Tiroit nodülü nedir? Tiroit nodülü belirtileri nelerdir, nasıl anlaşılır

Sağlık

Tiroid nedir?

Tiroid bezi boynun ön bölümünde adem elması adı verilen kıkırdağın hemen altında bulunan kelebek şeklinde bir organdır. Yaklaşık 20 gram ağırlığındadır. Vücudumuz için hayati önemi olan hormonlar salgılar.

Tiroid bezinin görevleri nelerdir?

Tiroid bezi T3-T4 hormonlarını salgılar. Bu hormonlar kan dolaşımına girerek metobolizmamızı düzenler, hızını kontrol eder. Vücudun değişik organ ve dokularında; kalp hızı, kolesterol seviyesi, kilo, ruhsal durum, adet düzeni gibi birçok farklı sistemi ilgilendiren fonksiyonları etkiler. Toplumda yaklaşık

%30-40 oranında tiroid bezinin çeşitli hastalıkları görülmektedir. Tiroid bezi hastalıklarının kadınlarda görülme sıklığı daha fazladır.

Tiroid bezinin sık görülen hastalıkları nelerdir?

  • Guatr
  • Tiroiditler
  • Tiroid kanserleri

Guatr nedir?

Guatr tiroid bezinin çeşitli nedenlere bağlı olarak büyümesi sonucu oluşur. Genellikle bu büyümeler tirod bezinde nodüller gelişmesi şeklinde olur. Tek veya çok sayıda olabilirler. İçinde sıvı bulunan kistler halinde olabilirler. Diffüz guatrda ise tiroid bezi genel olarak büyümüştür. Çok sık görülmesine rağmen çok büyük oranda iyi huyludurlar. Nodüller milimetrik boyutlarda olabileceği gibi boynun tamamını kaplayan büyük boyutlara ulaşabilirler. Tiroid nodülleri mutlaka incelenmelidir.

Belirtileri nelerdir?

Büyük oranda belirtisiz seyrederler. Ancak boynun ön kısmında büyüyen kitle olarak ele gelebilir. Büyüklük arttıkça nefes darlığı, yutma güçlüğü, ses kısıklığı şikayetlerine sebep olabilirler. Kana çok fazla tiroid hormonu salgılayan hiperaktif nodüller kalp hızında artış, sinirlilik, kilo kaybı, ellerde titreme ve terleme, uykusuzluk, ishal ile kendini belli eder. Hipotiroidin bulguları ise kalp hızında yavaşlama, kilo artışı, kabızlık, depresyon, vücutta yorgunluk, saçlarda kırılma ve dökülme, ciltte kuruluk, unutkanlık ve adet düzensizlikleridir.

Hipertiroidi Nedir?

Tiroid bezinin gereğinden fazla hormon salgıladığı duruma hipertiroidizm (zehirli guatr) denir. Zehirli guatr, nodüllü veya nodülsüz olabilir. Nodülsüz zehirli guatra Basedow Graves Hastalığı da denir.

Hipertiroidi Hipertiroidi (zehirli guatr) belirtileri ;

  • Çarpıntı,
  • Ellerde ve vücutta titreme,
  • Ani kilo kaybı,
  • Saçlarda dökülme,
  • Kaşıntı,
  • Boğazda dolgunluk hissi,
  • Aşırı iştah dolayısıyla çok yemek yeme ve su içme,
  • Aşırı terleme,
  • Çabuk yorulma,
  • Sinirlilik sık görülen şikayetlerdir.

Bazı hastalar, bulantı, ishal, kusma ve çok sık dışkılamadan yakınır. Bu saydıklarımızın hepsi aynı anda bulunmayabilir. Bu şikâyetlerin bazıları ön plandadır, diğer şikayetler ancak doktorun sorgulaması ile ifade edilebilir. Nodülsüz guatrlı hastaların bazılarında gözlerde büyüme ve gözlerin ileriye doğru çıkması mümkündür. Hastaların muayenesinde; kalp atımının çok arttığı, solunumun hızlandığı, ellerin titrediği ve avuç içinin terli olduğu görülür.

Hipotiroidi tedavisi

Yapılacak kan testleri sonucu teşhisin doğrulanmasını takiben eksik olan tiroid hormonunu vererek çok hızlı iyileşme sağlamak mümkündür. Bu hastalar ömür boyunca ilaç kullanmak zorundadır. Tedavide kullanılan tiroid hormonunun standart dozu yoktur. Bu nedenle her hastada yapılacak ölçüm ve takiplerle gerçek ve doğru idame dozu bulunmalıdır.

Tiroid nodülü nasıl anlaşılır?

Ayna karşısında tiroid kontrol edilir. Bunun için boynun ön kısmında Adem Elması’nın hemen altında genişleme veya şişlik olup olmadığına bakılmalıdır. Tiroid bezi bu bölgede yer alır. Bu kontroller başı geriye yaslayarak yapılmalıdır. Şayet bu bölgede genişleme veya şişlik görülürse bir hekime başvurulmalıdır.

Tiroid nodülü teşhisinde yapılması gerekenler nelerdir?

Tiroid bezinizde nodül saptanmışsa bir endokrinoloji uzmanı veya endokrin cerrahı tarafından takip ve tedaviniz yapılmalıdır. Doktorunuz sizden risk faktörleriniz için ayrıntılı bir bilgi alacak, muayenenizi yapacak ve gerekli olan testleri isteyecektir. Bu testlerden ilk istenecek olanlar kandaki tiroid hormon düzeyleri ve tiroid ultrasonografisi olacaktır. Hastaların çoğunda tiroid bezindeki nodüllerden hücre örnekleri almak amacıyla ince iğne ile biyopsi de yapılmaktadır. Bu işleme tiroid ince iğne aspirasyon biyopsisi denilmektedir. Sıklıkla ultrasonografi altında ve patolog eşliğinde yapılmaktadır. Tiroid nodüllerinde sıklıkla kullanılan bir diğer metod da tiroid sintigrafisidir. Bu tanı yönteminde tiroid nodüllerinin çok (sıcak nodül) veya az (soğuk nodül) çalıştıkları hakkında bilgi edinilebilmektedir.

Tiroid nodüllerinin tedavisi

Tiroid nodüllerinin tedavisi nodülün özelliğine bağlıdır. Şayet yapılan tiroid ince iğne aspirasyon biyopsisinde iyi huylu görülmüşse, büyüme eğilimi göstermeyen küçük nodüller takip edilebilir. Bazennodüllerin büyümesini engellemek veya küçültmek amacıyla tiroid hormon tedavisi tercih edilebilir. Şayet yapılan tiroid ultrasonografilerinde nodüller büyüme eğilimindeyse iğne biyopsileri tekrarlanmalıdır. İğne biyopsisi sonucunda kuşkulu hücreler izlenen hastalar ameliyata alınır. Ayrıca nefes borusu ve yemek borusunda hissedilen baskı sonucu nefes darlığı ve yutma güçlüğü yaşayan hastalarda da ameliyat tercih edilir.

Tiroid ameliyatları riskli mi? Ameliyat bölgesinde iz kalır mı?

Cerrahinin birçok dalı gibi tiroid cerrahisinde de günümüzde minimal invaziv (daha az zarar veren) teknikler ön plandadır. Teknolojideki gelişmelerle birlikte tiroid ameliyatı; damarları dikiş ya da bağlamaya ihtiyaç duymadan kapatan ve cihazlar yardımı ile yapılmaktadır.

Uygun olgularda ameliyatı çok küçük bir kesiden gerçekleştirmek mümkündür. Bu ileri teknoloji, yüksek frekanslı ultrasonik enerji kullanarak doku içinde bulunan proteinlerdeki hidrojen bantlarını ortadan kaldırmaktadır.

Kan damarları, göreceli olarak düşük ısıda (80°C) daha az ısı hasarı ile kapanırlar. Tiroid ameliyatı sırasında yaralanma ihtimali olan ve ses tellerine giden sinir ve vücudun kalsiyum dengesini sağlayan paratiroid organlarının, daha az kanamalı bir ortamda ve göreceli olarak daha az bir ısı ile korunmalarına imkân sağlanmaktadır.

Yapılan çalışmalarda, bu yöntemle klasik yönteme göre ameliyat süresinin kısaldığı gösterilmiştir. Ayrıca tiroid ameliyatı daha az kanama ile sonlandırılabildiği için ameliyat sonrası hastanın ağrı kesici ihtiyacı çok aza inebilmektedir. Geniş cilt kesisinden kaçınmak doğal olarak daha estetik bir görünüme ve daha çabuk iyileşmeye yardımcı olmaktadır.

Hastalar sıklıkla ameliyattan sonra bir gece hastanede kalmakta ve ertesi gün evlerine gönderilmektedirler. Ameliyattan sonra ses kısıtlamasına gerek yoktur. Normal yaşamlarına kısa sürede dönebilmektedirler. Kesi estetik yöntemle kapatıldığından dikiş alınmasına gerek kalmamaktadır.

Kimler Risk Altındadır?

  • Ailesinde guatr, tiroid nodül, tiroid kanseri ve tiroidit gibi tiroid hastalıkları olan kişiler,
  • Daha önceden tiroid nodülü nedeniyle ameliyat geçirmiş kişiler,
  • Sigara içenler,
  • Menopoz dönemindeki kadınlar,
  • Baş ve boyuna yönelik ışın tedavisi (radyoterapi) gören kişiler kontrol ve takiplerini düzenli olarak yaptırmalıdırlar.

Reklam

1508 YORUMLAR

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