Chii chinonzi Parathyroidectomy? Chinangwa, Maitiro & Kupora

Parathyroidectomy inzira yekuvhiya yekubvisa imwe kana anopfuura eparathyroid glands yako. Aya ma glands mana madiki, imwe neimwe yakakura se zviyo zverice, inogara kuseri kwegland yako yethyroid mumutsipa mako uye inodzora mazinga ecalcium muropa rako.

Apo ma glands aya anova akanyanyisa kana kukudziridza tumors, anogona kukonzera matambudziko makuru ehutano nekugadzira yakawandisa parathyroid hormone. Chiremba wako angakurudzira kuvhiyiwa uku kuti adzorere chiyero chemuviri wako checalcium uye kudzivirira matambudziko akadai semabwe eitsvo, kurasikirwa kwemapfupa, kana matambudziko emoyo.

Chii chinonzi parathyroidectomy?

Parathyroidectomy ndiyo kubviswa kwekuvhiya kweimwe kana anopfuura eparathyroid glands kana asingashande zvakanaka. Parathyroid glands yako ndeye mana madiki, oval-shaped glands ari kuseri kwethyroid yako mumutsipa mako.

Aya ma glands anogadzira parathyroid hormone (PTH), iyo inoita se thermostat ye calcium muropa rako. Kana mazinga ecalcium achiderera, PTH inoudza mapfupa ako kuti asunungure calcium uye itsvo dzako kuti dzitore calcium yakawanda kubva mumvura yako.

Dzimwe nguva imwe kana anopfuura eaya ma glands anowedzera kana kukudziridza benign tumors inonzi adenomas. Izvi zvinovaita kuti vagadzire PTH yakawandisa, zvichikonzera mazinga ecalcium anokuvadza muropa rako - mamiriro anonzi hyperparathyroidism.

Kuvhiyiwa kunogona kusanganisira kubvisa gland ine dambudziko chete (kana imwe chete ichikanganiswa) kana akawanda ma glands zvichienderana nemamiriro ako chaiwo. Chiremba wako achasarudza nzira yakanakisa zvichienderana nemigumisiro yako yekuyedzwa uye zvidzidzo zve imaging.

Nei parathyroidectomy ichiitwa?

Parathyroidectomy inoitwa kurapa hyperparathyroidism, mamiriro apo parathyroid glands yako inogadzira hormone yakawandisa. Iyi hormone yakawandisa inokonzera mazinga ecalcium muropa rako kukwira zvakanyanya, izvo zvinogona kukuvadza nhengo dzakawanda nekufamba kwenguva.

Chikonzero chinowanzoitika chekuvhiyiwa uku itumor isina njodzi inonzi parathyroid adenoma, iyo inokanganisa vanhu vanenge 85% vane hyperparathyroidism. Matumor aya haasi ekenza, asi anoita kuti gland yakakanganiswa ishande zvakanyanya, ichigadzira huwandu hwakawanda hwe parathyroid hormone.

Chiremba wako angakurudzira kuvhiyiwa kana uri kusangana nezviratidzo zvinokanganisa hupenyu hwako. Mazinga epamusoro e calcium anogona kukupa kuneta, kuvhiringidzika, kana kuora mwoyo, uye unogona kuona kusimba kwemhasuru kana kuwanzisa kuita weti.

Kuvhiyiwa kunova nekukurumidza kana ukaita matambudziko akakomba. Izvi zvinogona kusanganisira matombo eitsvo, kurasikirwa kwemapfupa kunotungamira ku osteoporosis, matambudziko emoyo, kana kukuvadzwa kweitsvo kubva pamazinga epamusoro e calcium.

Kazhinji, kuvhiyiwa kunobata kenza ye parathyroid, iyo inoitika muvanhu vashoma vanopfuura 1%. Mamiriro ezvinhu asingawanzoitiki se multiple endocrine neoplasia syndromes anogonawo kuda nzira iyi kudzivirira matambudziko emangwana.

Ndeipi nzira ye parathyroidectomy?

Parathyroidectomy inowanzoitwa pasi pe general anesthesia uye inotora anenge 1-2 maawa. Chiremba wako achaita incision diki muchikamu chepasi pemutsipa wako, kazhinji anenge 2-3 inches kureba.

Panguva yekuvhiyiwa, chiremba wako anonyatso paradzanisa mhasuru uye matishu kuti asvike pagland yako ye parathyroid. Vachaongorora gland yega yega kuti vaone kuti ndedzipi dzakakura kana dzisina kujairika, kazhinji vachishandisa nzira dzakakosha kuchengetedza tsinga dzemabhokisi ako ezwi.

Kana gland imwe chete yakakanganiswa, chiremba wako achabvisa gland iyoyo munzira inonzi focused parathyroidectomy. Iyi nzira shoma inoshandisa incision diki uye inowanzoita kuti kupora kukurumidze.

Kana magland akawanda achibatanidzwa, chiremba wako angaita nzira yakakura. Vanogona kubvisa 3½ glands, vachisiya chikamu chidiki chetishu ine hutano kuchengetedza basa re parathyroid, kana kutamisa imwe tishu ine hutano ku forearm yako.

Munguva yekuvhiyiwa, chiremba wako anogona kuyedza mazinga ako eparathyroid hormone munguva chaiyo. Izvi zvinobatsira kusimbisa kuti vakabvisa magland akakodzera uye kuti mazinga ako emahormone ari kudonha zvakakodzera.

Vamwe vanachiremba vanoshandisa nzira dzepamusoro dzakadai se intraoperative nerve monitoring kudzivirira tambo dzako dzezwi, kana nzira shoma dzinopinda vachishandisa zvikamu zvidiki nerubatsiro rwemifananidzo yakakosha kana maturusi ekuvhiya.

Maitiro ekugadzirira parathyroidectomy yako?

Kugadzirira kwako kunotanga nekuongororwa kwakakwana kwekurapa kuti uve nechokwadi chekuti wakagadzirira kuvhiyiwa. Chiremba wako achaongorora mishonga yako, kunyanya chero zvinoderedza ropa, uye anogona kukukumbira kuti umise mishonga yakati wandei usati waita maitiro acho.

Unofanirwa kuronga kuti mumwe munhu akutyire kumba mushure mekuvhiyiwa, sezvo usingakwanise kutyaira uchipora kubva ku anesthesia. Ronga kuva neshamwari kana nhengo yemhuri kuti igare newe kwemaawa makumi maviri nemana ekutanga mushure mekuita kwako.

Chikwata chako chekuvhiya chichakupa mirairo chaiyo yekudya nekumwa usati waita kuvhiyiwa. Kazhinji, unozofanira kudzivisa chikafu nemvura kwemaawa 8-12 usati waita maitiro ako kudzivirira matambudziko panguva yeanesthesia.

Gadzirira imba yako yekupora nekuisa nzvimbo yekuzorora yakasununguka nemapiro ekuwedzera kuti musoro wako uchengetwe wakakwira. Chengeta chikafu chipfava uye uve nemapaki echando akagadzirira, sezvo izvi zvinogona kubatsira kuderedza kuzvimba mushure mekuvhiyiwa.

Kana uchiputa, edza kusiya kana kuderedza kusvuta usati waita kuvhiyiwa, sezvo izvi zvinogona kuvandudza maitiro ako ekupora. Chiremba wako anogona zvakare kukurudzira mamwe mavitamini kana mishonga yekubatsira kubata mazinga ako ecalcium usati waita uye mushure mekuita maitiro acho.

Maitiro ekuverenga mhedzisiro yako ye parathyroidectomy?

Kubudirira mushure meparathyroidectomy kunonyanya kuyerwa necalcium yako uye mazinga eparathyroid hormone achidzokera kumazinga akajairika. Chiremba wako achaongorora mazinga aya mukati memaawa mushure mekuvhiyiwa uye achienderera mberi nekuatarisa panguva yekupora kwako.

Mazinga e calcium akajairika anowanzoita kubva pa 8.5 kusvika pa 10.5 mg/dL, kunyangwe chiremba wako achafunga nezve baseline yako yega. Unofanirwa kuona mazinga ako e calcium achiderera mukati me maawa makumi maviri nemana mushure mekuvhiyiwa kana maitiro acho akabudirira.

Mazinga ako e parathyroid hormone achayedzwawo nguva dzose. Mazinga e PTH akajairika anobva pa 15 kusvika pa 65 pg/mL, uye aya anofanirwa kujairika mukati memazuva kusvika kumavhiki mushure mekubvisa magland akanyanya kushanda.

Dzimwe nguva mazinga ako e calcium anogona kuderera zvakanyanya kwenguva pfupi, mamiriro anonzi hypocalcemia. Izvi zvinoitika nekuti mamwe ako e parathyroid glands anoda nguva yekugadzirisa uye kutanga kushanda zvakanaka zvakare mushure mekunyadziswa kwenguva yakareba.

Chiremba wako achateedzera zviratidzo zvako pamwe chete nemhedzisiro yako yelab. Kubatsirwa kubva kuzviratidzo zvakaita se kuneta, kusimba kwemhasuru, kana mhute yepfungwa kunogona kutora mavhiki akati wandei kusvika kumwedzi sezvo muviri wako uchigadzirisa kumazinga e calcium akajairika.

Kutevera kwenguva refu kunosanganisira kuongorora kuvandudzwa kwehutano hwemapfupa, basa reitsvo, uye kuona kuti mamwe ako e parathyroid glands anoramba achishanda zvakanaka. Vanhu vazhinji vanoona kuvandudzwa zvishoma nezvishoma muhukuru hwemapfupa uye basa reitsvo mumwedzi mushure mekuvhiyiwa.

Ungaita sei kuti utarise kupora kwako mushure me parathyroidectomy?

Kupora kwako kunotarisa pakutarisira mazinga e calcium uye kubvumira mutsipa wako kuti upore zvakanaka. Vanhu vazhinji vanoenda kumba zuva rimwe chete kana mushure mehusiku hwega hwechipatara, zvichienderana nemazinga avo e calcium uye hutano hwese.

Unogona kuda calcium uye vitamin D supplements pakutanga, sezvo mamwe ako e parathyroid glands achigadzirisa kubasa ravo idzva. Chiremba wako achanyora zviyero zvakatarwa zvichibva pamhedzisiro yako yebvunzo yeropa uye achizvigadzirisa sezvinodiwa.

Tarisa zviratidzo zve calcium yakaderera, izvo zvinogona kusanganisira kunzwa kunzwa muromo wako kana mumunwe wako, mhasuru cramps, kana kunzwa kushushikana. Zviratidzo izvi zvinowanzoita nani sezvo mazinga ako e calcium achigadzikana, asi taura nachiremba wako kana akakomba kana achiramba achiitika.

Chengeta kuvhiwa kwako nekukurichenesa uye kuoma, uye dzivisa kusimudza zvinhu zvinorema kana mabasa anonetesa kwemavhiki anenge 2. Vanhu vazhinji vanogona kudzokera kubasa remudeski mukati memazuva mashoma, asi mabasa emuviri anogona kuda nguva yakareba yekupora.

Izwi rako rinogona kurira zvakasiyana kana kunzwa kusina simba pakutanga nekuda kwekuzvimba pedyo netambo dzako dzezwi. Izvi zvinowanzoita nani mukati memazuva kusvika kumavhiki, asi zivisa chiremba wako kana shanduko dzezwi dzikaramba dziripo kupfuura mavhiki mashoma.

Ndezvipi zvakanakisa zvinobuda mushure meparathyroidectomy?

Mhedzisiro yakanakisa ndeyekuita mazinga akajairika ecalcium neparathyroid hormone anoramba akagadzikana kwenguva refu. Vanhu vazhinji vanowana kubudirira uku, vane mitengo yekurapa inodarika 95% kana ichiitwa nevavhiyi vane ruzivo.

Mhedzisiro yakanaka inosanganisirawo zororo kubva kuzviratidzo zvakakuendesa kuvhiyiwa pakutanga. Vanhu vazhinji vanocherechedza mazinga esimba akavandudzwa, mafungiro ari nani, kufunga kwakajeka, uye kuderedzwa kwesimba remhasuru mukati memavhiki kusvika kumwedzi.

Zvibatsiro zvenguva refu zvinosanganisira kudzivirirwa kubva kumatambudziko akakomba senge matombo eitsvo, kurasikirwa kwemapfupa, uye matambudziko emoyo. Basa reitsvo dzako rinowanzoita nani, uye mapfupa ako anogona kusimba nekufamba kwenguva sezvo calcium regulation inojairika.

Mhedzisiro yakanakisa inoitika kana iwe ukaramba uchienda kunotevera nguva dzose uye kutora zvinowedzera zvakarairwa sezvakarairwa. Chiremba wako achatarisa kufambira mberi kwako uye kugadzirisa kurapwa kuti ave nechokwadi chekuti mazinga ako ecalcium anoramba ari muchikamu chine hutano.

Kuvandudzwa kwemhando yehupenyu kazhinji kunoshamisa, nevakawanda vachitsanangura kunzwa sekunge ivo zvakare mushure memakore ezviratidzo zvinyoro zvavaisaziva zvakabatana nemamiriro avo eparathyroid.

Ndezvipi zvinhu zvine njodzi zvekuda parathyroidectomy?

Zera uye bonde zvinotamba mabasa akakosha munjodzi yako, nevakadzi vanopfuura 50 vachiwanzobatwa. Vakadzi vakapfuura menopause vane mitengo yakanyanya yepamusoro yematambudziko eparathyroid, pamwe nekuda kweshanduko dzehomoni dzinokanganisa calcium metabolism.

Mamwe mamiriro ezvinhu emagenetic anogona kuwedzera njodzi yako, kusanganisira multiple endocrine neoplasia syndromes uye familial hypocalciuric hypercalcemia. Kana uine nhengo dzemhuri dzine matambudziko eparathyroid, unogona kuva nenjodzi yakawedzerwa yekuzvigadzira iwe pachako.

Kutarisana nemwaranzi kunzvimbo yako yemutsipa, kunyanya panguva yehudiki, kunogona kuwedzera njodzi yako yekugadzira parathyroid tumors gare gare muhupenyu. Izvi zvinosanganisira kurapwa kwemwaranzi kune mamwe marudzi ekenza kana kunyange nzira dzekare dzekurapa dzakashandisa mwaranzi.

Kusagadzikana kwenguva refu kwematsvo kunogona kukanganisa gland yako ye parathyroid, dzimwe nguva zvichikonzera secondary hyperparathyroidism iyo inogona kuda kurapwa kwekuvhiya. Kushaikwa kwakanyanya kwevhitamini D kwemakore mazhinji kunogonawo kuita kuti pave nematambudziko eparathyroid.

Mishonga yakati wandei, kunyanya lithium inoshandiswa kune mood disorders, inogona kukanganisa basa reparathyroid nekufamba kwenguva. Vamwe vanhu vanotora lithium kwenguva refu vanogona kukudziridza parathyroid adenomas iyo inoda kubviswa kwekuvhiya.

Ndezvipi zvipingamupinyi zvinogona kuitika zveparathyroidectomy?

Chipingamupinyi chinowanzoitika ndicho chiyero checalcium chakaderera kwenguva pfupi, icho chinokanganisa vanhu vanenge 10-30% mushure mekuvhiyiwa. Izvi zvinowanzoita kuti zvigadziriswe mukati memazuva mashoma kusvika kumavhiki sezvo gland yako ye parathyroid yasara ichitanga kushanda zvakare zvakajairika.

Kuchinja kwezwi kunogona kuitika kana kuvhiyiwa kukanganisa tsinga dzinodzora tambo dzako dzezwi. Mazhinji ekuchinja kwezwi ndekwechinguvana uye anogadziriswa mukati memavhiki, asi kuchinja kwezwi zvachose kunoitika mune isingasviki 1% yezviitiko kana zvichiitwa nevachiremba vane ruzivo.

Kubuda ropa kana hutachiona panzvimbo yekuvhiya hazviwanzoitiki asi zvinogona kuitika. Zviratidzo zvinosanganisira kuzvimba kusinganzwisisike, kutsvuka, kudziya, kana kubuda kubva mukuvhiyiwa kwako, uye izvi zvinoda kutariswa kwekurapa nekukurumidza.

Hypoparathyroidism yechigarire chipingamupinyi chisingawanzoitiki asi chakakomba uko nyama yakawandisa ye parathyroid inobviswa, ichikusiya usingakwanise kuchengetedza mazinga ecalcium akajairika. Izvi zvinoda hupenyu hwese calcium uye vhitamini D supplementation.

Kazhinji, vanhu vanogona kusangana ne hyperparathyroidism inoramba iripo kana ichidzoka kana tishu isina kubviswa zvakakwana kana kana gland dzakawanda dzakabatwa. Izvi zvinogona kuda kuvhiyiwa kwakawedzerwa kana mamwe marapirwo.

Matambudziko asingawanzoitiki zvikuru anosanganisira kukuvadzwa kune zvimiro zviri pedyo zvakaita se esophagus kana tsinga huru dzeropa, asi izvi zvinoitika muvashoma vanopfuura 1% yezvinhu kana zvichiitwa nevavhiyi vane hunyanzvi.

Ndingafonera riniko chiremba mushure me parathyroidectomy?

Fonera chiremba wako nekukasira kana ukaona zviratidzo zvakakomba zve calcium yakaderera, kusanganisira muscle spasms, cramping yakakomba, kana kunzwa kunodzika kunopfuura muromo wako neminwe. Zviratidzo izvi zvinogona kuratidza mazinga e calcium akaderera zvikuru.

Fonera mupi wako wehutano kana ukaona zviratidzo zvehutachiona zvakatenderedza incision yako, zvakaita sekuwedzera kutsvuka, kudziya, kuzvimba, kana kubuda kwakaita sepus. Fivha iri pamusoro pe 101°F (38.3°C) mushure mezuva rekutanga inodawo kutariswa nekukasira.

Tsvaga rubatsiro rwekurapa kana ukaona kuzvimba kwakakomba kwemutsipa kana uine dambudziko rekufema kana kumedza. Kunyange zvazvo zvisingawanzoitiki, zviratidzo izvi zvinogona kuratidza kubuda ropa kana kuzvimba kunoda kurapwa nekukasira.

Ronga musangano wekutevera kana shanduko yezwi rako ikaramba ichipfuura mavhiki 2-3 kana ukaona izwi rako richideredzwa zvishoma nezvishoma pane kuvandudzika. Shanduko zhinji dzezwi dzinogadzirisa dzega, asi matambudziko anoramba achida kuongororwa.

Fonera chiremba wako kana ukanzwa kuneta zvakanyanya, kuvhiringidzika, kana kuora mwoyo mavhiki akati wandei mushure mekuvhiyiwa, sezvo izvi zvingaratidza kusagadzikana kwe calcium kunoda kugadziriswa mumishonga yako.

Mibvunzo inowanzo bvunzwa nezve parathyroidectomy

Q.1 Parathyroidectomy yakanaka kumabwe eitsvo here?

Hongu, parathyroidectomy inogona kubatsira zvikuru mukudzivirira matombo eitsvo anokonzerwa nemazinga epamusoro e calcium. Kana magland ako eparathyroid achigadzira mahomoni akawandisa, calcium yakawandisa muropa rako inozoserwa nematsvo ako, zvichikwidza njodzi yako yekugadzira matombo eitsvo ane calcium.

Mushure mekuvhiyiwa kwakabudirira, mazinga ako e calcium anodzokera kune zvakajairika, zvichideredza zvakanyanya njodzi yako yekugadzira matombo eitsvo matsva. Vanhu vazhinji vanowana kuti matambudziko avo ematombo eitsvo anogadziriswa zvachose mushure meparathyroidectomy.

Q.2 Ko calcium yakaderera mushure meparathyroidectomy inokonzera matambudziko echigarire here?

Calcium yakaderera mushure meparathyroidectomy inowanzoita yenguva pfupi uye haikonzeri matambudziko echigarire. Magland ako eparathyroid akasara anowanzo kuda nguva yekuti "kumuka" uye kutanga kushanda zvakanaka zvakare mushure mekunyadziswa negland inoshanda zvakanyanya.

Mazhinji mazinga e calcium evanhu anojairika mukati memazuva kusvika kumavhiki nekutsigirwa kwakakodzera. Calcium yakaderera yechigarire isingawanzoitiki uye inowanzoitika chete kana nyama yakawandisa ye parathyroid yakabviswa panguva yekuvhiyiwa.

Q.3 Ko parathyroidectomy inogona kuvandudza kuwanda kwemapfupa here?

Hongu, parathyroidectomy inowanzoita kuti kuwanda kwemapfupa kuvandudze nekufamba kwenguva. Mazinga epamusoro eparathyroid hormone anoita kuti calcium ibviswe mumapfupa ako, zvichikonzera kurasikirwa kwemapfupa uye kuwedzera njodzi yekutyoka.

Mushure mekuvhiyiwa kwakabudirira, mapfupa ako anogona kutanga kuvakazve nekusimbisa sezvo calcium regulation ichidzokera kune zvakajairika. Iyi nzira inotora nguva, uye unogona kuona kuvandudzwa zvishoma nezvishoma mumapfupa density scans pamusoro pemwedzi kusvika kumakore mushure mekuvhiyiwa.

Q.4 Zvinotora nguva yakareba sei kuti unzwe zvakajairika mushure meparathyroidectomy?

Vanhu vazhinji vanotanga kunzwa kuvandudzwa mukati memavhiki mashoma ekutanga mushure mekuvhiyiwa, asi kupora kwakakwana kunogona kutora mwedzi yakati wandei. Mazinga esimba, manzwiro, uye kujeka kwepfungwa zvinowanzoita zvishoma nezvishoma sezvo muviri wako uchigadzirisa kumazinga e calcium akajairika.

Zvimwe zviratidzo zvakaita serurwadzo mumapfupa kana kusava nesimba mumhasuru zvinogona kutora nguva refu kuti zvinyangarike zvachose. Munhu wese anopora nekumhanya kwake, uye chiremba wako achatarisa kufambira mberi kwako nekuyedzwa kweropa nguva dzose uye kuongororwa.

Q.5 Ndichada kutora zvinowedzera calcium nekusingaperi mushure meparathyroidectomy here?

Vanhu vazhinji havadi kutora zvinowedzera calcium nekusingaperi mushure meparathyroidectomy. Pakutanga, ungangoda calcium uye vitamin D supplements apo zvimwe zvironda zvako zveparathyroid zvichigadzirisa uye kutanga kushanda zvakajairika zvakare.

Chiremba wako achadzikisa zvishoma nezvishoma zvinowedzera zvako sezvo mazinga ako ecalcium achigadzikana. Vanhu vazhinji vanogona kupedzisira vamira kutora zvinowedzera zvachose, kunyangwe vamwe vachigona kuda kuramba vachitora vitamin D kana huwandu hudiki hwecalcium kwenguva refu.