{"id":4417,"date":"2024-02-01T09:00:59","date_gmt":"2024-02-01T09:00:59","guid":{"rendered":"https:\/\/ambercell.pixel-dev.lt\/inovativa-un-minimali-invaziva-vairogdziedzera-mezglu-arstesana\/"},"modified":"2024-02-08T14:42:26","modified_gmt":"2024-02-08T14:42:26","slug":"inovativa-un-minimali-invaziva-vairogdziedzera-mezglu-arstesana","status":"publish","type":"post","link":"https:\/\/ambercell.eu\/lv\/zinas\/inovativa-un-minimali-invaziva-vairogdziedzera-mezglu-arstesana\/","title":{"rendered":"Inovat\u012bva un minim\u0101li invaz\u012bva vairogdziedzera mezglu \u0101rst\u0113\u0161ana"},"content":{"rendered":"\n

Vairogdziedzera mezgli\u0146i ir veidojumi vairogdziedzer\u012b, kas var b\u016bt atsevi\u0161\u0137i vai vair\u0101ki. \u0160\u012bs no apk\u0101rt\u0113jiem vairogdziedzera audiem atdal\u012bt\u0101s atsevi\u0161\u0137\u0101s masas kl\u012bniskaj\u0101 praks\u0113 ir bie\u017ei sastopama par\u0101d\u012bba, un m\u016bsdien\u0101s netr\u016bkst veidu, k\u0101 t\u0101s \u0101rst\u0113t. Santa Cl\u00ednicas jau tr\u012bs gadus izmanto modernu, minim\u0101li invaz\u012bvu un efekt\u012bvu proced\u016bru – mikrovi\u013c\u0146u abl\u0101ciju.<\/strong><\/p>\n\n

Neregul\u0101ra patolo\u0123ija<\/strong><\/p>\n\n

Dr. A. Kalni\u0146\u0161 dal\u012bj\u0101s pieredz\u0113 par dTRA proced\u016br\u0101m sav\u0101 ikdienas praks\u0113, un p\u0113c tam dal\u012bbnieki tika aicin\u0101ti kl\u0101tien\u0113 v\u0113rot vair\u0101kas proced\u016bras Dr. A. Kalni\u0146a vad\u012bb\u0101. Sta\u017e\u0113\u0161an\u0101s laik\u0101 tr\u012bs sare\u017e\u0123\u012btas oper\u0101cijas veica \u0160au\u013cu Republik\u0101nisk\u0101s slimn\u012bcas Intervencion\u0101l\u0101s angiolo\u0123ijas noda\u013cas vad\u012bt\u0101js Vilmantas Smalinskas sadarb\u012bb\u0101 ar Dr. A. Kalni\u0146u. Lai gan visi tr\u012bs gad\u012bjumi bija sare\u017e\u0123\u012bti, oper\u0101cijas bija veiksm\u012bgas, pateicoties pieredz\u0113ju\u0161iem speci\u0101listiem.<\/p>\n\n

K\u0101 skaidro Santaro\u0161a kl\u012bnikas endokrinolo\u0123e Dr. Romena Laukiene, vairogdziedzera mezgli\u0146us izraisa gan labdab\u012bgas, gan \u013caundab\u012bgas slim\u012bbas, ta\u010du pacientiem nevajadz\u0113tu uztraukties, ja vairogdziedzer\u012b tiek konstat\u0113ti mezglaini boj\u0101jumi, jo 90-95% vairogdziedzera mezglu ir labdab\u012bgi. vairogdziedzera mezgli\u0146i ir labdab\u012bgi – asimptom\u0101tiski.<\/p>\n\n

“Vairogdziedzera mezgli\u0146u izplat\u012bba palp\u0101cij\u0101 ir 5-7%, bet ehokardiogr\u0101fij\u0101 – pat 67%, turkl\u0101t vairogdziedzera mezgli\u0146i bie\u017ei vien tiek nejau\u0161i atrasti da\u017e\u0101du att\u0113lveido\u0161anas izmekl\u0113jumu laik\u0101, piem\u0113ram, datortomogr\u0101fijas, magn\u0113tisk\u0101s rezonanses, pozitronu emisijas tomogr\u0101fijas u.c. izmekl\u0113jumos,” st\u0101sta Dr. R. Laukien\u0117.<\/p>\n\n

Vi\u0146a teica, ka vairogdziedzera mezgli\u0146i ir sastopami visu vecumu cilv\u0113kiem, gan sieviet\u0113m, gan v\u012brie\u0161iem, ta\u010du daudz bie\u017e\u0101k tie ir sastopami vec\u0101kiem cilv\u0113kiem, \u012bpa\u0161i sieviet\u0113m. Tom\u0113r \u0161\u012b jaunveidojuma c\u0113lo\u0146i, t\u0101pat k\u0101 citu org\u0101nu labdab\u012bgu vai \u013caundab\u012bgu audz\u0113ju c\u0113lo\u0146i, nav piln\u012bb\u0101 skaidri.<\/p>\n\n

“Tiek uzskat\u012bts, ka vairogdziedzera mezglu att\u012bst\u012bb\u0101 liela noz\u012bme ir joda tr\u016bkumam, joniz\u0113jo\u0161ajam starojumam, da\u017eu medikamentu lieto\u0161anai un di\u0113tai. Vairogdziedzera mezglu att\u012bst\u012bb\u0101 liela noz\u012bme ir ar\u012b \u0123en\u0113tiskiem c\u0113lo\u0146iem,” st\u0101sta endokrinolo\u0123e.<\/p>\n\n

Kad j\u0101uztraucas?<\/strong><\/p>\n\n

Lai gan, k\u0101 min\u0113ts iepriek\u0161, vairogdziedzera mezgli\u0146i bie\u017ei vien neizraisa nek\u0101dus kl\u012bniskus simptomus, lieli mezgli\u0146i, \u012bpa\u0161i ja tie atrodas vairogdziedzera apak\u0161\u0113j\u0101s da\u013c\u0101s, nolai\u017eoties dzi\u013c\u0101k kr\u016bt\u012bs, var saspiest blakus eso\u0161\u0101s kakla strukt\u016bras, piem\u0113ram, traheju, bar\u012bbas vadu un kakla asinsvadus.<\/p>\n\n

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“\u0160\u0101di mezgli\u0146i var rad\u012bt diskomfortu kakl\u0101, aizspiestu balsi, elpo\u0161anas vai r\u012b\u0161anas probl\u0113mas, k\u0101 ar\u012b kosm\u0113tiskas probl\u0113mas, deform\u0113jot kaklu. Hormonus ra\u017eojo\u0161s mezgli\u0146\u0161 izraisa vairogdziedzera aktiviz\u0113\u0161anos, kas izpau\u017eas ar bie\u017eu sirdsklauves pukst\u0113\u0161anu, sirds ritma trauc\u0113jumiem, sv\u012b\u0161anu, svara zudumu u. c.,” – st\u0101sta Dr. Laukiene.<\/p>\n\n\n\n

T\u0101p\u0113c, ja vairogdziedzer\u012b tiek konstat\u0113ti mezgli\u0146i, p\u0113c vi\u0146as teikt\u0101, ir j\u0101atbild uz trim galvenajiem jaut\u0101jumiem: vai mezgli\u0146\u0161 ir labdab\u012bgs vai \u013caundab\u012bgs; vai mezgli\u0146\u0161 izraisa vairogdziedzera darb\u012bbas trauc\u0113jumus; vai mezgli\u0146\u0161 izraisa simptomus, kas saist\u012bti ar spiedienu uz apk\u0101rt\u0113j\u0101m strukt\u016br\u0101m? Atkar\u012bb\u0101 no atbild\u0113m uz \u0161iem jaut\u0101jumiem tiek lemts, vai un k\u0101 nepiecie\u0161ama \u0101rst\u0113\u0161ana.<\/p>\n<\/div><\/div>\n\n

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Santara kl\u012bnik\u0101 visiem pacientiem, kuriem ar datortomogr\u0101fijas metodi ir konstat\u0113ti vairogdziedzera mezgli\u0146i, iesaka veikt ultrasonogr\u0101fiju vai, ja mezgli\u0146i ir lieli, datortomogr\u0101fiju.<\/p>\n\n

“Augstas iz\u0161\u0137irtsp\u0113jas ultraska\u0146a ir visjut\u012bg\u0101k\u0101 att\u0113lveido\u0161anas metode, ko izmanto, lai noteiktu un izm\u0113r\u012btu mezglainus boj\u0101jumus vairogdziedzer\u012b un lai at\u0161\u0137irtu vairogdziedzera mezglus no cit\u0101m patolo\u0123isk\u0101m strukt\u016br\u0101m kakl\u0101. Ja vairogdziedzera mezgli\u0146i ir \u013coti lieli, iedzi\u013cinoties kr\u016b\u0161u kurvja sien\u0101, tad veic datortomogr\u0101fiju, lai objekt\u012bvi nov\u0113rt\u0113tu vairogdziedzera mezglu spiediena paz\u012bmes uz blakus eso\u0161ajiem org\u0101niem,” st\u0101sta Dr. R. Laukien\u0117.<\/p>\n\n

Ja ir aizdomas, ka mezgli\u0146\u0161 ir \u013caundab\u012bgs, v\u0113l\u0101k var veikt mezgla aspir\u0101cijas punkciju – ar smalku adatu pa\u0146em materi\u0101lu citolo\u0123iskai izmekl\u0113\u0161anai.<\/p>\n\n

“Tas ir “zelta standarts” un vissvar\u012bg\u0101k\u0101 testa metode, lai at\u0161\u0137irtu labdab\u012bgus mezglus no \u013caundab\u012bgiem. Vairogdziedzera hormonu asins anal\u012bzes tiek izmantotas, lai nov\u0113rt\u0113tu vairogdziedzera funkciju. P\u0113c vairogdziedzera darb\u012bbas aktiviz\u0113\u0161an\u0101s tiek veikta vairogdziedzera scintigr\u0101fija, lai nov\u0113rt\u0113tu mezglu funkcion\u0101lo aktivit\u0101ti, kuras laik\u0101 var noteikt, vai mezgls ir hiperfunkcion\u0113jo\u0161s – “karsts” vai hipofunkcion\u0113jo\u0161s – “auksts”, – skaidro Dr. R. Laukien\u0117.<\/p>\n\n

Ja mezgli\u0146\u0161 ir labdab\u012bgs, nerada spiediena simptomus t\u0101 lieluma d\u0113\u013c un netrauc\u0113 vairogdziedzera darb\u012bbu, tas netiek \u0101rst\u0113ts. Tom\u0113r, ja mezgli\u0146\u0161 izraisa vairogdziedzera aktivit\u0101ti, to \u0101rst\u0113 ar radioakt\u012bvo jodu vai iz\u0146em \u0137irur\u0123iski.<\/p>\n\n

“Ja mezgli izraisa simptomus, kas saist\u012bti ar spiedienu uz apk\u0101rt\u0113j\u0101m strukt\u016br\u0101m vai kosm\u0113tiski deform\u0113 kaklu, tos iz\u0146em \u0137irur\u0123iski,” saka endokrinologs.<\/p>\n\n

Alternat\u012bva \u0137irur\u0123iskai \u0101rst\u0113\u0161anai<\/strong><\/p>\n\n

P\u0113d\u0113jos gados gan Eirop\u0101, gan ASV un da\u017e\u0101s \u0100zijas valst\u012bs labdab\u012bgu vairogdziedzera mezglu \u0101rst\u0113\u0161anai, kas izraisa spiedienu un kosm\u0113tiskus simptomus, k\u0101 alternat\u012bvu \u0137irur\u0123iskai oper\u0101cijai pla\u0161i izmanto t\u0101das minim\u0101li invaz\u012bvas metodes k\u0101 radiofrekvences, l\u0101zera vai mikrovi\u013c\u0146u abl\u0101ciju.<\/p>\n\n

K\u0101 nor\u0101da Santaro\u0161a kl\u012bnikas radiologs Juozas Jara\u0161\u016bnas (Juozas Jara\u0161\u016bnas), iepriek\u0161 min\u0113t\u0101s \u0101rst\u0113\u0161anas metodes Lietuv\u0101 netiek pla\u0161i izmantotas, bet vi\u0146u slimn\u012bc\u0101 labdab\u012bgu, simptomus izraiso\u0161u mezglu \u0101rst\u0113\u0161anai izmanto mikrovi\u013c\u0146u abl\u0101ciju – inovat\u012bvu un minim\u0101li invaz\u012bvu metodi, kas b\u016bs pieejama 2020. gad\u0101. Eiropa un 2023. gads Amerikas vairogdziedzera speci\u0101listu organiz\u0101cijas jau ir sniegu\u0161as detaliz\u0113tas vadl\u012bnijas par to, kam un k\u0101dos gad\u012bjumos tas tiek ierosin\u0101ts.<\/p>\n\n

“Vairogdziedzera mezgla abl\u0101cija ir jauna proced\u016bra Lietuv\u0101, kad ar adatu, izmantojot siltumu, izn\u012bcina vairogdziedzera mezgla dz\u012bvotsp\u0113j\u012bgos audus. Termiski izn\u012bcin\u0101tie vairogdziedzera mezgla audi gada laik\u0101 p\u0113c oper\u0101cijas sar\u016bk un k\u013c\u016bst iev\u0113rojami maz\u0101ki. Eiropas Vairogdziedzera speci\u0101listu organiz\u0101cija iesaka \u0161o proced\u016bru pacientiem ar labdab\u012bgu vairogdziedzera mezgli\u0146u, kas izraisa vizu\u0101las izmai\u0146as vai spiedienu vai diskomfortu kakl\u0101,” skaidro J. Jara\u0161\u016bnas.<\/p>\n\n

P\u0113c radiologa teikt\u0101, mikrovi\u013c\u0146u audu izn\u012bcin\u0101\u0161ana ir sen izmantota tehnolo\u0123ija cit\u0101s medic\u012bnas nozar\u0113s, bet tikai nesen tika izmantota vairogdziedzera slim\u012bbu \u0101rst\u0113\u0161an\u0101.<\/p>\n\n

“Proced\u016bras p\u0113k\u0161\u0146\u0101 popularit\u0101te skaidrojama ar to, ka ar to var pan\u0101kt l\u012bdz\u012bgu rezult\u0101tu k\u0101 ar oper\u0101ciju, vienlaikus maz\u0101k ietekm\u0113jot vairogdziedzera darb\u012bbu un apk\u0101rt\u0113jos audus. K\u0101 liecina literat\u016bras dati, gadu p\u0113c proced\u016bras vairogdziedzera mezgla tilpums samazin\u0101s par 75-90%, savuk\u0101rt turpm\u0101ki nov\u0113ro\u0161anas p\u0113t\u012bjumi liecina, ka tikai 5% mezglu \u010detrus gadus p\u0113c proced\u016bras atkal ir ataugu\u0161i,” st\u0101sta Jarasunas, piebilstot, ka gad\u012bjum\u0101, ja \u0101rst\u0113\u0161anas efekts ir nepietiekams vai mezgls ir ataudzis, vienm\u0113r ir iesp\u0113jams proced\u016bru atk\u0101rtot vai tikai p\u0113c tam izv\u0113l\u0113ties \u0137irur\u0123isku \u0101rst\u0113\u0161anu.<\/p>\n\n

Sagatavo\u0161an\u0101s, kurss un dziedin\u0101\u0161anas periods<\/strong><\/p>\n\n

J. Jara\u0161\u016bnas st\u0101sta, ka pacienti, kuriem tiek apsv\u0113rta iesp\u0113ja veikt mikrovi\u013c\u0146u abl\u0101ciju, sa\u0146em kl\u0101tienes konsult\u0101ciju, ultrasonogr\u0101fisko izmekl\u0113\u0161anu, lai nov\u0113rt\u0113tu vairogdziedzera mezgli\u0146u, un tiek izv\u0113rt\u0113ts, vai ir indik\u0101cijas \u0161ai proced\u016brai un vai to var dro\u0161i veikt.<\/p>\n\n

“Da\u017ereiz pirms \u0101rst\u0113\u0161anas ir j\u0101veic vairogdziedzera biopsija un asins anal\u012bzes, lai p\u0101rliecin\u0101tos, ka mezgli\u0146\u0161 nav \u013caundab\u012bgs. Visp\u0101r\u0113j\u0101 sagatavo\u0161an\u0101s ir t\u0101da pati k\u0101 jebkurai \u0137irur\u0123iskai proced\u016brai – ir j\u0101veic noteikti laboratoriskie asins anal\u012bzes un pacientiem proced\u016bras dien\u0101 j\u0101ierodas nealgotiem. Ierodoties slimn\u012bc\u0101, pacientiem tiek pie\u0161\u0137irta pal\u0101ta, un proced\u016bru veic taj\u0101 pa\u0161\u0101 r\u012bt\u0101,” st\u0101sta radiologs.<\/p>\n\n

K\u0101 skaidro \u0101rsts, vairogdziedzera mikrovi\u013c\u0146u abl\u0101ciju veic, izmantojot smalku adatu, t\u0101p\u0113c at\u0161\u0137ir\u012bb\u0101 no \u0137irur\u0123isk\u0101s metodes, kas paredz griezumu veik\u0161anu, uz kakla nerodas r\u0113tas.<\/p>\n\n

“\u0160\u012b proced\u016bra atst\u0101j tikai nelielu adatas nospiedumu, kas da\u017ek\u0101rt ir viens no iemesliem, k\u0101p\u0113c cilv\u0113ki izv\u0113las \u0161o \u0101rst\u0113\u0161anas metodi. Tas visvair\u0101k attiecas uz sieviet\u0113m, kur\u0101m kosm\u0113tiskais izskats ir \u013coti svar\u012bgs,” vi\u0146\u0161 saka.<\/p>\n\n

Turkl\u0101t \u0161o proced\u016bru veic viet\u0113j\u0101 anest\u0113zij\u0101 ar da\u013c\u0113ju sed\u0101ciju. Proced\u016bras laik\u0101 pacienti saglab\u0101 modr\u012bbu, l\u012bdz minimumam samazinot ar anest\u0113ziju saist\u012btos riskus. P\u0113c \u0161\u012bs proced\u016bras pacienti p\u0113cpusdien\u0101 var doties m\u0101j\u0101s.<\/p>\n\n

“P\u0113c proced\u016bras da\u017eas dienas var b\u016bt piet\u016bcis kakls, diskomforta saj\u016bta un nelielas s\u0101pes r\u012b\u0161anas laik\u0101. Da\u017eas dienas tiek lietoti prets\u0101pju l\u012bdzek\u013ci, bet liel\u0101koties pacienti nej\u016bt diskomfortu kakl\u0101 un medikamenti nav nepiecie\u0161ami. P\u0113c proced\u016bras m\u0113s nov\u0113rt\u0113jam \u0101rst\u0113\u0161anas efektu, veicot atk\u0101rtotu ultrasonogr\u0101fijas izmekl\u0113jumu, un pacienti ierodas uz kontroles viz\u012bt\u0113m p\u0113c 1, 3, 6, 12 un 24 m\u0113ne\u0161iem,” st\u0101sta J. Jara\u0161\u016bnas.<\/p>\n\n

Saska\u0146\u0101 ar literat\u016bras datiem komplik\u0101cijas p\u0113c \u0161\u012bs proced\u016bras ir reti sastopamas – tikai 4%.<\/p>\n\n

“Visbie\u017e\u0101k sastopam\u0101s komplik\u0101cijas ir saist\u012btas ar termiskiem boj\u0101jumiem un no tiem izrieto\u0161o balss aizspie\u0161anu, vairogdziedzera darb\u012bbas trauc\u0113jumiem un apk\u0101rt\u0113jo audu apdegumiem. Tom\u0113r tr\u012bs gadu laik\u0101, kop\u0161 tiek veikta mikrovi\u013c\u0146u abl\u0101cija, mums nav biju\u0161as s\u016bdz\u012bbas – rezult\u0101ti \u0161\u0137iet patie\u0161\u0101m labi,” saka \u0101rsts.<\/p>\n\n

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Sadarb\u012bb\u0101 ar Terumo Europe \u0160au\u013cu Republik\u0101niskaj\u0101 slimn\u012bc\u0101 tika organiz\u0113ts semin\u0101rs intervencion\u0101l\u0101s kardiolo\u0123ijas speci\u0101listiem par hroniskas tot\u0101l\u0101s okl\u016bzijas (CTO) jaut\u0101jumiem. <\/p>\n","protected":false},"author":8,"featured_media":4429,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[38],"tags":[],"class_list":["post-4417","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zinas"],"yoast_head":"\nInovat\u012bva un minim\u0101li invaz\u012bva vairogdziedzera mezglu \u0101rst\u0113\u0161ana - Ambercell<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ambercell.eu\/naujienos\/inovatyvus-ir-minimaliai-invazinis-budas-skydliaukes-mazgams-gydyti\/\" \/>\n<meta property=\"og:locale\" content=\"lv_LV\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Inovat\u012bva un minim\u0101li invaz\u012bva vairogdziedzera mezglu \u0101rst\u0113\u0161ana - 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