Ikhetho lokuba utyando lwe-thyroid , kwaye ubuyele ekhaya-endaweni yesibhedlele ukuhlala-luye lwafunyanwa kwizifundo ezahlukeneyo, kwaye limela utshintsho lwagqirha be-thyroid abaye baxubusha ngexesha elide iingenelo zentsholongwane kunye nokuhlinzwa okwangaphandle. Makhe sijonge kwiziphumo eziphikisanayo neziphikisanayo.
Isigulana nomonde
Ngokwesiko, utyando lokususa i-thyroid, ebizwa ngokuba yi- thyroidectomy , libandakanye ukuhlala ubusuku-ubuncinci - kwaye ngokuphindaphindiweyo ukuya kwiintsuku ezimbini ukuya kwezihlanu zokubhedlelelwa esibhedlele.
Utyando lwabagulayo lusemgangathweni olufanelekileyo, nangona iimeko ezinengxaki ziqhubekile emva kokuhlinzwa okwenziwa yi-thyroid.
Ukuhlala ixesha elide ukujonga ukunyangwa emva kokugqithwa kwexesha kudla ngokuchaneka ngokuxhalabisa malunga neengxaki zokuhamba emva kokuhlinzwa, i-thyroid isondele kwi-nerryal nererve and airway, ngaphezu kwengozi yokuphuma kwamanzi.
Kodwa abanye oogqirha bancomela ukuba utyando lwe-thyroid luqhutyelwa njengenkqubo yokuphulukana nesifo, ingakumbi ukuba iiprotoksi zikhona ukwenzela ukuba zinike i-calcium kunye ne-Vitamin D yokuxhaswa emva kokuhlinzwa ukwenzela ukunciphisa umngcipheko we-hypocalcemia.
Izifundo eziphikisanayo
Ngo-1998, inqaku kwi- Journal of Clinical Endocrinology kunye neMetabolism ( JCEM) nguDkt. Orlo Clark yahlalutya ingozi kwizigulana ezaziye zenziwa ngophenyo lwe-thyroid. Uhlalutyo lucebise ukuba amaninzi angama-94 abulawe ngamachiza kwi-100,000 imisebenzi ye-thyroid ayakukhuselwa ukuba izigulane zifakwe esibhedlele ngobusuku bodwa kunokukhutshwa ngaphandle kweeyure ezintandathu.
Kodwa ngomnyaka ofanayo, enye inqaku e- JCEM , elipapashwe ngumgqirha we-thyroid ogqithiseleyo uPaul LoGerfo, MD, wabala le mabango. ULoGerfo wabika ukuba wahamba ekwenzeni i-thyroidectomi ye-10 yokugula ngo-1992 ukuya kuma-80 ngo-1996, kungekho miphumo emibi. "Kulo suku, andizange ndibe nesigulana nasiphi na isigulane esasikhululwe kwisilathiso sokugula," uLoGerfo wabhala.
Iziphumo zophando olwenziwe kwintlanganiso yonyaka ka-2006 we-American Academy ye-Otolaryngology, nangona kunjalo, wacetyiswa ukuba utyando lwe-thyroid lukhuselekile kwaye lusebenza kakuhle kwizigulane ezininzi, kwaye lunokuba lukhethwayo kwizibhedlele zesigulane esinezonyango. Oku kubonakala kukuqinisekisa ukugqithwa kukaDkt. LoGerfo.
Uvavanyo olungabonakaliyo luhlolisise izigulane ezithatha i-thyroidectomy kwizibhedlele ezimbini zaseGeorgia phakathi kukaDisemba 2004 no-Oktobha 2005. Izigulane zahlula ngamaqela amabini. Abo bavunyelwe kwaye bahlala ubuncinci ubusuku bonke babecingwa njengezigulane. Izigulane zichazwe njengalezo zikhutshwe ngqo kwiyunithi yokubuyisela.
Abaphandi bajonga izinto ezininzi, kubandakanya ubude bokuhlinzwa, ixesha lokukhupha kunye neentlawulo ezipheleleyo ezibanjelwe esibhedlele. Ngethuba lokufunda, izigulane ezingama-91 zathotywayo. Uninzi lwabafazi kwaye babephakathi kweminyaka engama-45 ubudala. Amashumi angamashumi amahlanu anesibini aphathwa njengabangaphandle, kunye no-39 banikezelwa ngononophelo lwangaphantsi (26 bahlala ubusuku bonke, ngelixa-13 bavunyelwa malunga neentsuku ezi-3).
Kungenxa yokuba inkxalabo enkulu elandela i-thyroidectomy okanye i-thyroidectomy iyonke i-hypocalcemia, ukulahla okuyingozi kwinqanaba le-calcium, zonke izigulane zanikwa i-calcium supplement.
Amanqanaba e-calcium abuye alandelelwe kwiiveki ezintathu emva kokuhlinzwa.
Iintlobo zeenkqubo zonyango ezichazwe ngabaphandi ziquka:
- Iindleko eziphantsi kwezo zibini zigulane kunye nabatshutshisi.
- Ukuphuluka kwesineke kwenzeka ekhaya, kude ne-nosocomial enokwenzeka (izifo ezithintela esibhedlele).
- I-calalum ye-Oral supplements iyasebenza ekukhuseleni ukulahleka kwe-calcium emva kokuhlinzwa.
Abaphandi basacetyisa ukuba utyando lwe-thyroid lwezigulane kwezinye izigulane, kuquka:
- Izigulane ezinobuthakathaka bonyango ngenxa yobuthathaka okanye ubudala.
- Izigulane ezineemeko ezikhoyo okanye izifo zegazi.
- Izigulane eziza kubakho ezinye iinkqubo ngokukhawuleza ezifuna ukungena.
- Izigulane ezikhetha ngokukhethekileyo ukungeniswa.
- Izigulane ezinezilonda ze-thyroid ezinkulu.
Uphando olwenziwa ngo-2009 olupapashwe kwiiNkcazo eziNje kwi-Otolaryngologic Head kunye neNeck Surgery lenza uhlalutyo lweemvavanyo ezili-11 ezingafaniyo kwaye alufumani nomehluko kwiingxaki ezinkulu phakathi kwezigulane ezingazange zifune ukutshatyalaliswa emva kokuhlinzwa, nje kuphela ukuba izigulane zanikwa i-calcium kwaye I-vitamin D yokuxhaswa emva kokuhlinzwa ukunciphisa umngcipheko we-hypocalcemia.
Olunye uphando, olushicilelwe ngo-2015 kwiphepha leMpilo , libheke iziphumo ze-1,311 ze-thyroid zogqirha, ezi-1,026 (malunga ne-78%) ezazisisiphene. Abaphandi bafumanisa ukuba:
- Izinga lokufumana iziphumo zabangaphandle .9% kunye nezigulane ziye zavunywa ngokuphindaphindiweyo (3.5%).
- Kwakungekho nantlukwano kwizinga leengxaki.
Abaphengululi baphetha ngelithi ukuhlinzwa ngonyango kuphephile kwizigulane ezikhethiweyo.
Olunye uphando olushicilelwe ngo-2015 kwi- Danish Medical Journal aluvumelani, nangona kunjalo. Abaphandi bajonga iqondo lokuphuma kwe-thyroidectomy kwi-oproentradio yegciwane, kunye nokufumanisa ukuba ukuphuma kwegazi kwenzeka kwiiyure ezingama-6 zonyango kwiimeko ezifundwayo-zonke izigulane ze-thyroidectomy eDenmark - kwaye kuma-25% amacala phakathi kwama-6 Iiyure ezingama-24 emva kokuhlinzwa kunye nama-13% amatyala emva kweeyure ezingama-24.
Abaphengululi baphetha ukuba utyando oluqhelekileyo lwe-thyroid alukwazi ukucetyiswa, kwaye izigulane kufuneka zigcinwe ubuncinane emva kweeyure ezingama-6 emva kokuhlinzwa kwaye kufuneka zihlale kufuphi nesibhedlele ubuncinane kwezi zilandelayo iiyure ezingama-24.
Ziziphi Iziguli Ezifanele Ziyenze?
Indlela oqhubeka ngayo kufuneka kuxhomekeke kwimeko ethile - uhlobo oluthile kunye nobume bokuhlinzwa, i-age yakho, impilo yakho yonke, nezinye izinto ezinobungozi, ukhetho, kunye nobuchule be-thyroid yakho. Kodwa ukuba unokwenziwa kobuchopho be-thyroid, kwaye usebenza kunye nodokotela ohlinzayo we-thyroid ocebisa ukuba unyango lonyango, lungaba lukhetho olukhuselekileyo nolululo.
> Imithombo:
> Clark, Orlo H., MD, kunye. al. "Ukugqithisa kwe-Thyroid ye-Abbulatory: engadingekile kwaye eyingozi" Umbhalo we-Clinical Endocrinology & Metabolism Vol. 83, No. 4 1100-1103, 1998.
> Hopkins B, Steward D. "Utyando lwe-thyroid oluphulukisayo kunye nentuthuko eyenza ukuba kwenzeke." I- Curr Opin i-Otolaryngol Intloko Yokukhanda . 2009 Ngo-Apr; 17 (2): 95-9. PMID: 19373959
> LoGerfo, uPaul, MD, "Utyando lwe-Thyroid," Journal of Clinical Endocrinology & Metabolism, Vol. 83, No. 4 1097-1100, 1998
> Segel JM, et. al. "Utyando lwe-thyroid oludlulileyo: Ukhuseleko lweprotocol elungiselelwe kwizigulane ezingaphezu kwe-1 000." Ukuhlinzwa . 2015 Oct 12. > pii >: S0039-6060 (15) 00626-1. i-doi: 10.1016 / j.surg.2015.08.007. [Epub ngaphambi kokuprinta] PMID: 26471720
> Sørensen KR, i-Klug TE. "Ukuhlinzwa okwenziwe ngexesha eliqhelekileyo kungasinakunyuswa." UDan Med J. 2015 Feb; 62 (2). > pii >: A5016. PMID: 25634504
> Terris, David J., MD kunye. al. "Ukwelashwa kwe-Thyroid ekhuselekileyo ikhuselekile kwaye ifaneleka," Ukunikezelwa kwintlanganiso ye-110 yonyaka kunye ne-OTO EXPO ye-American Academy ye-Otolaryngology kunye neNeck Surgery Foundation , ngo-Septemba 17-20, 2006, eToronto, eCanada