Chii chinonzi Adrenalectomy? Chinangwa, Maitiro & Kupora

Adrenalectomy inzira yekuvhiya yekubvisa imwe kana ese maadrenal glands ako. Aya magland madiki, ane chimiro chetatu anogara pamusoro peitsvo imwe neimwe uye anogadzira mahomoni akakosha anobatsira kudzora ropa rako, metabolism, uye mhinduro yekushushikana. Kana magland aya akaita tumor kana kugadzira mahomoni akawanda, kuvhiyiwa kunogona kuve nzira yakanakisa yekudzosa hutano hwako uye kudzivirira matambudziko.

Chii chinonzi adrenalectomy?

Adrenalectomy zvinoreva kubviswa kwekuvhiya kwemaadrenal glands ako. Chiremba wako anogona kubvisa gland imwe chete (unilateral adrenalectomy) kana ese magland (bilateral adrenalectomy), zvichienderana nemamiriro ako chaiwo. Iyi nzira inobatsira kurapa matambudziko akasiyana eadrenal asingakwanise kutarisirwa nemishonga chete.

Maadrenal glands ako anenge akaenzana nenyama yewalnut uye anorema anenge 4-5 gramu imwe neimwe. Anogadzira mahomoni akakosha se cortisol, aldosterone, uye adrenaline anochengetedza muviri wako uchishanda nemazvo. Kana magland aya akava nezvirwere kana kuita zvakanyanya, kuabvisa kunogona kuponesa hupenyu.

Nei adrenalectomy ichiitwa?

Adrenalectomy inova inodiwa kana maadrenal glands ako akaita matambudziko akakomba anotyisidzira hutano hwako. Chikonzero chikuru ndechokubvisa tumor, ingave ine cancer kana isina asi ichikonzera kugadzirwa kwemahomoni akawanda.

Heano mamiriro makuru anogona kuda kuvhiyiwa uku:

• Tumor dzeAdrenal: Ose ari maviri ane kenza (adrenocortical carcinoma) uye tumor dzisina kenza (adenomas) dzinoburitsa mahomoni akawandisa
• Pheochromocytoma: Tumor dzinoburitsa adrenaline yakawandisa, zvichikonzera kukwira kweropa kunotyisa
• Cushing's syndrome: Kana adrenal yako ikaburitsa cortisol yakawandisa, zvichikonzera kuwedzera uremu, kukwira kweropa, uye chirwere cheshuga
• Conn's syndrome: Kuburitswa kwakanyanya kwealdosterone kuchikonzera kukwira kweropa kwakanyanya uye potassium yakaderera
• Adrenal metastases: Kana kenza kubva kune dzimwe nhengo dzemuviri wako ikapararira kumagranzi eadrenal

Kazhinji, vamwe vanhu vanoda bilateral adrenalectomy ye severe Cushing's disease kana dzimwe nzira dzekurapa dzakundikana. Chiremba wako achanyatso kuyera mabhenefiti achienzanisa nenjodzi asati akurudzira danho guru iri.

Ndeipi nzira ye adrenalectomy?

Chiremba wako anogona kuita adrenalectomy achishandisa nzira dzakasiyana, ne laparoscopic (minimally invasive) kuvhiyiwa ndiyo nzira yakajairika nhasi. Sarudzo inoenderana nehukuru nenzvimbo yetumor yako, hutano hwako hwese, uye hunyanzvi hwechiremba wako.

Hezvino zvinowanzoitika panguva yekuita:

1. Anesthesia: Uchapihwa general anesthesia kuitira kuti urare zvakakwana panguva yekuvhiyiwa
2. Kuiswa: Chiremba wako achakuisa padivi rako kana pasi kuti uwane adrenal glands
3. Kucheka: Kucheka kudiki (laparoscopic) kana kucheka kumwe kukuru (open surgery) kuchaitwa
4. Kubviswa kwegland: Chiremba wako anonyatso paradzanisa adrenal gland kubva kune matishu akapoteredza uye midzi yeropa
5. Kuvhara: Zvicheko zvinovharwa nemasutures kana glue yekuvhiya

Kuvhiwa kwe laparoscopic kunoshandisa zvikamu zvidiki zvitatu-4 uye kamera diki, zvichikonzera kurwadziwa kushoma uye kupora nekukurumidza. Kuvhiwa kwakavhurika kunoda kucheka kukuru asi kungave kwakakosha kune tumor hombe kana kana cancer ichifungidzirwa.

Maitiro ese anowanzo tora maawa 1-4, zvichienderana nekukomba kwenyaya yako uye kana imwe kana ese magland achida kubviswa.

Maitiro ekugadzirira adrenalectomy yako?

Kugadzirira adrenalectomy kunosanganisira matanho akati wandei akakosha kuti uve nechokwadi chekuti kuvhiwa kwako kunofamba zvakanaka uye zvakachengeteka. Chikwata chako chehutano chichakutungamira kuburikidza nedanho rega rega, asi hezvino zvaunogona kutarisira mumavhiki anotungamira maitiro ako.

Kugadzirira kwako kunogona kusanganisira matanho akakosha aya:

• Kuedzwa kwe-pre-operative: Kuongororwa kweropa, imaging scans, uye bvunzo dzemoyo kuti uongorore hutano hwako hwese
• Kugadzirisa mishonga: Chiremba wako anogona kunyora mishonga yekudzora BP kana mazinga emahormone pamberi pekuvhiwa
• Kuronga kutsiva mahormone: Kana ese magland achibviswa, iwe unozotanga kudzidza nezve kurapwa kwemahormone kwemahupenyu hwese
• Nzira dzekudya: Unozofanira kutsanya kwemaawa 8-12 usati wavhiwa
• Ongororo yemishonga: Dzimwe mishonga, kunyanya zvinoderedza ropa, zvinogona kuda kumiswa kwenguva pfupi

Kana uine pheochromocytoma, chiremba wako achanyora mishonga yakakosha inonzi alpha-blockers kwemavhiki akati wandei usati wavhiwa. Izvi zvinobatsira kudzivirira kuwedzera kweropa kunotyisa panguva yemaitiro.

Ita shuwa yekuronga kuti mumwe munhu akutyairire kumba uye agare newe kwezuva rekutanga kana maviri mushure mekuvhiwa. Kuva nerutsigiro panguva yekupora kwako kunoita mutsauko mukuru mukunyaradzwa kwako uye kuchengeteka.

Kupora mushure me adrenalectomy kuri sei?

Kupora kubva pa adrenalectomy kunosiyana zvichienderana nekuti wakaita laparoscopic kana kuvhiyiwa kwakavhurika, asi vanhu vazhinji vanoita zvakanaka nekuchengetwa kwakakodzera uye kushivirira. Muviri wako unoda nguva yekupora kubva pakuvhiyiwa uye kugadzirisa kune chero shanduko dzehomoni.

Hezvino zvaunogona kutarisira panguva yekupora kwako:

• Kugara muchipatara: Mazuva 1-2 ekuvhiyiwa kwe laparoscopic, mazuva 3-5 ekuvhiyiwa kwakavhurika
• Kutarisira kurwadziwa: Mishonga yekurwadziwa yakanyorwa kwevhiki yekutanga, wobva wava nezvinhu zvisingatengwi
• Kudzivirirwa kwezviitiko: Hapana kusimudza zvinhu zvinorema (kupfuura mapaundi gumi) kwemavhiki 2-4
• Kudzokera kubasa: Mavhiki 1-2 emabasa edesiki, mavhiki 4-6 emabasa emuviri
• Kupora kwakazara: Vanhu vazhinji vanonzwa zvakajairika mukati memavhiki 6-8

Kana wakabviswa gland dzese dze adrenal, unozofanira kutanga kurapwa kwehomoni pakarepo. Izvi zvinosanganisira kutora mishonga yezuva nezuva kutsiva mahomoni ayo gland dzako dze adrenal dzinowanzoita.

Chikwata chako chekuvhiya chichapa mirairo yakadzama nezvekuchengetwa kwemavanga, kana kutangazve zviitiko zvakajairika, uye zviratidzo zvekuyambira zvekutarisa. Kutevera matungamirirwo aya zvakanyatsonaka kunobatsira kuona mhedzisiro yakanaka.

Ndezvipi njodzi uye matambudziko e adrenalectomy?

Kufanana nechero kuvhiyiwa kukuru, adrenalectomy inotakura njodzi, asi matambudziko akakomba haawanzoitiki kana achiitwa nevavhiyi vane ruzivo. Kunzwisisa njodzi idzi kunokubatsira kuti uite sarudzo dzine ruzivo nezvekuchengetwa kwako uye kuziva zvekutarisa panguva yekupora.

Njodzi dzakajairika dzinogona kuitika nechero kuvhiyiwa zvinosanganisira:

• Kubuda ropa: Kunyange zvichiwanzika, kubuda ropa kwakanyanya kungada kuwedzerwa ropa
• Utachiona: Zvirwere panzvimbo yekuvhiyiwa zvinowanikwa muzviitiko zvisingasviki 5%
• Mavhiri eropa: Njodzi inoderedzwa nekufamba nekukurumidza uye zvinoderedza ropa kana zvichidikanwa
• Mhinduro dzeanesthesia: Zvisingawanzoitiki asi zvinogona kusanganisira matambudziko ekufema kana mhinduro dzekurwara

Njodzi dzakakosha dzine chekuita neadrenalectomy dzinosanganisira kukuvadzwa kwemitezo iri pedyo senge itsvo, chiropa, kana spleen. Chiremba wako anonyatso chengeta kuchengetedza zvivakwa izvi, asi njodzi iripo nekuda kwenzvimbo yeadrenal glands.

Kana uine bilateral adrenalectomy, uchavandudza mamiriro anonzi adrenal insufficiency, iyo inoda kurapwa kwehupenyu hwese hwehomoni. Kunyange izvi zvichityisa, vanhu vazhinji vanorarama hupenyu hwakajairika nekutarisirwa kwakakodzera kwemishonga.

Ndingafonera chiremba rini mushure meadrenalectomy?

Unofanira kubata chikwata chako chehutano nekukurumidza kana ukaona chero zviratidzo zvinonetsa mushure meadrenalectomy yako. Kunyange vanhu vazhinji vachipora zvakanaka, kuziva kuti ungatsvaga rubatsiro rini kunogona kudzivirira nyaya diki kubva pakuva matambudziko akakomba.

Fonera chiremba wako izvozvi kana ukaona:

• Zviratidzo zveutachiona: Fivha inodarika 101°F, kuwedzera kutsvuka kana kudziya kutenderedza incisions, kana pus drainage
• Kurwadziwa kwakanyanya: Kurwadziwa kunowedzera pane kuvandudza, kana kusadzorwa nemishonga yakarairwa
• Matambudziko ekufema: Kufema kwekufema, kurwadziwa muchipfuva, kana kukosora kunoramba kuripo
• Nyaya dzekugaya: Kuramba uchinetseka, kurutsa, kana kusakwanisa kuchengeta mvura pasi
• Zviratidzo zveadrenal crisis: Kusava nesimba kwakanyanya, dzungu, kuvhiringidzika, kana kufenda (kunyanya kana ese magland akabviswa)

Muchava nemisangano yekutevera yakarongwa kuti vatarise kupora kwenyu uye mazinga emahormone. Misangano iyi yakakosha pakuona kuti kupora kwenyu kunoramba kuri munzira uye kugadzirisa chero mishonga kana zvichidikanwa.

Kana makaita bilateral adrenalectomy, muchada kuongororwa nguva dzose kweupenyu hwenyu hwese kuti muone kuti hormone replacement therapy yenyu iri kushanda nemazvo.

Mibvunzo inowanzo bvunzwa nezve adrenalectomy

Q1: Ko adrenalectomy yakachengeteka here pakurapa tuma adrenal?

Hongu, adrenalectomy inoonekwa seyakajairika kurapwa kwetuma adrenal mazhinji uye ine marekodhi akanaka ekuchengeteka kana ichiitwa nevachiremba vane ruzivo. Maitiro acho anobudirira kubvisa tuma tumor dzese dzine kenza uye dzisina kenza dzinokonzera hormone overproduction.

Mitengo yekubudirira yakakwira kwazvo, nevakawanda vanhu vachiona kugadziriswa kwakakwana kwezviratidzo zvavo mukati memavhiki kusvika kumwedzi mushure mekuvhiyiwa. Laparoscopic adrenalectomy ine mhedzisiro yakanaka, ine mitengo yakaderera yematambudziko uye nguva yekupora nekukurumidza kana ichienzaniswa nekuvhiyiwa kwakavhurika.

Q2: Kubvisa imwe adrenal gland kunokanganisa mazinga angu emahormone here?

Kubvisa imwe adrenal gland (unilateral adrenalectomy) kazhinji hakukonzeri matambudziko emahormone enguva refu nekuti gland yako yasara inogona kugadzira mahormone akakwana zvinodiwa nemuviri wako. Gland yako yasara ye adrenal inowanzo kukura zvishoma kuti itsive.

Zvisinei, muviri wako unogona kuda mavhiki mashoma kusvika kumwedzi kuti ugadzirise zvizere. Munguva iyi, unogona kuona kumwe kuneta kana zviratidzo zvishoma, asi izvi zvinowanzo gadziriswa sezvo gland yako yasara ichitora kugadzirwa kwakazara kwehomoni.

Q3: Ndichada hormone replacement therapy mushure me adrenalectomy here?

Kana imwe chete adrenal gland yabviswa, iwe kazhinji hauzodi hormone replacement therapy nekuti gland yako yasara inogona kugadzira mahormone akakwana. Chiremba wako achatarisa mazinga ako emahormone kuti ave nechokwadi chekuti zvese zviri kushanda nemazvo.

Kana zvese zvironda zveadrenal zvabviswa, unozoda kurapwa kwehomoni kwenguva refu nemishonga yakaita se hydrocortisone uye fludrocortisone. Kunyange izvi zvichida mishonga yezuva nezuva uye kuongororwa nguva dzose, vanhu vazhinji vanochengeta hupenyu hwakanaka nekutarisirwa kwakakodzera.

Q4: Zvinotora nguva yakareba sei kupora kubva ku laparoscopic adrenalectomy?

Vanhu vazhinji vanodzoka kumabasa avo enguva dzose mukati memavhiki 2-4 mushure me laparoscopic adrenalectomy. Unogona kunzwa zvakanaka zvakakwana kuti udzokere kubasa mukati mevhiki 1-2 kana uine basa rekunyora, kunyangwe uchizofanira kudzivisa kusimudza zvinhu zvinorema kwemwedzi mumwe chete.

Kupora zvizere, kusanganisira kupora kwakakwana kwematishu emukati uye kudzoka kumabasa ese, kazhinji kunotora mavhiki 6-8. Zvikamu zvidiki kubva ku laparoscopic surgery zvinopora nekukurumidza kupfuura chikamu chikuru chinodiwa kune open surgery.

Q5: Zvirwere zveadrenal zvinogona kudzoka mushure me adrenalectomy here?

Mukana wekudzoka kwe tumor unoenderana nerudzi rwe tumor yakabviswa. Zvirwere zvakanaka (adenomas) hazvizombodzoki mushure mekubviswa kwakakwana, uye vanhu vazhinji vanoonekwa sevanopora.

Zvirwere zvakaipa (adrenocortical carcinomas) zvine njodzi yakakwira yekudzoka, ndosaka uchizoda nguva dzose follow-up scans uye bvunzo dzeropa. Kunyangwe nezvirwere zvine hasha, vanhu vazhinji vanoramba vasina cancer kwemakore kana kunyange zvachose mushure mekubudirira adrenalectomy.