Njengoba umdlavuza we -roid ngaphezulu utholakala, umphumela wukuthi ukuhlinza okuningi kwe -roid-okubizwa ngokuthi i- thyroidectomies- kwenziwa. Nakuba izinga lokucindezeleka ngemuva kokuhlinzwa kwe-thyroid kubonakala sengathi lincane, isifundo sitholile ukuthi amanani angase aphakeme kakhulu kunalokho abike ngaphambilini. Ucwaningo lubuye lubonise ukuthi amaqembu amaningana asengozini enkulu yokucindezeleka ngonyaka ngemuva kokuhlinzwa okwelashwa.
Kuze kube manje, iningi lezifundo ezibhekene nezinkinga ngemuva kokuhlinzwa okwelashwa zenziwa ezibhedlela ezithile noma izikhungo zezokwelapha, eziningi zazo ezenza umthamo omkhulu wezokwelapha. Abahlinzeki abahlinzayo abaphezulu kanye nezikhungo zokuhlinza ezenza izinombolo eziningi ze-thyroidectomi ngonyaka ziye zaboniswa ukuthi zinezinga eliphansi kakhulu lokucindezeleka.
Ucwaningo lwama-multi-center lwango-2017 lubheke kokubili izigulane eziphezulu zevolumu nezindleko eziphansi, izibhedlela nezikhungo zokuhlinza. Imiphumela ebikwe kuyi- Journal of Clinical Endocrinology ne-Metabolism , yabheka iziguli ezingaba ngu-28 000 ezazihlinzekwa ngegciwane ngenxa yomdlavuza wegciwane ohlukile noma we-medullary, ohlolwa iminyaka engama-13.
Ukuthola Okuseshweni
Abacwaningi bathola:
- Isiguli seziguli ezingu-1,820 (6.5%) sathuthukisa izinkinga ezihlukahlukene emva kokusebenza, kuhlanganise nomkhuhlane, ukutheleleka, i-hematoma, imicimbi ye-cardiopulmonary, nezenzakalo ze-thromboembolic (ama-blood clots)
- Ingqikithi yezingu-3,427 (12,3%) yakha izinkinga ezithile zokuhlinzeka nge-thyroid ezihlanganisa i-hypoparathyroidism / hypocalcemia (amazinga aphansi e-calcium ngenxa yokulimala kwezingqungquthela eziphathekayo), nokukhubazeka noma ukulimaza emithonjeni ye-laryngeal kanye nezintambo zomculo
Izinga lokuhlukunyezwa kusuka ekuhlinzekeni kwegciwane laliphakeme kakhulu emaqenjini amathathu:
- Iziguli ezineminyaka engaphezu kwengu-65, ezaziphindwe kabili ukubhekana nezinkinga kunabangaphansi kweminyaka engama-65 (Ingqikithi yamaphesenti ayishumi kweziguli asebekhulile zenze izinkinga ezijwayelekile futhi amaphesenti angu-19 anenkinga ethile ye -roid. Kwalabo abangaphansi kweminyaka engu-65, amazinga ayengama-3 amaphesenti namaphesenti ayisithupha, ngokulandelana)
- Iziguli ezazinezinye izimo zezempilo, ezibizwa ngokuthi ama-comorbidities
- Iziguli ezinomdlavuza we-thyroid ophakeme kakhulu, obenezinga eliphezulu kakhulu lezinkinga ezingamaphesenti angu-23
Ngokusho komlobi ocwaningo oluthile, uMaria Papaleontiou, uMdokotela waseMichigan Medicine:
Amaphesenti angu-12 eziguli ayenenkinga ethile yokuhlinzeka nge-thyroid ngokuqondene. Iningi lazo odokotela abahlinzayo licaphuna isilinganiso samaphesenti angu-1 kuya kwangu-3. Lokhu ku-quadruple lokho esikucabangayo. I-thyroidectomy ibhekwa njengokusebenza okuphephile ngokujwayelekile, kodwa abanye abantu basengozini kakhulu futhi badinga ukunakekelwa okuningiliziwe ekunakekelweni kwangaphambili nangemva kokusebenza.
Lokho Kusho Ukuphi Iziguli?
Umlobi omkhulu wokufunda uMegan Haymart, MD weMichigan Medicine wathi:
Uma sisebenzelana neziguli ukuze siphathe umdlavuza wegciwane, njalo sihlanganisa izinzuzo nezingozi. Lolu cwaningo lubonisa ukuthi kunezinkinga eziningi kusuka ekuhlinzekeni komdlavuza wegciwane kunalindelekile. Iphakamisa ithuba lokufundisa kokubili iziguli nabahlinzeki ukunciphisa izinkinga nokuthuthukisa imiphumela.
Lolu cwaningo lunezimpendulo eziningana ezigulini kuze kube ngamathuba okunciphisa izinkinga.
- Uma ungena kwelinye lamacembu amathathu-engaphezu kuka-65, nezinye izimo zezempilo, noma umdlavuza ophakeme-kufanele ucabange ukufuna nokuhlinzwa lapho kunesidingo esikhulu sokuhlinza imithwalo yegciwane, kanye nodokotela ohlinzayo onolwazi ekuhlinzekeni kwe-thyroid. (Qaphela ukuthi iningi lezinhlinzeko ze-thyroid e-US lenziwa ngamaphayona aphansi.)
- Qinisekisa ukuxoxa ngezibonakaliso nezingozi ze-hypoparathyroidism ne-hypocalcemia nodokotela wakho ohlinzayo, futhi uqaphele izimpawu emva kokuhlinzwa.
- Xoxa ngesidingo sokuhlinzwa nodokotela wakho. NgokukaDkt. Haymart, "Izingxoxo mayelana nokuhlinzwa okunomthelela kulabo abanezifo ezinobungozi obuphansi zingase zifanele. Ngisho nasezigulini ezinobungozi obuphansi, ingozi yezwi lokukhubazeka ukuqhubeka nokukhubazeka isamaphesenti amabili futhi ingozi ye-hypoparathyroidism ingamaphesenti angu-8. Lokhu kuphakeme kunalokho esingathanda ukukubona. Zikhona yini izinketho zokwenza ukuhlinzekwa okuncane kwalezi ziguli? Uma izinzuzo zokulawulwa komdlavuza zifana kodwa izingozi zenkinga yesikhathi eside zizoba ngaphansi, kudingeka sinikeze iziguli ngalolu khetho. "
Izwi elivela
Ngokusho kwe-Columbia-Presbyterian Hospital yaseNew York, esinye sezikhungo ezihlinzekwa ukuhlinzeka nge -roid, esinye isazi sokuhlinza esaziwayo-esisodwa esingase sibe nemiphumela ephansi yokucindezeleka-ngokuhlinzekwa okungaphezu kuka-1 000 kwe-thyroid kanye / noma yokuhlinzwa noma umsebenzi wakhe.
Ngokusho kwe-American Thyroid Association:
Ngokuvamile, ukuhlinzeka nge-thyroid kwenziwa kahle ngudokotela ohlinzayo oye waqeqeshwa ngokukhethekile futhi owenza ukuhlinzeka nge -roid njalo. Izinga lokuhlukumezeka kwemisebenzi ye-thyroid liphansi uma umsebenzi owenziwa ngudokotela ohlinzayo owenza umsebenzi omkhulu we-thyroid unyaka ngamunye. Iziguli kufanele zicele udokotela wabo ozofika lapho ezoba khona umsebenzi we -roid noma lapho ezothumela ilungu lomndeni.
Ukuze uthole udokotela ohlinzayo we-thyroid high-volume, ungase ufune ukufunda ngendlela yokuthola udokotela ohlinzayo wegciwane eliphezulu .
> Imithombo:
> I-American Thyroid Association. "Ukuhlinzwa kwe-thyroid." Online: http://www.thyroid.org/thyroid-surgery/
> Papaleontiou M, Hughes DT, Guo C, Banerjee M, Haymart MR. UkuHlola okuHlanganisiwe kweziNdaba zeziNkinga ezilandela ukwelashwa kweCarry Thyroid. I Journal of Clinical Endocrinology & Metabolism, 2017; I-DOI: 10.1210 / jc.2017-00255 I-intanethi: https://academic.oup.com/jcem/article-abstract/doi/10.1210/jc.2017-00255/3778176/Imibandela-Ingqikithi-Isidingo-I- = okugcwele