Ni iki cyitwa Parathyroidectomy? Impamvu, Uburyo & Gukira

Parathyroidectomy ni uburyo bwo kubaga bwo gukuraho imwe cyangwa nyinshi mu ngingo za parathyroid. Izi ngingo ntoya enye, buri imwe ingana n'umuceri, ziba inyuma y'ingingo ya thyroïde mu ijosi ryawe kandi zigenzura urugero rwa kalisiyumu mu maraso yawe.

Iyo izi ngingo zikabije gukora cyangwa zigatuma habaho ibibyimba, bishobora gutera ibibazo bikomeye by'ubuzima bitewe no gukora umusemburo wa parathyroid mwinshi cyane. Muganga wawe ashobora kugusaba kubagwa kugira ngo asubize umubiri wawe urugero rwa kalisiyumu risanzwe kandi birinde ingorane nka za nyiramvumba, igabanuka ry'amagufa, cyangwa ibibazo by'umutima.

Ni iki cyitwa parathyroidectomy?

Parathyroidectomy ni ugukuraho mu kubaga imwe cyangwa nyinshi mu ngingo za parathyroid iyo zitagikora neza. Ingingo zawe za parathyroid ni utwongere dutoya tune, dufite ishusho ya ovale, tuboneka inyuma ya thyroïde mu ijosi ryawe.

Izi ngingo zikora umusemburo wa parathyroid (PTH), ukora nk'icyuma gigenzura kalisiyumu mu maraso yawe. Iyo urugero rwa kalisiyumu rugabanutse, PTH ibwira amagufa yawe kurekura kalisiyumu n'impyiko zawe zo gukuramo kalisiyumu nyinshi mu nkari zawe.

Rimwe na rimwe imwe cyangwa nyinshi muri izi ngingo ziraguka cyangwa zigatuma habaho ibibyimba byiza byitwa adenomas. Ibi bituma bakora PTH nyinshi cyane, bigatuma urugero rwa kalisiyumu ruzamuka cyane mu maraso yawe - icyo gihe cyitwa hyperparathyroidism.

Kubagwa birimo gukuraho gusa ingingo ifite ikibazo (niba imwe gusa yagizweho ingaruka) cyangwa ingingo nyinshi bitewe n'uburwayi bwawe bwihariye. Umuganga wawe uzabaga azagena uburyo bwiza bushingiye ku ngaruka z'ibizamini byawe n'ubushakashatsi bw'amashusho.

Kuki parathyroidectomy ikorwa?

Parathyroidectomy ikorwa kugira ngo ivure hyperparathyroidism, uburwayi aho ingingo zawe za parathyroid zikora umusemburo mwinshi cyane. Uyu musemburo w'ikirenga utuma urugero rwa kalisiyumu mu maraso yawe ruzamuka cyane, bishobora kwangiza ingingo nyinshi uko igihe kigenda.

Impamvu isanzwe itera kubagwa iyi ni igituntu cyiza cyitwa parathyroid adenoma, kikaba gifata hafi 85% by'abantu bafite hyperparathyroidism. Izi ntuntu ntiziba kanseri, ariko zituma urugingo rurebwa rukora cyane, rukora umubare mwinshi wa hormone ya parathyroid.

Muganga wawe ashobora kugusaba kubagwa niba ufite ibimenyetso bigira ingaruka ku mibereho yawe. Urwego rwo hejuru rwa kalisiyumu rushobora gutuma wumva unaniwe, uruhuka, cyangwa wumva ubabaye, kandi ushobora kubona intege nke z'imitsi cyangwa kunyara kenshi.

Kubagwa birihutishwa niba ugize ibibazo bikomeye. Ibi bishobora kuba harimo amabuye mu mpyiko, igihombo cy'amagufwa gitera osteoporosis, ibibazo by'umutima, cyangwa kwangirika kw'impyiko bitewe n'urwego rwo hejuru rwa kalisiyumu.

Mu buryo butavugwa cyane, kubagwa bivura kanseri ya parathyroid, iboneka mu buryo butarenze 1% by'abantu. Ibindi bibazo bidasanzwe nka syndrome ya multiple endocrine neoplasia nayo ishobora gusaba iyi nzira kugirango hirindwe ibibazo bizaza.

Ni iki gikorerwa parathyroidectomy?

Parathyroidectomy ikorwa muri rusange ikoreshwa anesthesie kandi bitwara isaha imwe cyangwa ebyiri. Umuganga ubaga azakora agace gato mu gice cyo hasi cy'ijosi ryawe, akenshi ni santimetero 5-7 z'uburebure.

Mugihe cyo kubagwa, umuganga ubaga asenya neza imitsi n'ibice by'umubiri kugirango agere ku ngingo za parathyroid. Bazagenzura buri ngingo kugirango bamenye izo zabyimbye cyangwa zidasanzwe, akenshi bakoresha uburyo bwihariye bwo kubungabunga imitsi y'ijwi ryawe.

Niba urugingo rumwe gusa rufite ikibazo, umuganga ubaga azakuraho urwo rugingo gusa mu buryo bwiswe focused parathyroidectomy. Ubu buryo butagira ingaruka nyinshi bukoresha agace gato kandi akenshi butuma umuntu akira vuba.

Iyo ingingo nyinshi zifite uruhare, umuganga ubaga ashobora gukora uburyo burambuye. Bashobora gukuraho ingingo 3½, basiga igice gito cy'igice cyiza kugirango bakomeze imikorere ya parathyroid, cyangwa bakimurira igice cyiza ku kuboko kwawe.

Mugihe cyo kubaga, umuganga wawe ashobora gupima urugero rwa hormone ya parathyroid mu gihe nyacyo. Ibi bifasha kwemeza ko bakuyeho imitsi ikwiye kandi ko urugero rwa hormone yawe rugenda rugabanuka neza.

Abaganga bamwe bakoresha uburyo buhanitse nko gukurikiranira hafi imitsi mu gihe cyo kubaga kugirango barinde imitsi yawe ivuga, cyangwa uburyo butuma habaho kubaga gake hakoreshejwe ibikomere bito bifashishije amashusho yihariye cyangwa ibikoresho byo kubaga.

Ni gute witegura kubagwa parathyroidectomy?

Kwitegura kwawe bitangirira ku isuzuma ryimbitse ryubuvuzi kugirango wemeze ko witeguye kubagwa. Muganga wawe azasuzuma imiti yawe, cyane cyane iyo ikoreshwa mu gutuma amaraso atavura, kandi ashobora kukubwira guhagarika imiti imwe na mbere yuko igikorwa gikorwa.

Uzakeneye gutegura umuntu uzakujyana mu rugo nyuma yo kubagwa, kuko ntuzashobora gutwara imodoka mugihe ukira anesthesia. Teganya kugira inshuti cyangwa umuryango ugumana nawe mumasaha 24 ya mbere nyuma yigikorwa cyawe.

Itsinda ryawe ryabaga rizagutanga amabwiriza yihariye yerekeye kurya no kunywa mbere yo kubagwa. Mubisanzwe, uzakenera kwirinda ibiryo n'amazi mumasaha 8-12 mbere yigikorwa cyawe kugirango wirinde ingorane mugihe cya anesthesia.

Tegura urugo rwawe kugirango ukire ukoresheje ahantu ho kuruhukira neza hamwe n'imitozo yinyongera kugirango ukomeze umutwe wawe uzamuye. Shyira ibiryo byoroshye kandi ugire ibikombe bya barafu biteguye, kuko ibi bishobora kugabanya kubyimba nyuma yo kubagwa.

Niba unywa itabi, gerageza kureka cyangwa kugabanya kunywa itabi mbere yo kubagwa, kuko ibi bishobora kunoza uburyo bwawe bwo gukira. Muganga wawe ashobora kandi gushimangira ibiyobyabwenge bimwe na bimwe cyangwa imiti kugirango ifashe gucunga urugero rwawe rwa kalisiyumu mbere na nyuma yigikorwa.

Ni gute usoma ibisubizo byawe bya parathyroidectomy?

Intsinzi nyuma ya parathyroidectomy igaragarira cyane cyane nurugero rwawe rwa kalisiyumu na hormone ya parathyroid isubira mumiterere isanzwe. Muganga wawe azagenzura uru rugero mumasaha nyuma yo kubagwa kandi akomeze kubikurikirana mugihe ukira.

Ubusanzwe urugero rwa kalisiyumu rugomba kuba hagati ya 8.5 na 10.5 mg/dL, nubwo muganga wawe azareba urugero rwawe rwa mbere. Ugomba kubona urugero rwa kalisiyumu rwawe rugabanuka mu masaha 24 nyuma yo kubagwa niba uburyo bwakozwe bwaragenze neza.

Urugero rwa hormone ya paratiroyide na rwo ruzagenzurwa buri gihe. Ubusanzwe urugero rwa PTH rugomba kuba hagati ya 15 na 65 pg/mL, kandi ibi bigomba gusubira mu buryo busanzwe mu minsi cyangwa mu byumweru nyuma yo gukuraho imitsi ikora cyane.

Rimwe na rimwe urugero rwa kalisiyumu yawe rushobora kugabanuka cyane by'agateganyo, icyo gihe cyitwa hypocalcemia. Ibi bibaho kuko imitsi ya paratiroyide isigaye ikeneye igihe cyo kumenyera no kongera gukora neza nyuma yo kumara igihe kirekire itagikora.

Muganga wawe azakurikiza ibimenyetso byawe kimwe n'ibisubizo bya laboratori. Kugabanya ibimenyetso nk'umunaniro, intege nke z'imitsi, cyangwa umutwe ushobora gufata ibyumweru byinshi cyangwa amezi menshi uko umubiri wawe umenyera urugero rusanzwe rwa kalisiyumu.

Gukurikiranira hafi igihe kirekire birimo gukurikirana imikorere y'amagufa, imikorere y'impyiko, no kureba niba imitsi ya paratiroyide isigaye ikora neza. Abantu benshi babona iterambere rigenda buhoro buhoro mu gukomera kw'amagufa no mu mikorere y'impyiko mu mezi akurikira kubagwa.

Ni gute wakwitwara nyuma yo kubagwa paratiroyide?

Uburyo bwo koroherwa bwawe bushingiye ku kugenzura urugero rwa kalisiyumu no korohereza ijosi ryawe gukira neza. Abantu benshi bataha umunsi umwe cyangwa nyuma yo kumara ijoro mu bitaro, bitewe n'urugero rwa kalisiyumu rwabo n'ubuzima muri rusange.

Birashoboka ko uzakenera kalisiyumu na vitamine D mu ntangiriro, uko imitsi ya paratiroyide isigaye imenyerana n'umurimo mushya. Muganga wawe azandika imiti ifite urugero runaka rishingiye ku bisubizo byawe by'ibizamini by'amaraso kandi abihindure uko bikwiye.

Reba ibimenyetso bya kalisiyumu nke, bishobora kurimo kuribwa hafi y'umunwa wawe cyangwa mu ntoki zawe, kuribwa kw'imitsi, cyangwa kumva ufite impungenge. Ibi bimenyetso mubisanzwe biragabanuka uko urugero rwa kalisiyumu rwawe rugenda rugaruka mu buryo busanzwe, ariko vugana na muganga wawe niba bikomeye cyangwa bikomeza.

Witondere igikomere cyawe ukigumisha cyera kandi cyumye, kandi wirinde kuzamura ibintu biremereye cyangwa gukora imirimo ivunanye mu byumweru 2. Abantu benshi bashobora gusubira mu kazi ko ku meza mu minsi mike, ariko akazi gakenera imbaraga zishobora gusaba igihe kirekire cyo koroherwa.

Ijwi ryawe rishobora kumvikana mu buryo butandukanye cyangwa rigasa nk'iricogoye mu ntangiriro bitewe no kubyimba hafi y'imitsi ikoreshwa mu kuvuga. Ibi bikunze gukira mu minsi cyangwa mu byumweru, ariko menyesha muganga wawe niba impinduka z'ijwi zikomeje nyuma y'ibyumweru bike.

Mbese ni izihe nyungu ziza nyuma yo kubaga parathyroid?

Ibyiza ni ukugira urugero rusanzwe rwa kalisiyumu na hormone ya parathyroid bigahoraho igihe kirekire. Abantu benshi bagira iyi nyungu, hamwe n'umuvuduko wo gukira urenze 95% iyo bikozwe n'abaganga b'inararibonye.

Ibyiza kandi birimo koroherezwa ku bimenyetso byakuzanye mu kubagwa. Abantu benshi babona imbaraga zikomeye, imyumvire myiza, gutekereza neza, no kugabanya intege nke z'imitsi mu byumweru cyangwa mu mezi.

Inyungu zirambye zirimo kurengerwa ku ngorane zikomeye nk'amabuye yo mu mpyiko, igabanuka ry'amagufa, n'ibibazo by'umutima. Imikorere y'impyiko zawe akenshi iratera imbere, kandi amagufa yawe ashobora gukomera uko igihe kigenda gihita kalisiyumu igasubira mu buryo busanzwe.

Ibyiza bibaho iyo ugumye mu kwitabwaho buri gihe kandi ugafata imiti yanditswe nk'uko byategetswe. Muganga wawe azagenzura iterambere ryawe kandi ahindure imiti kugira ngo arebe ko urugero rwa kalisiyumu rwawe ruguma mu rugero rwiza.

Iterambere ry'ubuzima bwiza akenshi riba rikomeye, hamwe n'abantu benshi basobanura kumva bameze nk'uko bari nyuma y'imyaka y'ibimenyetso bito batamenyaga ko bifitanye isano n'uburwayi bwabo bwa parathyroid.

Mbese ni izihe mpamvu zishobora gutuma ukeneye kubagwa parathyroid?

Imyaka n'igitsina bifite uruhare rukomeye mu kugaragaza ibyago, aho abagore bafite imyaka irenga 50 aribo bakunze kwibasirwa cyane. Abagore bamaze guca imbyaro bafite umuvuduko mwinshi w'ibibazo bya parathyroid, bishoboka bitewe n'impinduka za hormone zigira ingaruka ku mikorere ya kalisiyumu.

Uburwayi bumwe bwo mu rugero rw'imiryango bushobora kongera ibyago byawe, harimo indwara nyinshi zifitanye isano n'imisemburo ndetse n'indwara ya familial hypocalciuric hypercalcemia. Niba ufite abagize umuryango bafite ibibazo bya parathyroid, ushobora kugira ibyago byinshi byo kubigira nawe.

Guhura n'imirasire mbere hose mu gice cy'ijosi ryawe, cyane cyane mu bwana, bishobora kongera ibyago byo guteza imitsi ya parathyroid nyuma mu buzima. Ibi birimo imiti ikoreshwa mu kuvura izindi kanseri cyangwa se n'uburyo bwa kera bwo kuvura bwakoreshaga imirasire.

Indwara y'impyiko y'igihe kirekire ishobora kugira ingaruka ku ngingo za parathyroid, rimwe na rimwe bigatuma habaho hyperparathyroidism ya kabiri ishobora gusaba kuvurwa mu kubaga. Kubura cyane kwa vitamine D mu myaka myinshi bishobora no gutuma habaho ibibazo bya parathyroid.

Imiti imwe n'imwe, cyane cyane lithium ikoreshwa mu ndwara zo mu mutwe, ishobora kugira ingaruka ku mikorere ya parathyroid uko igihe kigenda. Abantu bamwe bafata lithium igihe kirekire bashobora guteza adenomas ya parathyroid isaba gukurwaho mu kubaga.

Ni izihe ngaruka zishobora guterwa no gukuraho parathyroid?

Ingaruka isanzwe ni urwego ruto rw'umubiri rwa calcium, rugira ingaruka ku bantu bagera kuri 10-30% nyuma yo kubagwa. Ibi mubisanzwe bikemuka mu minsi cyangwa mu byumweru nk'uko ingingo za parathyroid zisigaye zitangira gukora neza.

Impinduka z'ijwi zishobora kubaho niba kubagwa bigize ingaruka ku miti y'imitsi igenzura imirya yawe. Impinduka nyinshi z'ijwi ni iz'igihe gito kandi zikemuka mu byumweru, ariko impinduka z'ijwi zihoraho zibaho ku bantu batarenze 1% iyo bikozwe n'abaganga bafite ubunararibonye.

Kuva amaraso cyangwa kwandura ahakorewe kubagwa ni ingaruka zidakunze kubaho ariko zishoboka. Ibimenyetso birimo kubyimba bidasanzwe, umutuku, gushyuha, cyangwa kuvusha ku gice cyakoreweho icyuma, kandi ibi bisaba ubufasha bwihuse bw'abaganga.

Hypoparathyroidism ihoraho ni ingaruka idakunze kubaho ariko ikomeye aho imitsi ya parathyroid nyinshi ikurwaho, bigatuma udashobora gukomeza urwego rusanzwe rwa calcium. Ibi bisaba kongera calcium na vitamine D mu buzima bwose.

Mu buryo butajya bubaho, abantu bashobora guhura na hyperparathyroidism ihoraho cyangwa igaruka niba igice kidahwitse kitarakurwaho burundu cyangwa niba ingingo nyinshi zaragizweho ingaruka. Ibi bishobora gusaba kubagwa bundi bushya cyangwa izindi nshuti.

Ingorane zitajya zibaho cyane zirimo kwangiza ibice byegeranye nk'umuhogo cyangwa imitsi minini y'amaraso, ariko ibi bibaho munsi ya 1% by'inzira iyo zikorwa n'abaganga babishoboye.

Ni ryari nkwiriye kubona umuganga nyuma yo kubagwa parathyroidectomy?

Vugana n'umuganga wawe ako kanya niba uhuye n'ibimenyetso bikomeye bya kalisiyumu nkeya, harimo imitsi y'imitsi, kuribwa cyane, cyangwa kuribwa bikwirakwira hanze y'umunwa wawe n'intoki. Ibi bimenyetso bishobora kugaragaza urwego rwa kalisiyumu ruri hasi cyane.

Hamagara umuganga wawe niba ubona ibimenyetso byo kwandura hafi y'igikomere cyawe, nk'ukwiyongera kw'umutuku, ubushyuhe, kubyimba, cyangwa imyanda isa na pus. Umuriro uri hejuru ya 101 ° F (38.3 ° C) nyuma y'umunsi wa mbere nawo usaba kwitabwaho ako kanya.

Shaka ubuvuzi niba ugira kubyimba mu ijosi cyane cyangwa ugira ingorane zo guhumeka cyangwa kumeza. Nubwo bitajya bibaho, ibi bimenyetso bishobora kugaragaza kuva amaraso cyangwa kubyimba bikenera kuvurwa byihutirwa.

Teganya gahunda yo gusuzumwa niba impinduka z'ijwi ryawe zikomeza kurenza ibyumweru 2-3 cyangwa niba ubona ijwi ryawe rigenda ricika intege aho kurushaho. Impinduka nyinshi z'ijwi zikemuka zonyine, ariko ibibazo bihoraho bishobora gukenera isuzuma.

Vugana n'umuganga wawe niba wumva unaniwe cyane, wahindutse cyangwa wumva ucitse intege nyuma y'ibyumweru byinshi nyuma yo kubagwa, kuko ibi bishobora kugaragaza imiterere ya kalisiyumu idahwitse ikeneye guhindurwa mu miti yawe.

Ibikunze kubazwa kuri parathyroidectomy

Q.1 Ese parathyroidectomy ni nziza ku mabuye yo mu mpyisi?

Yego, kubaga parathyroidectomy birashobora kugira akamaro kanini mu gukumira amabuye yo mu mpyiko akomoka ku rwego rwo hejuru rwa kalisiyumu. Iyo imitsi ya parathyroid ikora umusemburo mwinshi cyane, kalisiyumu nyinshi mu maraso yawe yinjizwa mu mpyiko zawe, bikongera ibyago byo gukora amabuye yo mu mpyiko ya kalisiyumu.

Nyuma yo kubagwa neza, urwego rwawe rwa kalisiyumu rusubira mu buryo busanzwe, rugabanya cyane ibyago byo gukora amabuye mashya yo mu mpyiko. Abantu benshi basanga ibibazo byabo by'amabuye yo mu mpyiko bikemuka burundu nyuma ya parathyroidectomy.

Q.2 Ese kalisiyumu nkeya nyuma ya parathyroidectomy itera ibibazo bihoraho?

Kalisiyumu nkeya nyuma ya parathyroidectomy mubisanzwe ni iy'agateganyo kandi ntigutera ibibazo bihoraho. Imitsi yawe ya parathyroid isigaye mubisanzwe ikeneye igihe cyo "gukanguka" no kongera gukora neza nyuma yo guhagarikwa n'imitsi ikora cyane.

Urwego rwa kalisiyumu rw'abantu benshi rusanzwe mu minsi cyangwa mu byumweru hamwe no kongerwa neza. Kalisiyumu nkeya ihoraho ni gake kandi mubisanzwe bibaho gusa niba imitsi ya parathyroid nyinshi yakurwaho mugihe cyo kubagwa.

Q.3 Ese parathyroidectomy irashobora guteza imbere ubucucike bw'amagufa?

Yego, parathyroidectomy akenshi ituma ubucucike bw'amagufa butera imbere uko igihe kigenda. Urwego rwo hejuru rwa hormone ya parathyroid rutuma kalisiyumu ikurwa mu magufa yawe, bigatuma amagufa atakara kandi ibyago byo kuvunika bikiyongera.

Nyuma yo kubagwa neza, amagufa yawe ashobora gutangira kongera kubakwa no gukomera uko kalisiyumu isubira mu buryo busanzwe. Iyi nzira ifata igihe, kandi urashobora kubona impinduka zigenda zigenda mu gusuzuma ubucucike bw'amagufa mu mezi cyangwa imyaka nyuma yo kubagwa.

Q.4 Bifata igihe kingana iki kugirango wumve ko usanzwe nyuma ya parathyroidectomy?

Abantu benshi batangira kumva impinduka mu byumweru byambere nyuma yo kubagwa, ariko gukira burundu birashobora gufata amezi menshi. Urwego rw'imbaraga, imitekerereze, n'ubwenge akenshi bigenda bitera imbere uko umubiri wawe uhinduka ku rwego rwa kalisiyumu rusanzwe.

Ibimenyetso bimwe na bimwe nk'ububabare bwo mu magufa cyangwa kunanuka kw'imitsi bishobora gutwara igihe kirekire kugira ngo bikire burundu. Buri wese akira ku buryo bwe, kandi muganga wawe azakurikiza iterambere ryawe akoresheje ibizamini by'amaraso bya buri gihe no kugenzura.

Q.5 Ese nzakeneye gufata imiti yongera kalisiyumu iteka ryose nyuma yo kubaga paratiroyide?

Abantu benshi ntibakeneye gufata imiti yongera kalisiyumu iteka ryose nyuma yo kubaga paratiroyide. Mbere na mbere, birashoboka ko uzakeneye kalisiyumu na vitamine D mugihe ibice byawe bisigaye bya paratiroyide bikosora kandi bigatangira gukora neza.

Muganga wawe azagabanya buhoro buhoro imiti yawe mugihe urwego rwawe rwa kalisiyumu ruzahagarara. Abantu benshi bashobora gushobora kureka gufata imiti burundu, nubwo bamwe bashobora gukenera gukomeza gufata vitamine D cyangwa ingano ntoya ya kalisiyumu igihe kirekire.