Yini i-Parathyroidectomy? Inhloso, Inqubo & Ukululama

I-Parathyroidectomy iyinqubo yokuhlinzwa yokususa elinye noma ngaphezulu lamagland parathyroid akho. Lawa magland amane amancane, ngalinye lingaba nobukhulu obungangokwamanzi elayisi, ahlala ngemuva kwegland yakho ye-thyroid entanyeni yakho futhi alawule amazinga e-calcium egazini lakho.

Lapho lawa magland eseba namandla ngokweqile noma ethuthukisa izimila, angadala izinkinga ezinkulu zempilo ngokukhiqiza i-parathyroid hormone eningi kakhulu. Udokotela wakho angase ancome lokhu kuhlinzwa ukuze kubuyiselwe ibhalansi ye-calcium yemvelo yomzimba wakho futhi kuvinjelwe izinkinga ezinjengamatshe ezinso, ukulahlekelwa amathambo, noma izinkinga zenhliziyo.

Yini i-parathyroidectomy?

I-Parathyroidectomy ukususwa ngokuhlinzwa kwelinye noma ngaphezulu kwamagland parathyroid uma engasebenzi kahle. Amagland akho e-parathyroid amagland amane amancane, anesimo se-oval atholakala ngemuva kwe-thyroid yakho entanyeni yakho.

Lawa magland akhiqiza i-parathyroid hormone (PTH), esebenza njenge-thermostat ye-calcium egazini lakho. Lapho amazinga e-calcium ehla, i-PTH itshela amathambo akho ukuthi akhiphe i-calcium nezinso zakho ukuthi zimunce i-calcium eningi emchamweni wakho.

Ngesinye isikhathi elinye noma ngaphezulu lawa magland akhula noma athuthukise izimila ezingenasici ezibizwa ngokuthi ama-adenomas. Lokhu kubenza bakhiqize i-PTH eningi kakhulu, okuholela emazingeni aphezulu kakhulu e-calcium egazini lakho - isimo esibizwa ngokuthi i-hyperparathyroidism.

Ukuhlinzwa kungabandakanya ukususa nje igland enenkinga (uma eyodwa kuphela ethintekile) noma amagland amaningi kuye ngesimo sakho esithile. Udokotela ohlinzayo uzonquma indlela engcono kakhulu esekelwe emiphumeleni yakho yokuhlolwa kanye nezifundo zokucabanga.

Kungani kwenziwa i-parathyroidectomy?

I-Parathyroidectomy yenziwa ukwelapha i-hyperparathyroidism, isimo lapho amagland akho e-parathyroid ekhiqiza amahomoni amaningi kakhulu. Leli homoni elingaphezu kwemvelo libangela amazinga e-calcium egazini lakho ukuthi anyuke kakhulu, okungalimaza izitho eziningi ngokuhamba kwesikhathi.

Isizathu esivame kakhulu salolu hlobo lokuhlinzwa yisithumba esingelona umdlavuza esibizwa nge-parathyroid adenoma, esithinta cishe u-85% wabantu abane-hyperparathyroidism. Lezi zithumba azinayo umdlavuza, kodwa zenza ukuthi igland ekhungethwe isebenze ngokweqile, ikhiqize amanani amaningi e-parathyroid hormone.

Udokotela wakho angase ancome ukuhlinzwa uma uhlangabezana nezimpawu ezithinta izinga lempilo yakho. Amazinga aphezulu e-calcium angakwenza uzizwe ukhathele, udidekile, noma ucindezelekile, futhi ungase uqaphele ubuthakathaka bemisipha noma ukuvama ukuchama.

Ukuhlinzwa kuba okuphuthumayo uma uba nezinkinga ezinzima. Lokhu kungabandakanya amatshe ezinso, ukulahlekelwa amathambo okuholela ku-osteoporosis, izinkinga zesigqi senhliziyo, noma ukulimala kwezinso ngenxa yamazinga aphezulu e-calcium aqhubekayo.

Ngokuvamile, ukuhlinzwa kuphatha umdlavuza we-parathyroid, okwenzeka ezingeni elingaphansi kuka-1% wamacala. Ngisho nezimo ezingavamile njenge-multiple endocrine neoplasia syndromes zingase zidinge le nqubo ukuvimbela izinkinga zesikhathi esizayo.

Yini inqubo ye-parathyroidectomy?

I-Parathyroidectomy ivame ukwenziwa ngaphansi kwe-anesthesia ejwayelekile futhi ithatha cishe ihora elingu-1-2. Udokotela ohlinzayo uzokwenza ukusikeka okuncane engxenyeni engezansi yentamo yakho, ngokuvamile okungaba ngamasentimitha angu-2-3 ubude.

Ngesikhathi sokuhlinzwa, udokotela ohlinzayo uhlukanisa ngokucophelela imisipha nezicubu ukuze afinyelele kuma-parathyroid glands akho. Bazohlola igland ngayinye ukuze bathole ukuthi yiziphi ezikhulisiwe noma ezingavamile, ngokuvamile besebenzisa izindlela ezikhethekile zokugcina imizwa yakho yebhokisi lezwi.

Uma igland eyodwa kuphela ethintekile, udokotela ohlinzayo uzosusa leyo gland kuphela ngenqubo ebizwa nge-focused parathyroidectomy. Le ndlela encane yokuhlasela isebenzisa ukusikeka okuncane futhi ngokuvamile ivumela ukululama okusheshayo.

Lapho ama-gland amaningi ehilelekile, udokotela ohlinzayo angase enze inqubo ebanzi kakhulu. Bangase basuse ama-gland angu-3½, beshiya ingxenye encane yezicubu ezinempilo ukuze kugcinwe umsebenzi othile we-parathyroid, noma batshale ezinye izicubu ezinempilo engalweni yakho.

Ngesikhathi sokuhlinzwa, udokotela ohlinzayo angase ahlolisise amazinga akho e-parathyroid hormone ngesikhathi sangempela. Lokhu kusiza ukuqinisekisa ukuthi bakhiphe amaglandla alungile nokuthi amazinga akho e-hormone ayancipha ngendlela efanele.

Abanye odokotela abahlinzayo basebenzisa izindlela ezithuthukile njengokuqapha imizwa ngesikhathi sokuhlinzwa ukuvikela izintambo zakho zezwi, noma izindlela ezingahlaseli kakhulu zisebenzisa ukusikeka okuncane ngosizo lwezithombe ezikhethekile noma amathuluzi okuhlinza.

Ungalungiselela kanjani i-parathyroidectomy yakho?

Ukulungiselela kwakho kuqala ngokuhlolwa okujulile kwezokwelapha ukuqinisekisa ukuthi usukulungele ukuhlinzwa. Udokotela wakho uzobuyekeza imithi yakho, ikakhulu noma iyiphi imithi yokunciphisa igazi, futhi angase akucele ukuthi uyeke imithi ethile ngaphambi kwenqubo.

Uzodinga ukuhlela ukuthi othile akuqhubele ekhaya ngemuva kokuhlinzwa, njengoba ngeke ukwazi ukuqhuba ngenkathi ululama ku-anesthesia. Hlela ukuthi umngane noma ilungu lomndeni lihlale nawe amahora angama-24 okuqala ngemuva kwenqubo yakho.

Ithimba lakho lokuhlinza lizokunikeza imiyalelo ethile mayelana nokudla nokupheka ngaphambi kokuhlinzwa. Ngokuvamile, uzodinga ukugwema ukudla noketshezi amahora angu-8-12 ngaphambi kwenqubo yakho ukuvimbela izinkinga ngesikhathi se-anesthesia.

Lungisa ikhaya lakho ukuze ululame ngokumisa indawo yokuphumula enethezekile ngemigqomo eyengeziwe ukuze ugcine ikhanda lakho liphakeme. Gcina ukudla okuthambile futhi ube namaphakethe eqhwa alungile, njengoba lokhu kungasiza ukunciphisa ukuvuvukala ngemuva kokuhlinzwa.

Uma ubhema, zama ukuyeka noma ukunciphisa ukubhema ngaphambi kokuhlinzwa, njengoba lokhu kungathuthukisa inqubo yakho yokuphulukisa. Udokotela wakho angase futhi ancome izithasiselo ezithile noma imithi ukusiza ukuphatha amazinga akho e-calcium ngaphambi nangemuva kwenqubo.

Ungawafunda kanjani imiphumela yakho ye-parathyroidectomy?

Impumelelo ngemuva kwe-parathyroidectomy ngokuyinhloko ilinganiswa ngamazinga akho e-calcium ne-parathyroid hormone abuyela ebangeni elijwayelekile. Udokotela wakho uzohlola lawa mazinga kungakapheli amahora ngemuva kokuhlinzwa futhi aqhubeke nokuwaqapha ngesikhathi sokululama kwakho.

Amazingo se-calcium ngokuvamile asukela ku-8.5 kuya ku-10.5 mg/dL, nakuba udokotela wakho ezocabangela izinga lakho elijwayelekile. Kufanele ubone amazinga akho e-calcium ehla kungakapheli amahora angama-24 ngemuva kokuhlinzwa uma inqubo iphumelele.

Amazinga akho e-parathyroid hormone nawo azohlolwa njalo. Amazinga e-PTH ajwayelekile asukela cishe ku-15 kuya ku-65 pg/mL, futhi lokhu kufanele kujwayeleke phakathi nezinsuku kuya emavikini ngemuva kokususa amaglands asebenza ngokweqile.

Ngezinye izikhathi amazinga akho e-calcium angase ehle kakhulu okwesikhashana, isimo esibizwa nge-hypocalcemia. Lokhu kwenzeka ngoba amaglands akho asele e-parathyroid adinga isikhathi sokuzivumelanisa futhi aqale ukusebenza kahle futhi ngemuva kokucindezelwa isikhathi eside.

Udokotela wakho uzoqapha izimpawu zakho kanye nemiphumela yakho yelabhorethri. Ukukhululeka ezimpawini ezinjengokukhathala, ubuthakathaka bemisipha, noma inkungu yengqondo kungathatha amasonto amaningana kuya ezinyangeni njengoba umzimba wakho uzivumelanisa namazinga e-calcium ajwayelekile.

Ukulandelela isikhathi eside kufaka phakathi ukuqapha ukuthuthukiswa kwempilo yamathambo, ukusebenza kwezinso, nokuqinisekisa ukuthi amaglands akho asele e-parathyroid ayaqhubeka nokusebenza kahle. Abantu abaningi babona ukuthuthuka kancane kancane ekuminyaneni kwamathambo nasekusebenzeni kwezinso ezinyangeni ezilandelayo ngemuva kokuhlinzwa.

Ungayiphatha kanjani ukululama kwakho ngemuva kwe-parathyroidectomy?

Ukwelulama kwakho kugxila ekuphatheni amazinga e-calcium nokuvumela intamo yakho ukuthi iphole kahle. Abantu abaningi baya ekhaya ngosuku olufanayo noma ngemuva kokuhlala esibhedlela ubusuku obubodwa, kuye ngamazinga abo e-calcium nempilo yonke.

Kungenzeka udinga izithasiselo ze-calcium ne-vitamin D ekuqaleni, njengoba amaglands akho asele e-parathyroid ezivumelanisa nomsebenzi wawo omusha. Udokotela wakho uzoqoka imithamo ethile ngokusekelwe emiphumeleni yakho yokuhlolwa kwegazi futhi ayilungise njengoba kudingeka.

Qaphela izimpawu ze-calcium ephansi, ezingabandakanya ukuluma emlonyeni wakho noma emunweni wakho, imisipha eqinile, noma ukuzizwa ukhathazekile. Lezi zimpawu zivame ukuthuthuka njengoba amazinga akho e-calcium ezinzile, kodwa xhumana nodokotela wakho uma zinzima noma ziqhubeka.

Nakekela ukusikeka kwakho ngokukugcina kuhlanzekile futhi komile, futhi gwema ukuphakamisa izinto ezisindayo noma imisebenzi eqinile cishe amasonto ama-2. Abantu abaningi bangabuyela emsebenzini wedesk ngaphakathi kwezinsuku ezimbalwa, kodwa imisebenzi yomzimba ingase idinge isikhathi eside sokululama.

Izwi lakho lingase lizwakale lihlukile noma libe buthakathaka ekuqaleni ngenxa yokuvuvukala eduze kwentambo yakho yezwi. Lokhu kuvame ukuthuthuka phakathi kwezinsuku kuya emavikini, kodwa yazisa udokotela wakho uma izinguquko zezwi ziqhubeka ngaphezu kwamasonto ambalwa.

Yini imiphumela emihle kakhulu ngemva kwe-parathyroidectomy?

Umphumela ongcono kakhulu ukufinyelela amazinga ajwayelekile e-calcium ne-parathyroid hormone ahlala ezinzile isikhathi eside. Abantu abaningi banale mpumelelo, ngamanani okuphulukisa adlula ama-95% uma enziwa ngodokotela ohlinzayo abanolwazi.

Imiphumela emihle ihlanganisa nokukhululeka ezimpawini eza kukuhlinzwa ekuqaleni. Abantu abaningi baqaphela amazinga amandla athuthukisiwe, imizwa engcono, ukucabanga okucacile, kanye nokuncipha kobuthakathaka bemisipha phakathi kwamasonto nezinyanga.

Izinzuzo zesikhathi eside zihlanganisa ukuvikelwa ezinkingeni ezinzima njengamatshe ezinso, ukulahlekelwa amathambo, nezinkinga zenhliziyo. Ukusebenza kwezinso zakho kuvame ukuthuthuka, futhi amathambo akho angase aqine ngokuhamba kwesikhathi njengoba ukulawulwa kwe-calcium kujwayeleka.

Imiphumela emihle kakhulu yenzeka uma ugcina ukunakekelwa okuvamile kokulandela kanye nokuthatha izithasiselo eziqokiwe njengoba kuqondisiwe. Udokotela wakho uzoqapha inqubekela phambili yakho futhi alungise ukwelashwa ukuze aqinisekise ukuthi amazinga akho e-calcium ahlala ebangeni elinempilo.

Ukuthuthukiswa kwekhwalithi yempilo kuvame ukuba okumangalisayo, nabantu abaningi bechaza ukuzizwa sengathi bangabona futhi ngemva kweminyaka yezimpawu ezincane ababengazi ukuthi zihlobene nesimo sabo se-parathyroid.

Yiziphi izici eziyingozi zokudinga i-parathyroidectomy?

Ubudala nobulili badlala indima ebalulekile engozini yakho, nabesifazane abaneminyaka engaphezu kwengama-50 bechaphazeleka kakhulu. Abesifazane abase-postmenopausal banamazinga aphezulu kakhulu ezinkingeni ze-parathyroid, mhlawumbe ngenxa yezinguquko ze-hormonal ezithinta i-calcium metabolism.

Izimo ezithile zofuzo zingakhuphula ingozi yakho, okuhlanganisa izifo eziningi ze-endocrine neoplasia kanye ne-familial hypocalciuric hypercalcemia. Uma unamalungu omndeni anezinkinga ze-parathyroid, ungase ube nengozi eyengeziwe yokuzithuthukisa wena.

Ukuvezwa ngaphambilini emisebeni endaweni yakho yentamo, ikakhulukazi ngesikhathi sobuntwana, kungakhuphula ingozi yakho yokuthuthukisa imithombo ye-parathyroid kamuva empilweni. Lokhu kufaka phakathi ukwelashwa ngemisebe ngeminye iminyango yomdlavuza noma ngisho nezinqubo zokwelapha ezindala ezazisebenzisa imisebe.

Isifo sezinso sesikhathi eside singathinta amagciwane akho e-parathyroid, ngezinye izikhathi okuholela ku-hyperparathyroidism yesibili engase idinge ukuhlinzwa. Ukuntuleka okukhulu kwe-vitamin D eminyakeni eminingi kungahle kube nomthelela ezinkingeni ze-parathyroid.

Imithi ethile, ikakhulukazi i-lithium esetshenziselwa izifo zemizwa, ingathinta ukusebenza kwe-parathyroid ngokuhamba kwesikhathi. Abanye abantu abathatha i-lithium isikhathi eside bangase bathuthukise i-parathyroid adenomas edinga ukususwa ngokuhlinzwa.

Ziyini izinkinga ezingenzeka ze-parathyroidectomy?

Inkinga evame kakhulu amazinga aphansi e-calcium wesikhashana, ethinta cishe u-10-30% wabantu ngemuva kokuhlinzwa. Lokhu kuvame ukuxazululwa ezinsukwini kuya emavikini njengoba amagciwane akho asele e-parathyroid eqala ukusebenza ngokujwayelekile futhi.

Ushintsho lwezwi lungenzeka uma ukuhlinzwa kuthinta imizwa elawula izintambo zakho zezwi. Iningi lezinguquko zezwi zisesikhashana futhi zixazululwa emasontweni, kodwa izinguquko zezwi ezingapheli zenzeka ngaphansi kuka-1% wamacala uma zenziwa ngodokotela abahlinzayo abanolwazi.

Ukuphuma kwegazi noma ukutheleleka endaweni yokuhlinzwa kuyizinkinga ezingavamile kodwa ezingenzeka. Izimpawu zifaka ukuvuvukala okungavamile, ububomvu, ukufudumala, noma ukuphuma esiqeshini sakho, futhi lokhu kudinga ukunakekelwa kwezokwelapha ngokushesha.

I-hypoparathyroidism engapheli yinkinga engavamile kodwa engathi sína lapho kususwa inani elikhulu lezicubu ze-parathyroid, okukushiya ungenakukwazi ukugcina amazinga e-calcium ajwayelekile. Lokhu kudinga ukwengezwa kwe-calcium ne-vitamin D impilo yakho yonke.

Ngezinye izikhathi ezingavamile, abantu bangase bahlangabezane ne-hyperparathyroidism eqhubekayo noma ephindayo uma izicubu ezingavamile zingasuswanga ngokuphelele noma uma amagland amaningi athinteka. Lokhu kungase kudingeke ukuhlinzwa okwengeziwe noma ezinye izindlela zokwelapha.

Izinkinga ezingavamile kakhulu zihlanganisa ukulimala kwezakhiwo eziseduze njenge-esophagus noma imithambo emikhulu yegazi, kodwa lokhu kwenzeka ngaphansi kuka-1% wezinqubo uma zenziwa ngodokotela ohlinzayo abanekhono.

Kufanele ngibone nini udokotela ngemva kwe-parathyroidectomy?

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nezimpawu ezinzima ze-calcium ephansi, okuhlanganisa ama-spasms emisipha, ukuqaqamba okukhulu, noma ukuzwa ukuluma okusabalala ngaphandle komlomo wakho neminwe. Lezi zimpawu zingabonisa amazinga e-calcium aphansi ngokuyingozi.

Shayela umhlinzeki wakho wezempilo uma uqaphela izimpawu zokutheleleka ngase-incision yakho, njengokwanda kobubomvu, ukufudumala, ukuvuvukala, noma ukukhipha okufana ne-pus. Umkhuhlane ongaphezu kuka-101°F (38.3°C) ngemva kosuku lokuqala naye udinga ukunakwa ngokushesha.

Funani ukunakekelwa kwezempilo uma uthola ukuvuvukala okukhulu entanyeni noma unenkinga yokuphefumula noma ukugwinya. Nakuba kungavamile, lezi zimpawu zingabonisa ukopha noma ukuvuvukala okudinga ukwelashwa ngokushesha.

Hlela i-aphoyintimenti yokulandela uma izinguquko zezwi lakho ziqhubeka ngemva kwamasonto angu-2-3 noma uma uqaphela ukuthi izwi lakho liya liba buthaka kunokuba lithuthuke. Izinguquko eziningi zezwi zizixazulula zodwa, kodwa izinkinga eziqhubekayo zingase zidinge ukuhlolwa.

Xhumana nodokotela wakho uma uzizwa ukhathele kakhulu, udidekile, noma ucindezelekile emasontweni amaningana ngemva kokuhlinzwa, njengoba lokhu kungabonisa ukungalingani kwe-calcium okuqhubekayo okudinga ukulungiswa emithini yakho.

Imibuzo evame ukubuzwa mayelana ne-parathyroidectomy

Q.1 Ingabe i-parathyroidectomy ilungele amatshe ezinso?

Yebo, i-parathyroidectomy ingasebenza kahle kakhulu ekuvikeleni amatshe ezinso abangelwa amazinga aphezulu e-calcium. Lapho amaglandla akho e-parathyroid ekhiqiza amahomoni amaningi kakhulu, i-calcium eyeqile egazini lakho ihlungwa ngezinso zakho, okwandisa ingozi yakho yokwakha amatshe ezinso asekelwe ku-calcium.

Ngemuva kokuhlinzwa okuphumelelayo, amazinga akho e-calcium abuyela kokujwayelekile, okunciphisa kakhulu ingozi yakho yokuthuthukisa amatshe ezinso amasha. Abantu abaningi bathola ukuthi izinkinga zabo zamatshe ezinso zixazululeka ngokuphelele ngemva kwe-parathyroidectomy.

Q.2 Ingabe i-calcium ephansi ngemva kwe-parathyroidectomy ibangela izinkinga ezingapheli?

I-calcium ephansi ngemva kwe-parathyroidectomy ivame ukuba yesikhashana futhi ayibangeli izinkinga ezingapheli. Amaglandla akho e-parathyroid asele ngokuvamile adinga isikhathi sokuthi "avuke" futhi aqale ukusebenza kahle futhi ngemva kokucindezelwa yiglandla elisebenza ngokweqile.

Amazinga e-calcium abantu abaningi ajwayeleka phakathi nezinsuku kuya emavikini ngokwengezwa okufanele. I-calcium ephansi engapheli iyivelakancane futhi ivame ukwenzeka kuphela uma inyama eningi ye-parathyroid isusiwe ngesikhathi sokuhlinzwa.

Q.3 Ingabe i-parathyroidectomy ingathuthukisa ukuminyana kwamathambo?

Yebo, i-parathyroidectomy ivame ukuholela ekuthuthukisweni kokuminyana kwamathambo ngokuhamba kwesikhathi. Amazinga aphezulu e-parathyroid hormone abangela ukuthi i-calcium idonswe emathanjeni akho, okuholela ekulahlekelweni kwamathambo kanye nokwanda kwengozi yokuphuka.

Ngemva kokuhlinzwa okuphumelelayo, amathambo akho angaqala ukwakhiwa kabusha futhi aqiniswe njengoba ukulawulwa kwe-calcium kubuyela kokujwayelekile. Le nqubo ithatha isikhathi, futhi ungase ubone ukuthuthuka kancane kancane ekuskeneni kokuminyana kwamathambo ezinyangeni kuya eminyakeni ngemva kokuhlinzwa.

Q.4 Kuthatha isikhathi esingakanani ukuzizwa ujwayelekile ngemva kwe-parathyroidectomy?

Abantu abaningi baqala ukuzwa ukuthuthuka emasontweni ambalwa okuqala ngemva kokuhlinzwa, kodwa ukululama okuphelele kungathatha izinyanga eziningana. Amazinga amandla, imizwa, kanye nokucaca kwengqondo kuvame ukuthuthuka kancane kancane njengoba umzimba wakho uzivumela emazingeni e-calcium ajwayelekile.

Ezinye izimpawu ezinjengobuhlungu bamathambo noma ubuthakathaka bemisipha kungase kuthathe isikhathi eside ukuthi zinyamalale ngokuphelele. Wonke umuntu uphola ngesivinini sakhe, futhi udokotela wakho uzoqapha ukuqhubeka kwakho ngokuhlolwa kwegazi njalo nokuhlolwa.

Q.5 Ngizodinga yini ukuthatha izithasiselo ze-calcium unomphela ngemva kwe-parathyroidectomy?

Abantu abaningi abadingi ukuthatha izithasiselo ze-calcium unomphela ngemva kwe-parathyroidectomy. Ekuqaleni, cishe uzodinga izithasiselo ze-calcium ne-vitamin D ngenkathi amagland amanye e-parathyroid alungisa futhi aqale ukusebenza ngokujwayelekile futhi.

Udokotela wakho uzonciphisa kancane izithasiselo zakho njengoba amazinga akho e-calcium ezinzile. Abantu abaningi bangagcina beyeka ukuthatha izithasiselo ngokuphelele, nakuba abanye bengase badinge ukuqhubeka nokuthatha i-vitamin D noma amanani amancane e-calcium isikhathi eside.