Ukuthi Amathambo ’Izifo Ziwathinta Kanjani Amehlo

-Delile

• Siyini isifo samathuna?
• Ziyini izimpawu ze-Graves ’ophthalmopathy?
• Yini ebangela i-ophthalmopathy yamathuna?
• Kutholakala kanjani ukuthi i-Graves ’ophthalmopathy?
• Yelashwa kanjani i-ophthalmopathy yamathuna?
• Uyini umbono?

Siyini isifo samathuna?

Isifo seGraves yisifo sokuzilimaza esibangela ukuthi indlala yakho yegilo ikhiqize ama-hormone amaningi kunokuba kufanele. I-thyroid engasebenzi ngokweqile ibizwa nge- hyperthyroidism.

Phakathi kwezimpawu ezingaba khona zesifo se-Graves kukhona ukushaya kwenhliziyo okungajwayelekile, ukwehla kwesisindo, kanye nendlala yegilo eyandisiwe (goiter).

Kwesinye isikhathi, amasosha omzimba ahlasela izicubu nemisipha ezungeze amehlo. Lesi yisimo esibizwa nge-thyroid eye disease noma i-Graves ’ophthalmopathy (GO). Ukuvuvukala kubangela ukuthi amehlo azizwe eqinile, omile futhi ecasukile.

Lesi simo singenza futhi namehlo akho avele aqhume.

Isifo samehlo samathuna sithinta abantu abaphakathi kwamaphesenti angama-25 kuya kwangama-50 abanesifo samathuna.UHiromatsu Y, et al. (2014). I-ophthalmopathy yamathuna: I-Epidemiology nomlando wemvelo. INGABE:
I-10.2169 / i-internalmedicine.53.1518 Kungenzeka futhi kubantu abangenaso isifo se-Graves.

Qhubeka ufunde ukuze ufunde kabanzi ngesifo samehlo se-Graves, ukwelashwa, nokuthi yini ongayenza ukuze unciphise izimpawu.

Ziyini izimpawu ze-Graves ’ophthalmopathy?

Isikhathi esiningi, isifo samehlo seGraves sithinta womabili amehlo. Cishe amaphesenti ayi-15 esikhathi, kuhilela iso elilodwa kuphela.UHiromatsu Y, et al. (2014). I-ophthalmopathy yamathuna: I-Epidemiology nomlando wemvelo. INGABE:
I-10.2169 / i-internalmedicine.53.1518 Akukho ukuxhumana phakathi kwezimpawu zamehlo akho nobukhulu be-hyperthyroidism yakho.

Izimpawu ze-GO zingafaka:

• amehlo omile, ubungqabavu, ukucasuka
• ingcindezi yamehlo nobuhlungu
• ububomvu nokuvuvukala
• kuhoxiswa izinkophe
• ukufiphala kwamehlo, okubizwa nangokuthi i-proptosis noma i-exophthalmos
• ukuzwela ukukhanya
• ukubona kabili

Ezimweni ezimbi kakhulu, ungaba nenkinga yokuhambisa noma ukuvala amehlo akho, isilonda se-cornea, kanye nokucindezelwa kwethambo le-optic. I-GO ingaholela ekulahlekelweni kombono, kepha lokhu akuvamile.

Izimpawu ngokuvamile ziqala ngasikhathi sinye nezinye izimpawu zesifo se-Graves, kodwa abanye abantu baba nezimpawu zamehlo kuqala. Akuvamile ukuthi iGO ikhule isikhathi eside ngemuva kokwelapha isifo se-Graves. Kungenzeka futhi ukuthuthukisa i-GO ngaphandle kokuba ne-hyperthyroidism.

Yini ebangela i-ophthalmopathy yamathuna?

Isizathu ngqo asicaci, kepha kungaba yinhlanganisela yezici zofuzo nezemvelo.

Ukuvuvukala okuzungeze iso kungenxa yempendulo ezenzakalelayo. Izimpawu zibangelwa ukuvuvukala okuzungeze iso nokubuyisa amajwabu amehlo.

Isifo samehlo samathuna ngokuvamile senzeka ngokuhlangana ne-hyperthyroidism, kodwa hhayi njalo. Kungenzeka uma i-thyroid yakho ingasebenzi ngokweqile njengamanje.

Izici ezinobungozi ze-GO zifaka:

• amathonya ezakhi zofuzo
• ukubhema
• ukwelashwa kwe-iodine kwe-hyperthyroidism

Ungaba nesifo samathuna nganoma yisiphi isikhathi, kepha abantu abaningi baphakathi kweminyaka yobudala engama-30 nengama-60 ekuxilongweni. Isifo samathuna sithinta cishe amaphesenti amathathu abesifazane kanye no-0.5% wamadoda.Isifo samathuna. (2017).
niddk.nih.gov/health-information/endocrine-diseases/graves-disease

Kutholakala kanjani ukuthi i-Graves ’ophthalmopathy?

Lapho usuvele wazi ukuthi unesifo se-Graves, udokotela wakho angenza ukuxilongwa ngemuva kokuhlola amehlo akho.

Uma kungenjalo, udokotela wakho uzoqala ngokubheka ngamehlo akho futhi ahlole intamo yakho ukubona ukuthi i-thyroid yakho ikhulisiwe yini.

Ngemuva kwalokho, igazi lakho lingahlolwa ukuthi alinayo yini i-hormone ekhuthaza i-thyroid (TSH). I-TSH, i-hormone ekhiqizwa ku-pituitary gland, ivuselela i-thyroid ukukhiqiza ama-hormone. Uma unesifo se-Graves, izinga lakho le-TSH lizoba liphansi, kodwa uzoba namazinga aphezulu ama-hormone e-thyroid.

Igazi lakho lingabuye lihlolelwe ama-antibody e-Graves. Lokhu kuhlolwa akudingeki ukwenza ukuxilongwa, kepha kungenziwa noma kunjalo. Uma kuvela ukuthi awunalo iqiniso, udokotela wakho angaqala ukufuna okunye ukuxilongwa.

Ukufanekisa izivivinyo ezifana ne-ultrasound, CT scan, noma i-MRI kunganikeza ukubukeka okuningiliziwe ngendlala yegilo.

Awukwazi ukukhiqiza ama-hormone e-thyroid ngaphandle kwe-iodine. Yingakho udokotela wakho angafuna ukwenza inqubo ebizwa ngokuthi yi-radioactive iodine uptake. Kulolu vivinyo, uzothatha iodine enemisebe ethile bese uvumela umzimba wakho ukuthi uyimunce. Kamuva, ikhamera ekhethekile yokuskena ingasiza ekunqumeni ukuthi igilo lakho lithatha kahle kangakanani iodine.

Emaphesenti angama-20 abantu abane-hyperthyroidism, izimpawu zamehlo zivela ngaphambi kwanoma yiziphi ezinye izimpawu.UHiromatsu Y, et al. (2014). I-ophthalmopathy yamathuna: I-Epidemiology nomlando wemvelo. INGABE:
I-10.2169 / i-internalmedicine.53.1518

Yelashwa kanjani i-ophthalmopathy yamathuna?

Ukwelapha isifo se-Graves kubandakanya izindlela ezithile zokwelapha ukugcina amazinga ama-hormone ebangeni elijwayelekile. Isifo samehlo samathuna sidinga ukwelashwa kwaso, ngoba ukwelapha isifo samathuna akusizi ngaso sonke isikhathi ngezimpawu zamehlo.

Kukhona isikhathi sokuvuvukala okusebenzayo lapho izimpawu ziba zimbi khona. Lokhu kungathatha izinyanga eziyisithupha noma ngaphezulu. Bese kuba nesigaba esingasebenzi lapho izimpawu zizinza khona noma ziqala ukuthuthuka.

Kunezinto ezimbalwa ongazenza uwedwa ukunciphisa izimpawu, njenge:

• Amaconsi wamehlo ukugcoba nokukhulula amehlo omile, acasukile. Sebenzisa amaconsi wamehlo angenazo izisusi ezibomvu noma izivimbelakuvunda. Ama-gel okugcoba futhi angasiza ngesikhathi sokulala uma izinkophe zakho zingavali yonke indlela. Buza udokotela wakho ukuthi yimiphi imikhiqizo engasiza kakhulu ngaphandle kokucasula amehlo akho ngokuqhubekayo.
• Ukucindezela okupholile ukukhulula okwesikhashana ukucasuka. Lokhu kungaduduza ikakhulukazi ngaphambi nje kokuba ulale noma lapho uvuka ekuseni ekuseni.
• Izibuko zelanga ukusiza ukuvikela ekuzweleni kokukhanya. Izibuko zingakuvikela nasemoyeni noma emoyeni ovela kubalandeli, ukushisa okuqondile nomoya opholile. Izibuko ezihlanganiswayo zingasiza kakhulu ngaphandle.
• Izibuko ezibhalwe ngodokotela ngama-prism kungasiza ukulungisa umbono ophindwe kabili. Azisebenzi kuwo wonke umuntu, noma kunjalo.
• Lala uphakamise ikhanda ukunciphisa ukuvuvukala nokukhulula ukucindezela kwamehlo.
• Ama-Corticosteroids njenge-hydrocortisone noma i-prednisone kungasiza ukunciphisa ukuvuvukala. Buza udokotela wakho ukuthi kufanele ngabe usebenzisa i-corticosteroids.
• Ungabhemi, njengoba ukubhema kungenza izinto zibe zimbi kakhulu. Uma ubhema, buza udokotela wakho ngezinhlelo zokuyeka ukubhema. Kufanele futhi uzame ukugwema intuthu kagwayi, nothuli nezinye izinto ezingacasula amehlo akho.

Qiniseka ukuthi utshela udokotela wakho uma kungekho lutho olusebenzayo futhi uqhubeke nokuba nombono ophindwe kabili, ukwehla kombono, noma ezinye izinkinga. Kukhona ezinye izindlela zokuhlinza ezingasiza, kufaka phakathi:

• Ukuhlinzwa kokucindezelwa komzimba kwe-Orbital ukukhulisa isokhethi yamehlo ukuze iso lihlale endaweni engcono. Lokhu kufaka phakathi ukususa ithambo phakathi kwesokhethi yamehlo nezinsimbi ukudala isikhala sezicubu ezivuvukile.
• Ukuhlinzwa ijwabu leso ukubuyisela amajwabu amehlo esimweni semvelo ngokwengeziwe.
• Ukuhlinzwa kwemisipha yamehlo ukulungisa umbono ophindwe kabili. Lokhu kufaka ukusika imisipha ethinteke izicubu ezibomvu bese uyiphinda uyibuyisele emuva emuva.

Lezi zinqubo zingasiza ekuthuthukiseni umbono noma ukubonakala kwamehlo akho.

Imvamisa, ukwelashwa ngemisebe, noma i-orbital radiotherapy, isetshenziselwa ukunciphisa ukuvuvukala kwezicubu nezicubu ezizungeze amehlo. Lokhu kwenziwa ngokuhamba kwezinsuku ezimbalwa.

Uma izimpawu zamehlo akho zingahlobene nesifo se-Graves, ezinye izindlela zokwelashwa zingafaneleka kakhulu.

Uyini umbono?

Ayikho indlela yokuvimbela ngokuphelele isifo se-Graves noma isifo se-Graves. Kodwa uma unesifo samathuna nentuthu, unamathuba aphindwe ka-5 okuba nesifo samehlo kunabantu abangabhemi.UDraman MS, et al. (2017). I-TEAMeD-5: Ukuthuthukisa imiphumela ezifweni zeso le-thyroid.
endocrinology.org/endocrinologist/125-autumn17/feature/teamed-5-improving-outcomes-in-thyoid-eye-disease/ Izifo zamehlo zivame ukuba nzima kakhulu kubantu ababhemayo.

Uma uthola ukuthi unesifo i-Graves ’, cela udokotela wakho ukuthi akuhlole ngezinkinga zamehlo. I-GO inzima ngokwanele ukusongela umbono cishe ngamaphesenti ama-3 kuye kwayi-5 wesikhathi.UHiromatsu Y, et al. (2014). I-ophthalmopathy yamathuna: I-Epidemiology nomlando wemvelo. INGABE:
I-10.2169 / i-internalmedicine.53.1518

Izimpawu zamehlo zivame ukusimama ngemuva kwezinyanga ezingaba yisithupha. Bangase baqale ukuthuthuka ngokushesha noma bahlale bezinzile unyaka noma emibili ngaphambi kokuba baqale ukuthuthuka.

Isifo samehlo samathuna singelashwa ngempumelelo, futhi izimpawu zivame ukuba ngcono ngisho nangaphandle kokwelashwa.