka pilikia, piʻi ka hopena o ka hoʻomohala ʻana o ka maʻi, a hiki i ka oligophrenia a me nā ʻano koʻikoʻi.
He maikaʻi loa ka nānā ʻana o ka hypothyroidism me ka hoʻomākaukau ʻana i ka hoʻokaumaha hormone thyroid. ʻO ka lāʻau lapaʻau ʻoiaʻiʻo loa no ka hypothyroidism i manaʻo ʻia ʻo ka hormone thyroid i loaʻa synthetically (artificially).
ʻO ke ʻano wale o ke kauʻana i ke ʻano me kēia lāʻau lapaʻau ke kipa maʻamau i ke kauka, nāna e koho i ke ʻano kūpono o ka lāʻau a hoʻoponopono iā ia i ka wā mālama.
Hoʻomaka nā hōʻailona o ka hypothyroidism e nalowale, nui loa i ka wiki mua o ka lāʻau. ʻO kā lākou pau loa i hoʻopau ʻia i loko o kekahi mau mahina. Loaʻa nā keiki i ka makahiki mua o ke ola a ma kahi ʻelemakule ponoʻole ka mālama ʻana. ʻO nā kānaka a me nā nāwaliwali nāwaliwali e pane mālie e lawe i ka lāʻau.
- Inā maʻa ʻia ka hypothyroidism ma muli o ka nele o kāu gland thyroid, kahi maʻi o Hashimoto, a i ʻole ka maʻi radiation, i ʻole ke ʻano o kona mālama ʻana. ʻO kaʻoiaʻiʻo, aia kekahi mau hihia, me ka thyroiditis Hashimoto, ua hoʻihoʻi hou ʻia ka hana o ka pancreas.
- Inā ʻo nā ala āpau ke kumu o ka hypothyroidism, ma hope o ka pauʻana o nā maʻi lalo, nalowale nā hōʻailona o ka hypothyroidism.
- ʻO ke kumu o ka hypothyroidism kekahi mau lāʻau lapaʻau, ma hope o ke hoʻopau ʻia ʻana o ka ʻōmaʻomaʻo o ka thyroid.
- ʻAʻole pono ia ʻo Hypothyroidism i nā ʻano latin o nā lawelawe. Eia nō naʻe, i ʻole e pau i ka holomua o ka maʻi, pono ka mea maʻi e nānā mau loa.
Loaʻa nā ʻikepili e pili ana i nā pono o ka ʻoihana substitution no ka hypothyroidism latent i loaʻa i kēia lā, a ʻokoʻa nā manaʻo o nā ʻepekema e pili ana i kēia pilikia. I kēlā mau hihia, i ka wā e hoʻoholo ai i ka kūpono o ka mālama ʻana, ke kūkākūkā pū me ka mea kauka me ka mālama ʻana i ka pono o ke kumukūʻai kālā o ka mālama ʻana a me nā mea e pili ana i ka maʻi me ia.
E makaʻala! ʻO ka poʻe maʻi e hōʻeha nei i nā maʻi o ka pūnaehana cardiovascular a me ka diabetes mellitus e pono ai i ka dosis pono o nā lāʻau lapaʻau, ʻoiai ua nui ka nui o ka holomua o ka nui o ke kaina pectoris a i kahi atrial fibrillation.
Kukola
Me ka hōʻike ʻana i ka hypothyroidism congenital, ua kau ke kauka i nā lāʻau lapaʻau e komo ai i ka sodium levothyroxine, ka mea e ola ai ka nui.
- Levoxyl.
- Synthroid.
- Hūpiha.
Pono e lawe ʻia nā lāʻau lapaʻau e like me nā kuhikuhi a me ke koho ʻana i ka endocrinologist. Ma hope o 1.5-2 mau mahina o ka mālama ʻana, pono ia e kipa i ke kauka i mea e hōʻoia i ke kūpono o ka ʻona i ʻōlelo ʻia. Inā hoʻohuli ʻo ia ka liʻiliʻi loa o ka nui, loaʻa nā maʻi i ka hōʻailona o ka hypothyroidism:
- ʻO ka loaʻa kālā.
- Kaaudeana
- ʻOmaʻomaʻo.
- Kalani.
Inā nui aʻe ke ʻano, ua ʻokoʻa nā hōʻailona:
- Insomnia
- ʻŪngū.
- Kaipo keiki.
I ka poʻe maʻi me ka puʻuwai puʻuwai, i ka hoʻomaka ʻana o ka mālama ʻana, e hoʻolaʻa pinepine ʻia kahi liʻiliʻi o ka levothyroxine, e hoʻonui iki ʻia e pono. Inā paʻakikī ka hypothyroidism i ka manawa o ka hopena o ka maʻi, ʻaʻole hiki ke ʻae ʻia ke hoʻopiʻi.
Nui! I ka hiki ʻole o ka hoʻomaʻamaʻa kūpono ʻana, ʻo ka hypothyroidism congenital i loko o nā keiki hiki ke alakaʻi i kahi kūlana maʻamau, akā he mea weliweli loa ia - ke ola hypothyroid (myxedema coma). Ke mālama ʻia nei ka mālama ʻia ʻana o kēia maʻi ma kahi haukapila, i loko o ka waihona mālama mālama me ka hoʻokele intravenous o ka hoʻomākaukau ʻana i ka lāʻau thyroid.
Inā hele ʻole ka hana i ka hanu, ua hana ʻia kahi ʻano hana hoʻowalewale kūloko. Ke hoʻomanawanui nei ka mea maʻi i kahi ʻano kauka piha piha no ka hiki ʻana o nā pathologies concomitant o ka puʻuwai. Inā loaʻa iā lākou, e kuhikuhi ʻia ka hana kūpono.
Ke kāohi nei i ka hypothyroidism i kahi keiki
Pono ke ʻano o ka hypothyroidism i ka wā hapai me ka mālama kūikawā, no ka mea e hiki ke hoʻopilikia i ka hoʻomohala ʻana o ka wahine a me nā kumu o nā alahele congenital.
- Me ka hypothyroidism i kahi wahine hāpai, pono koke e mālama. Inā hōʻike ka maʻi i mua o ka hapai ʻana, pono mau ka wahine e kiaʻi pono i ka pae o ka hormone thyroid a hoʻokau i ka hoʻoponopono kūpono ʻana i ka lāʻau i ʻōlelo ʻia i loko o ka lāʻau. Ke lawe nei i kahi keiki, pono ka hoʻonui ʻana i ka hāmeʻe ma 25-50%.
- Hiki ke ola no ka mālama ʻana me ka hypothyroidism postpartum. Me ka hoʻomaka ʻana o kēlā me kēia hāpai ʻana hou, pono nā wahine e hoʻomaʻamaʻa piha i ka hypothyroidism. ʻO kekahi manawa hele ka maʻi postpartum ma hope iho, a ma nā hanana ʻē aʻe, e hoʻomau ka maʻi ma ke ola o ka wahine.
Hoʻoponopono mālama
ʻO ka manawa pinepine loa, ʻo ka mālama ʻana o ka hypothyroidism ke ola lōʻihi, no laila e lawe pono ʻia ka lāʻau lapaʻau e ʻae e like me ke kumu. I ka manawa e holomua ana ka hypothyroidism congenital, no laila ke ʻano nui o ka nui o ka hormone mai ka manawa i ka manawa, e like me ka nui o ka attenuation o ka hana thyroid.
I loko o nā hapa he nui e lawe ana i ka hoʻomākaukau ʻana i ka hormone thyroid, ma hope o kā lākou haʻalele ʻana, e hoʻomohala ʻia nā hōʻailona o ka hypothyroidism me ka ikaika hou. I kēlā kūlana, pono e hoʻomau ʻia ka lāʻau lapaʻau.
Hiki i nā kongenital hypothyroidism ke kūkulu i ka hoʻopiʻi ʻana o kekahi maʻi maʻi. I kēia hihia, ma hope o ka hoʻōla ʻia o ka maʻi lalo, hoʻihoʻi hou ʻia ka hana thyroid. I mea e hoʻāʻo ai i kāna hana, e hoʻopau ʻia kahi manawa iki o ka hoʻohana ʻana i kahi mākaukau hormone thyroid.
ʻO ka hapa nui o nā poʻe maʻi me kēia huki ʻana e nānā i kahi hoʻihoʻi iki ʻana i nā hōʻailona nui o ka hypothyroidism. ʻO kēia no ke kino, me kekahi lohi, hoʻouna i nā hōʻailona i ka gland thyroid e pili ana i ka pono e hana hou i nā hana.
Inā hiki i ka gland ke hoʻokō kūʻokoʻa me ka wā e hiki mai ana, hiki ke hoʻopau ʻia ka mālama ʻana. ʻĀ, inā haʻahaʻa ka hana ʻana o ka hormone, pono ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau.
ʻO ka lawe ʻana i ka hoʻomākaukau ʻana i ka hormone thyroid e koi i ka mea maʻi e kipa i kahi keʻena olakino 2 mau manawa i kēlā makahiki (no ka hōʻoia hōʻoia). Ua hoʻāʻo ʻia ka poʻe maʻi no ka hoʻoulu ʻana i ka hormone thyroid (TSH). Hōʻike ka hopena o ke aʻo ʻana i ka hoʻokō ʻana o ka neʻe o ka hormone me nā kūleʻa.
