Ukukhethwa kokuhlinzwa kwe -roid , nokubuyela ekhaya - esikhundleni sokuhlala esibhedlela - kuye kwaba yizinhlobonhlobo zezifundo, futhi kubonisa ukuguqulwa kwabahlinzayo begciwane abaye baxoxisana isikhathi eside ngezinzuzo zeziguli ezihlinzekwa iziguli. Ake sibheke imiphumela ephikisanayo nephikisanayo.
Isiguli esiphathelene nokugula
Ngokwesiko, ukuhlinzwa ukukhipha i-thyroid, eyaziwa ngokuthi i- thyroidectomy , kuhilelekile ukuhlala ubusuku - okungenani - kanti njalo ezinsukwini ezimbili ukuya kwezingu-5 zokweliswa esibhedlela.
Lokhu kuhlinzekwa kwezingane eziphuthumayo kusezingeni elilinganiselwe, naphezu kokuthi izinkinga ziyingozi kakhulu emva kokuhlinzwa kwe-thyroid.
Ukuhlala isikhathi eside kokubonwa ngemuva kokuhlinzwa sekuvame ukulungiswa ngokukhathazeka mayelana nezinkinga zokuhamba ngemuva kokuhlinzwa, i-thyroid isondelene ne-laryngeal nererve and airway, ngaphezu kwengozi yokuphuma kwegazi.
Kodwa odokotela abathile batusa ukuthi ukuhlinzekwa kwe-thyroid ngokuvamile kwenziwa njengendlela yokuphulukisa iziguli, ikakhulukazi uma izivumelwano zisekhona ukuze zihlinzekwe ngokuqhubekayo nge-calcium kanye ne-Vitamin D ukuxhaswa ngemuva kokuhlinzwa ukuze kuncishiswe ingozi ye-hypocalcemia.
Izifundo eziphikisanayo
Ngo-1998, isihloko se- Journal of Clinical Endocrinology and Metabolism ( JCEM) sikaDkt. Orlo Clark sicubungula izingozi zabagulayo abaye bahlinzwa ngokuhlinzwa kwe-thyroid. Ukuhlaziywa kwaphakamisa ukuthi ukufa okungaphezulu kwamaphesenti angu-94 okuhlobene nokudla kwegazi okwenziwa yi-100,000 ye-thyroid kungavinjelwa uma iziguli ziboshwa esibhedlela ebusuku kodwa zingakhululwa amahora ayisithupha.
Kodwa ngonyaka ofanayo, esinye isihloko esiseJCEM , esanyatheliswa ngudokotela ohlinzayo wegciwane uPaul LoGerfo, MD, wafakazela lokho. ULoGerfo wabika ukuthi wahamba ekwenzeni i-thyroidectomies engu-10 engaphili kahle ngo-1992 ukuze enze 80 ngo-1996, kungekho miphumela emibi. "Kulolu suku, angizange ngimemezele noma yisiphi isineke esasikhululwe esibhedlela," kusho uLoGerfo.
Imiphumela yocwaningo olwethulwa emhlanganweni waminyaka yonke ka-2006 we-American Academy of Otolaryngology, kodwa-ke, yaphakamisa ukuthi ukwelashwa okwelashwa ngaphandle kwesifo kuphephile futhi kuphumelele ezigulini eziningi, futhi kungase kube kuhle ukuhlala esibhedlela sesiguli. Lokhu kubonakala kuqinisekisa ukucatshangwa kukaDkt. LoGerfo.
Ucwaningo olungazange luhlolwe lwahlola iziguli ezithatha i-thyroidectomy ezibhedlela ezimbili zaseGeorgia phakathi kukaDisemba 2004 no-Okthoba 2005. Iziguli zahlukaniswa ngamaqembu amabili. Labo abavunyelwe futhi bahlala okungenani ngobusuku bonke babebhekwa njengeziguli. Izidakamizwa zachazwa njengalezo ezikhishwe ngokuqondile e-unit recovery.
Abacwaningi babheka izici eziningana, kuhlanganise nobude bokuhlinzwa, isikhathi sokukhipha kanye namacala okukhokhwa esibhedlela. Phakathi nesikhathi sokutadisha, iziguli ezingu-91 zathola ukuhlinzwa kwe-thyroid. Abaningi babebesifazane futhi babephakathi kweminyaka engu-45 ubudala. Amashumi angamashumi ayisihlanu nambili baphathwa njengezifo eziphuthumayo, kanti abangu-39 banikezwa ukunakekelwa kwengane (26 bahlala ubusuku bonke, kanti abangu-13 bavunyelwa cishe izinsuku ezingu-3).
Ngenxa yokuthi ukukhathazeka okukhulu okulandela i-thyroidectomy engenanxenye noma eyingqikithi yile-hypocalcemia, ukwehla okungaba yingozi kumazinga e-calcium, zonke iziguli zanikezwa nge-calcium supplements.
Amazinga e-calcium nawo aqaphelwa amasonto amathathu emva kokuhlinzwa.
Izinzuzo zezinqubo zokwelashwa ezikhulunywe ngabacwaningi zihlanganisa:
- Izindleko eziphansi kokubili iziguli kanye nabashuwalense.
- Ukuphuluka kwesineke kwenzeka ekhaya, kude nosokomial okungenzeka (izifo ezitholwa esibhedlela).
- I-oral calcium supplements iphumelela ekuvimbeleni ukulahlekelwa kwe-calcium ngemuva kokuhlinzwa.
Abacwaningi basakhuthaza ukuhlinzeka ngesifo sofuba kwezinye iziguli, kuhlanganise:
- Iziguli ezinobuthakathaka bezokwelapha ngenxa yobuthakathaka noma ubudala.
- Iziguli ezinezimo ezikhona noma izifo zegazi.
- Iziguli ezizobhekana nezinye izinqubo ngesikhathi esifanayo zidinga ukungena.
- Iziguli ezikhetha ngokukhethekile ukuvunyelwa.
- Iziguli ezinezilonda ezinkulu zegciwane.
Ucwaningo lwango-2009 lwanyatheliswa ku- Opinions yamanje ku-Otolaryngologic Head and Neck Surgery lwenza ukuhlaziywa kwemiphumela engu-11 ehlukahlukene futhi akutholanga umehluko ezinkingeni ezinkulu phakathi kweziguli ezingazange zidinge ukuhlinzwa ngemuva kokuba iziguli zinikezwe i-calcium njalo I-Vitamin D yokuxhaswa emva kokuhlinzwa ukunciphisa ingozi ye-hypocalcemia.
Esinye isifundo, eshicilelwe ngo-2015 emaphepheni Ukuhlinzwa , sabheka imiphumela yezinhlinzeko ze-thyroid eziyi-1,311, okuyi-1,026 (cishe i-78%) eyayisiphilisi. Abacwaningi bathola ukuthi:
- Izindleko zokutholwa kwabagulayo zazingu -9% kanti iziguli zagonywa kaningi kakhulu (3.5%).
- Kwakungekho ukungezwani emazingeni okuncintisana.
Abacwaningi baphetha ngokuthi ukwelashwa okwelashwa ngaphandle kwesifo kuphephile kwiziguli ezikhethiwe kahle.
Olunye ucwaningo olushicilelwe ngo-2015 kuDanish Medical Journal aluvumelani, kodwa. Laba baphandi babheka izinga lokuphuma kwe-thyroidectomy ekuhlinzekeni kwegciwane lesandulela ngculazi, futhi bathola ukuthi lokhu kuphuma kwegazi kwenzeka ngaphakathi kwamahora angu-6 okuhlinzwa, ngamaphesenti angu-63 amacala abawafundela - zonke iziguli ze-thyroidectomy eDenmark - futhi kuma-25% amacala aphakathi kuka-6 no-6 Amahora angu-24 ngemuva kokuhlinzwa futhi amacala angu-13% ngemva kwamahora angu-24.
Abacwaningi baphetha ngokuthi ukuhlinzeka ngokuhlinzwa okwelashwa okuvamile okungekho emphakathini akunakunconywa, futhi iziguli kufanele zigcinwe okungenani amahora angu-6 emva kokuhlinzwa futhi kufanele zihlale eduze nesibhedlela okungenani amahora angu-24 alandelayo.
Yini Okufanele Iziguli Zenze?
Indlela oqhubeka ngayo kufanele ixhomeke esimeni sakho - uhlobo lwakho oluthile kanye nemvelo yokuhlinzwa kwe-thyroid, iminyaka yakho, impilo yakho yonke, ezinye izinto eziyingozi, izintandokazi, kanye nobuchwepheshe besigqila sakho sobuchopho. Kodwa uma une-chirurgical procedure yokuhlinzwa, futhi usebenza nomhlinzeki ohlinzayo we-thyroid okhuthaza ukuhlinzeka ngeziguli, kungase kube ukhetho oluphephile futhi olusebenzayo kuwe.
> Imithombo:
> Clark, Orlo H., MD, et. al. "Ukuhlinzwa Kwe-Thyroid Okumangalisayo: Akudingekile Futhi Kuyingozi" I-Journal of Clinical Endocrinology & Metabolism Vol. 83, No. 4 1100-1103, 1998.
> Hopkins B, Steward D. "Ukuhlinzwa okwelashwa okuphuthumayo kanye nentuthuko eyenza kwenzeke." Curr Opin Otolaryngol Head Neck Surg . 2009, 17 (2): 95-9. I-PMID: 19373959
> LoGerfo, uPaul, MD, "Ukuhlinzwa Okuhlinzekwa Ngokwelashwa Kwangaphandle," I-Journal of Clinical Endocrinology & Metabolism, Vol. 83, No. 4 1097-1100, 1998
> Segel JM, et. al. "Ukuhlinzwa okuhlinzekwa yi-thyroid: Ukuphepha kweprotocol elungele iziguli ezingaphezu kuka-1 000." Ukuhlinzwa . 2015 Oct 12. > pii >: S0039-6060 (15) 00626-1. doi: 10.1016 / j.surg.2015.08.007. [Epub ngaphambi kokuphrinta] PMID: 26471720
> Sørensen KR, i-Klug TE. "Ukuhlinzekwa kwe-thyroid okuphulukisiwe njalo akunakunconywa." UDan Med J. 2015 Feb; 62 (2). > pii >: A5016. I-PMID: 25634504
> Terris, David J., MD et. al. "Ukuhlinzeka ngeziguli ze-Thyroid kuyinto ephephile futhi efiselekayo," Isethulo eMhlanganweni Wonyaka Wonyaka we-110 no-OTO EXPO we-American Academy of Otolaryngology's Head and Neck Surgery Foundation , ngo-September 17-20, 2006, eToronto, eCanada