{"id":30929,"date":"2023-05-03T14:55:27","date_gmt":"2023-05-03T07:55:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30929"},"modified":"2023-05-03T14:55:27","modified_gmt":"2023-05-03T07:55:27","slug":"tiep-can-hoi-chung-giam-hoat-giap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/tiep-can-hoi-chung-giam-hoat-giap\/","title":{"rendered":"Ti\u1ebfp c\u1eadn h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p l\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c c\u01a1 quan \u0111\u00edch c\u1ee7a c\u01a1 th\u1ec3 x\u1ea3y ra do gi\u1ea3m s\u1ea3n xu\u1ea5t v\u00e0\/ho\u1eb7c gi\u1ea3m t\u00e1c d\u1ee5ng hormon gi\u00e1p. N\u1ebfu kh\u00f4ng nh\u1eadn bi\u1ebft s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb, suy gi\u00e1p c\u00f3 th\u1ec3 d\u1eabn t\u1edbi c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng.<\/strong><\/p>\n

\"hoi-chung-giam-ho\u1ea1t-giap\"<\/p>\n

1. Nguy\u00ean nh\u00e2n <\/strong>h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p<\/h2>\n

1.1. Ti\u00ean ph\u00e1t<\/strong><\/p>\n

95% tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

– Vi\u00eam tuy\u1ebfn gi\u00e1p Hashimoto.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt, I131<\/sup> hay x\u1ea1 tr\u1ecb b\u1ec7nh tuy\u1ebfn gi\u00e1p<\/p>\n

– \u1ee8c ch\u1ebf t\u1ed5ng h\u1ee3p hormon gi\u00e1p : do th\u1eeba hay thi\u1ebfu iode; x\u1eef d\u1ee5ng thu\u1ed1c lithium, amiodarone.<\/p>\n

– B\u1ea5t th\u01b0\u1eddng sinh t\u1ed5ng h\u1ee3p hormon gi\u00e1p.<\/p>\n

– Hi\u1ebfm h\u01a1n: nhi\u1ec5m s\u1eafc t\u1ed1 s\u1eaft, sarcoidosis, amyloidosis.<\/p>\n

1.2. Th\u1ee9 ph\u00e1t <\/strong><\/p>\n

– Suy tuy\u1ebfn y\u00ean do u tuy\u1ebfn y\u00ean, do ph\u1eabu thu\u1eadt.<\/p>\n

– X\u1ea1 tr\u1ecb v\u00f9ng \u0111\u1ea7u-c\u1ed5 trong u tuy\u1ebfn y\u00ean.<\/p>\n

– Nhi\u1ec5m s\u1eafc t\u1ed1 s\u1eaft, Sarcoidosis.<\/p>\n

– \u0110\u1ed9t bi\u1ebfn th\u1ee5 th\u1ec3 TRH.<\/p>\n

– R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng v\u00f9ng d\u01b0\u1edbi \u0111\u1ed3i l\u00e0m gi\u1ea3m s\u1ea3n xu\u1ea5t v\u00e0\/ho\u1eb7c ph\u00f3ng th\u00edch TRH. Th\u01b0\u1eddng ph\u1ed1i h\u1ee3p v\u1edbi b\u1ec7nh l\u00fd tuy\u1ebfn y\u00ean.<\/p>\n

1.3. Nguy\u00ean nh\u00e2n \u0111\u1eb7c bi\u1ec7t<\/strong><\/p>\n

– \u0110\u1ec1 kh\u00e1ng ngo\u1ea1i bi\u00ean v\u1edbi t\u00e1c d\u1ee5ng hormon gi\u00e1p.<\/p>\n

– B\u1ea5t th\u01b0\u1eddng th\u1ee5 th\u1ec3 T4<\/sub> \u1edf t\u1ebf b\u00e0o.<\/p>\n

2. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p<\/h1>\n

Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng \u0111a d\u1ea1ng do nhi\u1ec1u c\u01a1 quan \u0111\u00edch c\u1ee7a c\u01a1 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng, li\u00ean quan b\u1ec7nh nguy\u00ean, tu\u1ed5i t\u00e1c v\u00e0 nh\u1ea5t l\u00e0 tu\u1ef3 thu\u1ed9c v\u00e0o th\u1eddi gian v\u00e0 m\u1ee9c \u0111\u1ed9 thi\u1ebfu h\u1ee5t hormone gi\u00e1p . C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u01b0 sau .<\/p>\n

2.1. T\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3<\/strong><\/p>\n

Bi\u1ec3u hi\u1ec7n r\u00f5 trong giai \u0111o\u1ea1n tr\u1ebb nh\u1ecf v\u00e0 th\u1eddi k\u1ef3 ni\u00ean thi\u1ebfu.<\/p>\n

S\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 bi\u1ec7t ho\u00e1 c\u1ee7a n\u00e3o x\u1ea3y ra ph\u1ea7n l\u1edbn (2\/3) trong v\u00f2ng 2 n\u0103m \u0111\u1ea7u ti\u00ean; v\u00ec v\u1eady vi\u1ec7c thay th\u1ebf s\u1edbm b\u1eb1ng hormon gi\u00e1p ngay sau sinh s\u1ebd l\u00e0m h\u1ea1n ch\u1ebf t\u1ed1i \u0111a th\u01b0\u01a1ng t\u1ed5n n\u00e3o v\u0129nh vi\u1ec5n. Thi\u1ebfu h\u1ee5t hormon gi\u00e1p sau 3 tu\u1ed5i kh\u00f4ng g\u00e2y ch\u1eadm ph\u00e1t tri\u1ec3n tinh th\u1ea7n, nh\u01b0ng l\u1ea1i g\u00e2y ch\u1eadm ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3, ch\u1eadm ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng d\u00e0i c\u0169ng nh\u01b0 ch\u1eadm m\u1ecdc r\u0103ng v\u0129nh vi\u1ec5n.<\/p>\n

2.2. Da-ni\u00eam m\u1ea1c<\/strong><\/p>\n

– M\u1eb7t tr\u00f2n nh\u01b0 m\u1eb7t tr\u0103ng, \u00edt bi\u1ec3u l\u1ed9 t\u00ecnh c\u1ea3m, tr\u00e1n nhi\u1ec1u n\u1ebfp nh\u0103n.<\/p>\n

– M\u00ed m\u1eaft ph\u00f9, nh\u1ea5t l\u00e0 mi d\u01b0\u1edbi.<\/p>\n

– G\u00f2 m\u00e1 t\u00edm, nhi\u1ec1u mao m\u1ea1ch b\u1ecb d\u00e3n; m\u00f4i d\u1ea7y v\u00e0 t\u00edm.<\/p>\n

– Da \u1edf v\u00f9ng m\u1eb7t v\u00e0 b\u00e0n tay c\u00f3 m\u00e0u v\u00e0ng b\u1ee7ng ( th\u00e2m nhi\u1ec3m caroten ) .<\/p>\n

– B\u00e0n tay, b\u00e0n ch\u00e2n d\u1ea7y, c\u00e1c ng\u00f3n to v\u00e0 d\u1ea7y, kh\u00f3 g\u1ea5p b\u00e0n tay, b\u00e0n ch\u00e2n.<\/p>\n

– Ni\u00eam m\u1ea1c l\u01b0\u1ee1i b\u1ecb x\u00e2m nhi\u1ec5m l\u00e0m cho l\u01b0\u1ee1i to ra; d\u00e2y thanh \u00e2m b\u1ecb th\u00e2m nhi\u1ec5m l\u00e0m gi\u1ecdng n\u00f3i kh\u00e0n; ni\u00eam m\u1ea1c v\u00f2i Eustache b\u1ecb x\u00e2m nhi\u1ec5m g\u00e2y \u00f9 tai, nghe k\u00e9m.<\/p>\n

– Da kh\u00f4 bong v\u1ea3y.<\/p>\n

– T\u00f3c kh\u00f4, d\u1ec5 r\u1ee5ng; ph\u00eda ngo\u00e0i ch\u00e2n m\u00e0y th\u01b0a ho\u1eb7c r\u1ee5ng h\u1ebft (d\u1ea5u hi\u1ec7u \u201c\u0111u\u00f4i ch\u00e2n m\u00e0y\u201d); l\u00f4ng n\u00e1ch, l\u00f4ng mu r\u1ee5ng.<\/p>\n

2.3. Chuy\u1ec3n ho\u00e1<\/strong><\/p>\n

– S\u1ee3 l\u1ea1nh.<\/p>\n

– Ch\u1eadm h\u1ea5p thu glucose \u1edf ru\u1ed9t, gi\u1ea3m s\u1eed d\u1ee5ng glucose v\u00e0 \u0111\u1ec1 kh\u00e1ng insulin.<\/p>\n

– T\u0103ng c\u00e2n d\u00f9 \u0103n k\u00e9m. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n t\u0103ng c\u00e2n v\u1eeba ph\u1ea3i do \u1ee9 d\u1ecbch.<\/p>\n

2.4. Th\u1ea7n kinh<\/strong><\/p>\n

\u0110au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, r\u1ed1i lo\u1ea1n nh\u1eadn th\u1ee9c, \u0111i\u1ebfc, \u00f9 tai, d\u1ecb c\u1ea3m.<\/p>\n

2.5. Tim m\u1ea1ch<\/strong><\/p>\n

– Nh\u1ecbp ch\u1eadm, th\u1ec3 t\u00edch t\u1ed1ng m\u00e1u gi\u1ea3m, l\u01b0u l\u01b0\u1ee3ng tim gi\u1ea3m, tr\u00e0n d\u1ecbch m\u00e0ng tim.<\/p>\n

2.6. C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/strong><\/p>\n

– M\u1ecfi, y\u1ebfu c\u01a1, co r\u00fat c\u01a1.<\/p>\n

– C\u00f3 th\u1ec3 \u0111au kh\u1edbp, tr\u00e0n d\u1ecbch kh\u1edbp ho\u1eb7c gi\u1ea3 b\u1ec7nh g\u00fat.<\/p>\n

– \u1ede tr\u1ebb em: ch\u1eadm ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng d\u00e0i.<\/p>\n

2.7. D\u1ea1 d\u00e0y-ru\u1ed9t<\/strong><\/p>\n

– T\u00e1o b\u00f3n, ch\u01b0\u1edbng b\u1ee5ng.<\/p>\n

– Gi\u1ea3m ti\u1ebft d\u1ecbch d\u1ea1 d\u00e0y do vi\u00eam teo th\u00e2n d\u1ea1 d\u00e0y teo trong vi\u00eam tuy\u1ebfn gi\u00e1p.<\/p>\n

– Kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i t\u1ebf b\u00e0o th\u00e0nh d\u1ea1 d\u00e0y v\u00e0 thi\u1ebfu m\u00e1u \u00e1c t\u00ednh th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh l\u00fd gi\u00e1p t\u1ef1 mi\u1ec5n.<\/p>\n

2.8. Sinh d\u1ee5c<\/strong><\/p>\n