Kuchotsa Matenda a Parathyroid

Zamkati

• Kodi kuchotsa khungu kwa parathyroid ndi chiyani?
• Chifukwa chiyani ndikufunika kuchotsedwa kwa gland?
• Zizindikiro za hypercalcemia
• Mitundu ya maopareshoni amtundu wa parathyroid
• Parathyroidectomy yotsogozedwa ndi wailesi
• Parathyroidectomy yothandizidwa ndi makanema (yotchedwanso endoscopic parathyroidectomy)
• Kukonzekera opaleshoni
• Kuopsa kwa opaleshoni
• Pambuyo pa opaleshoni

Kodi kuchotsa khungu kwa parathyroid ndi chiyani?

Zilonda za parathyroid zimakhala ndi zidutswa zinayi zazing'ono komanso zozungulira. Amamangiriridwa kumbuyo kwa chithokomiro m'khosi mwako. Matendawa ndi gawo la dongosolo la endocrine. Makina anu endocrine amatulutsa ndikuwongolera mahomoni omwe amakhudza kukula kwanu, kukula, magwiridwe antchito amthupi, komanso momwe mumamverera.

Matenda a parathyroid amayang'anira kuchuluka kwa calcium m'magazi anu. Mulingo wa calcium ukakhala wochepa m'magazi anu, tiziwalo timeneti timatulutsa timadzi ta parathyroid (PTH), timene timatenga calcium m'mafupa anu.

Kuchotsa kwamatenda amtundu wa parathyroid kumatanthauza mtundu wa opareshoni yochitidwa kuti ichotse gland izi. Amadziwikanso kuti parathyroidectomy. Opaleshoniyi itha kugwiritsidwa ntchito ngati magazi anu ali ndi calcium yambiri. Izi ndizodziwika kuti hypercalcemia.

Chifukwa chiyani ndikufunika kuchotsedwa kwa gland?

Hypercalcemia imachitika kashiamu wamagazi amakhala okwera modabwitsa. Chifukwa chodziwika kwambiri cha hypercalcemia ndikuchulukitsa kwa PTH m'modzi kapena angapo am'matumbo. Ichi ndi mtundu wa hyperparathyroidism wotchedwa primary hyperparathyroidism. Pulayimale hyperparathyroidism imafala kwambiri pakati pa akazi kuposa amuna. Anthu ambiri omwe amapezeka kuti ali ndi hyperthyroidism ali ndi zaka zopitilira 45. Zaka zapakati pazomwe amapezeka ndi zaka 65.

Mwinanso mungafunike kuchotsa khungu la parathyroid ngati muli:

• zotupa zotchedwa adenomas, zomwe nthawi zambiri zimakhala zowawa ndipo sizimasanduka khansa
• zotupa khansa pafupi kapena pafupi ndi glands
• parathyroid hyperplasia, momwemo kuti matumbo onse anayi amakula.

Magazi a calcium amatha kukwera ngakhale atakhala ndi vuto limodzi lokha. Ndi khungu limodzi lokha lophatikizana lomwe limagwira nawo pafupifupi 80 mpaka 85% ya milandu.

Zizindikiro za hypercalcemia

Zizindikiro zimakhala zosamveka bwino kumayambiriro kwa hypercalcemia. Pamene vutoli likupita, mutha kukhala ndi:

• kutopa
• kukhumudwa
• kupweteka kwa minofu
• kusowa chilakolako
• nseru
• kusanza
• ludzu lokwanira
• kukodza pafupipafupi
• kupweteka m'mimba
• kudzimbidwa
• kufooka kwa minofu
• chisokonezo
• impso miyala
• kuphwanya mafupa

Anthu omwe alibe zizindikiro amangofunikira kuwunika. Milandu yofatsa imatha kuyendetsedwa ndi zamankhwala. Komabe, ngati hypercalcemia ndiyomwe imayambitsa matenda a hyperparathyroidism, maopareshoni okhawo omwe amachotsa gland (s) omwe angakhudzidwe ndi omwe amachiza.

Zotsatira zoyipa kwambiri za hypercalcemia ndi izi:

• impso kulephera
• matenda oopsa
• chantho
• matenda amitsempha yamagazi
• mtima wokulitsidwa
• atherosclerosis (mitsempha yokhala ndi mafuta owerengeka omwe amakhala ouma ndikuchita bwino)

Izi mwina chifukwa cha kuchuluka kwa calcium m'mitsempha ndi ma valve amtima.

Mitundu ya maopareshoni amtundu wa parathyroid

Pali njira zosiyanasiyana zopezera ndikuchotsa matenda amtundu wa parathyroid.

Mwachizolowezi, dokotala wanu amafufuza ma gland onse anayi kuti awone omwe ali ndi matenda ndi omwe ayenera kuchotsedwa. Izi zimatchedwa kufufuzira khosi kwamayiko awiri. Dokotala wanu amapanga cheke pakati kuti muchepetse gawo la khosi lanu. Nthawi zina, dokotalayo amachotsa gland zonsezi mbali imodzi.

Ngati muli ndi kujambula komwe kumawonetsa gland imodzi yokha yamankhwala musanachite opareshoni, mutha kukhala ndi parathyroidectomy yocheperako yocheperako pang'ono (yochepera inchi imodzi m'litali). Zitsanzo za maluso omwe angagwiritsidwe ntchito pochita opareshoni yamtunduwu, yomwe ingafune zina zazing'onoting'ono, monga:

Parathyroidectomy yotsogozedwa ndi wailesi

Pochita parathyroidectomy yotsogozedwa ndi wailesi, dotolo wanu amagwiritsa ntchito zinthu zowulutsa ma radio zomwe zilonda zonse zinayi zamatenda zimayamwa. Kafukufuku wapadera amatha kupeza komwe kunachokera cheza chilichonse kuchokera ku gland iliyonse kuti athe kuyang'ana komwe kumapezeka matendawa. Ngati m'modzi kapena awiri mbali imodzimodzi ali ndi matenda, dotolo wanu amangofunika kupanga kamphindi kakang'ono kuti achotse matendawa.

Parathyroidectomy yothandizidwa ndi makanema (yotchedwanso endoscopic parathyroidectomy)

Pochita parathyroidectomy yothandizira makanema, dokotala wanu amagwiritsa ntchito kamera yaying'ono pa endoscope. Pogwiritsa ntchito njirayi, dokotalayo amapanga ziwalo ziwiri kapena zitatu zazing'onoting'ono za endoscope ndi zida zochitira opaleshoni m'mbali mwa khosi ndi gawo limodzi pamwamba pa chifuwa. Izi zimachepetsa mabala owoneka.

Parathyroidectomy yocheperako yocheperako imathandizira kuti achire mwachangu. Komabe, ngati sizotheka zonse zomwe zimadwala zimapezeka ndikuchotsedwa, kuchuluka kwa calcium kumapitilira, ndipo pangafunikire kuchitidwanso opaleshoni yachiwiri.

Anthu omwe ali ndi parathyroid hyperplasia (yomwe imakhudza ma gland onse anayi) nthawi zambiri amachotsedwa glands atatu ndi theka. Dokotalayo amasiya minofu yotsalayo kuti iwongolere kuchuluka kwa calcium m'magazi. Komabe, nthawi zina minofu yamatumbo yomwe imafunikira kuti ikhalebe mthupi imachotsedwa m'khosi ndi kuyikika pamalo ofikirika, monga nkono, kuti ingafunike kuchotsedwa pambuyo pake.

Kukonzekera opaleshoni

Muyenera kusiya kumwa mankhwala omwe amalepheretsa magazi kuti agwire pafupifupi sabata imodzi asanachite opareshoni. Izi zikuphatikiza:

• aspirin
• clopogwire
• ibuprofen (Advil)
• naproxen (Aleve)
• warfarin

Anesthesiologist wanu akuwunikirani za mbiri yanu yamankhwala ndikudziwitsani mtundu wamankhwala ogwiritsira ntchito. Muyeneranso kusala kudya musanachite opaleshoni.

Kuopsa kwa opaleshoni

Kuopsa kwa opaleshoniyi kumaphatikizapo zoopsa zomwe zimakhudzidwa ndi opaleshoni ina iliyonse. Choyamba, opaleshoni yokhayokha imatha kubweretsa mavuto kupuma komanso kusokonezeka ndi zina kapena zovuta zina ndi mankhwala omwe agwiritsidwa ntchito. Monga maopareshoni ena, magazi ndi matenda ndizothekanso.

Zowopsa za opaleshoniyi zimaphatikizapo kuvulala kwa chithokomiro komanso mitsempha m'khosi yomwe imayendetsa zingwe zamawu. Nthawi zina, mutha kukhala ndi vuto la kupuma. Izi zimatha kutha milungu ingapo kapena miyezi ingapo opaleshoni.

Magazi a calcium m'magazi nthawi zambiri amatsika pambuyo pa opaleshoniyi. Magazi a calcium akakhala otsika kwambiri, amatchedwa hypocalcemia. Izi zikachitika, mumatha kumva dzanzi kapena kumva kulasalasa m'manja, zala zakumapazi, kapena milomo. Izi zimapewa kapena kuthandizidwa mosavuta ndi calcium zowonjezera, ndipo vutoli limayankha mwachangu zowonjezera. Nthawi zambiri sizokhazikika.

Muthanso kuganizira kufikira dokotala wodziwa bwino ntchito kuti muchepetse ziwopsezo. Madokotala ochita opaleshoni ya parathyroidectomies osachepera 50 pachaka amadziwika kuti ndi akatswiri. Katswiri waluso atha kukhala ndi mavuto otsika kwambiri pakuchita opaleshoni. Komabe, ndikofunikira kukumbukira kuti palibe opaleshoni yomwe ingatsimikizidwe kuti ilibe zoopsa zilizonse.

Pambuyo pa opaleshoni

Mutha kubwerera kunyumba tsiku lomwelo la opareshoni kapena kugona mchipatala. Nthawi zambiri pamakhala zowawa kapena zovuta pambuyo pochita opareshoni, monga zilonda zapakhosi. Anthu ambiri amatha kubwerera kumagwiridwe awo asanathe sabata kapena awiri, koma zimatha kusiyanasiyana pamunthu ndi munthu.

Monga zodzitetezera, calcium yamagazi anu ndi milingo ya PTH idzayang'aniridwa kwa miyezi isanu ndi umodzi mutachitidwa opaleshoni. Mutha kutenga zowonjezera kwa chaka chimodzi mutachitidwa opaleshoni kuti mumangenso mafupa omwe abedwa ndi calcium.