Njira yokhala opaleshoni ya chithokomiro , ndi kubwerera kwawo - mmalo mwa chipatala - yakhala ikuyendera maphunziro osiyanasiyana, ndipo ikuimira kusintha kwa madokotala opanga chithokomiro amene akhala akutsutsana kalekale phindu la opaleshoni yopita kuchipatala kapena opaleshoni. Tiyeni tiwone zotsatira zotsutsana ndi zotsutsana.
Wodwala ndi Wodwala
Kawirikawiri, opaleshoni yochotsa chithokomiro, yomwe imatchedwa thyroidectomy , yakhala ndikugona usiku wonse - nthawi zambiri - ndipo kawirikawiri masiku awiri mpaka asanu a chipatala china.
Kuchita opaleshoni imeneyi kumagwiritsabe ntchitobe, ngakhale kuti zovuta zimakhala zochepa pambuyo pa opaleshoni ya chithokomiro.
Kutalika kwa kafukufuku wam'tsogolo pambuyo pa opaleshoni kawirikawiri kumakhala kovomerezeka ndi nkhaŵa zokhudzana ndi zovuta zapambuyo pa opaleshoni, chithokomiro chili pafupi ndi mitsempha ya mchere ndi kuuluka, kuphatikizapo kuika magazi.
Koma madokotala ena amalimbikitsa kuti opaleshoni ya chithokomiro nthawi zonse imakhala ngati njira yochiritsira matenda, makamaka ngati ma protocol alipo kuti nthawi zonse apereke calcium ndi Vitamini D supplementation post-opaleshoni pofuna kuchepetsa chiopsezo cha hypocalcemia.
Maphunziro Otsutsana
Mu 1998, nkhani ya Journal of Clinical Endocrinology ndi Metabolism ( JCEM) ya Dr. Orlo Clark inafotokoza zoopsa kwa odwala omwe anachitidwa opaleshoni ya chithokomiro. Kafukufukuyu anawonetsa kuti pafupifupi 94 kufa kwa odwala matenda a chithokomiro pa 100,000 chithokomiro akhoza kutetezedwa ngati odwala ali m'chipatala usiku wonse m'malo momangokhala maola asanu ndi limodzi.
Koma chaka chomwecho, nkhani ina ku JCEM , yomwe inalembedwa ndi dokotala wa opaleshoni ya chithokomiro dzina lake Paul LoGerfo, LoGerfo adanena kuti adachokera kuchipatala chachitetezo cha m'kati mwa chaka cha 1992 kuti achite 80 mu 1996, opanda zotsatira zoipa. "Mpaka lero, sindinayambe kulandira odwala aliyense amene anamasulidwa kuchipatala," LoGerfo analemba.
Zotsatira za kafukufuku woperekedwa pamsonkhano wapachaka wa 2006 wa American Academy of Otolaryngology, komabe, adanena kuti opaleshoni ya chithandizo cha chithokomiro imakhala yotetezeka kwa odwala ambiri, ndipo ikhoza kukhala yabwino kwa chipatala chokhala ndi chipatala. Izi zikuwoneka kutsimikizira zomwe Dr. LoGerfo adanena.
Kafukufuku wosayendetsedwa anayezetsa odwala omwe ali ndi chithokomiro pazipatala ziwiri za Georgia pakati pa December 2004 ndi Oktoba 2005. Odwala adagawidwa m'magulu awiri. Anthu omwe anavomerezedwa ndi kukhala osachepera usiku ankaonedwa ngati odwala. Matendawa amatanthauzidwa ngati omwe achotsedwa mwachindunji kuchokera kuchipatala.
Ofufuzawa adawona zifukwa zingapo, kuphatikizapo nthawi ya opaleshoni, nthawi yoti akwaniritse ndi milandu yonse yomwe amalembedwa kuchipatala. Panthawi yophunzira, odwala 91 anachitidwa opaleshoni ya chithokomiro. Ambiri anali akazi ndipo anali a zaka 45. Amayi makumi asanu ndi awiri anagwiritsidwa ntchito ngati odwala, ndipo 39 anapatsidwa chisamaliro chapakati (26 anagona usiku, pamene 13 anavomerezedwa kwa masiku pafupifupi atatu).
Chifukwa chodetsa nkhaŵa chachikulu chotsatira chithandizo cha chithokomiro chochepa kapena chokwanira ndi hypocemia, yomwe imakhala yowonongeka kwambiri ya calcium, odwala onse anapatsidwa calcium supplements.
Maselo a calcium adayang'ananso kwa masabata atatu atatha opaleshoni.
Phindu la mankhwala opatsirana opatsirana omwe amatchulidwa ndi ofufuza ndi awa:
- Mtengo wotsika kwa odwala onse ndi a inshuwalansi.
- Kuchotsa odwala kumachitika kunyumba, kutali ndi zovuta zotchedwa nosocomial (matenda opatsidwa kuchipatala).
- Mavitamini owonjezera a calcium ndi othandiza poteteza kuchepa kwa calcium pambuyo pa opaleshoni.
Ofufuzawa akupatsanso opaleshoni ya chithokomiro kwa odwala ena, kuphatikizapo:
- Odwala odwala chifukwa cha kufooka kapena msinkhu.
- Odwala omwe ali ndi zikhalidwe zofanana kapena matenda a magazi.
- Odwala omwe ali ndi njira zina panthawi imodzi zomwe zimafuna kuvomereza.
- Odwala omwe amakonda makamaka kuvomerezedwa.
- Odwala omwe ali ndi zilonda zambiri za chithokomiro.
Kafukufuku wa 2009 wofalitsidwa mu Opaleshoni Yamakono ya Otolaryngologic Head and Neck Surgery adafufuza mndandanda wa mayesero khumi ndi anayi osasinthika ndipo sanapeze kusiyana kwakukulu pakati pa odwala omwe sanafunike kuchitidwa opaleshoni, malinga ngati odwala amapatsidwa calcium nthawi zonse Vitamini D supplementation pambuyo pa opaleshoni kuti athetse chiopsezo cha hypocalcemia.
Phunziro lina, lofalitsidwa mu 2015 mu magazini ya Surgery , linayang'ana zotsatira za opaleshoni ya chithokomiro 1,311, zomwe 1,026 (pafupifupi 78%) zinali zapadera. Ofufuza anapeza kuti:
- Kuwerengera kwa anthu odwala matenda odwala matenda odwala matendawa anali oposa 9% ndipo odwala anali odwala kwambiri (3.5%).
- Panalibe kusiyana pakati pa chiwerengero cha mavuto.
Akatswiriwa anapeza kuti opaleshoni ya chithandizo cha chithokomiro imakhala yotetezeka mwa odwala osankhidwa bwino.
Kafukufuku wina wofalitsidwa mu 2015 ku Danish Medical Journal sanatsutse. Ochita kafukufukuwa anawona momwe magazi amathandizira kuchitidwa opaleshoni ya chithokomiro, ndipo anapeza kuti kutuluka kwa magazi kumeneku kunachitika pakadutsa maola asanu ndi limodzi mwa opaleshoni 63 peresenti ya milandu yomwe anaphunzira - odwala onse a thyroidectomy ku Denmark - ndipo 25% mwa milandu pakati pa 6 ndi Patapita maola 24 ndikuchitidwa opaleshoni ndi 13% ya milandu pambuyo pa maola 24.
Ofufuzawo anapeza kuti opaleshoni ya chithokomiro yosayembekezereka siikondweretsedwa, ndipo odwala ayenera kuwonetseredwa kwa maola asanu ndi limodzi pambuyo pa opaleshoni ndipo ayenera kukhala pafupi ndi chipatala kwa maola 24 otsatirawa.
Kodi Ayenera Kuchita Zotani?
Momwe mukuyendera ziyenera kudalira mkhalidwe wanu - mawonekedwe anu enieni ndi opaleshoni ya chithokomiro, msinkhu wanu, thanzi lanu lonse, zifukwa zina zoopsya, zokonda zanu, ndi luso la dokotala wanu wa opaleshoni. Koma ngati mukuchita opaleshoni ya chithokomiro, ndipo mukugwira ntchito ndi dokotala wodziwa chithandizo cha chithokomiro amene amalimbikitsa opaleshoni ya kuchipatala, ikhoza kukhala njira yabwino ndi yothandiza kwa inu.
> Zotsatira:
> Clark, Orlo H., MD, ndi. al. "Kupaleshoni Kwambiri Kwambiri pa Chithokomiro: Sikofunika Ndiponso N'koopsa" Journal ya Clinical Endocrinology & Metabolism Vol. 83, No. 4 1100-1103, 1998.
> Hopkins B, Steward D. "Kuchita opaleshoni ya chithokomiro ndi kupititsa patsogolo kukuthandizani ." Curr Opin Otolaryngol Mutu Wopambana . 2009 Apr; 17 (2): 95-9. PMID: 19373959
> LoGerfo, Paul, MD, "Opaleshoni Yophatikizapo Chithokomiro," Journal of Clinical Endocrinology & Metabolism, Vol. 83, No. 4 1097-1100, 1998
> Segel JM, ndi. al. "Kuchita opaleshoni ya chithokomiro: Chitetezo cha pulogalamu yapamwamba yomwe imapezeka m'magulu oposa 1,000." Opaleshoni . 2015 Oct 12. > pii >: S0039-6060 (15) 00626-1. do: 10.1016 / j.surg.2015.08.007. [Epub patsogolo pa kusindikiza] PMID: 26471720
> Sørensen KR, Klug TE. "Kuchita opaleshoni ya chithokomiro nthawi zonse sikungathandize." Dan Med J. 2015 Feb; 62 (2). > pii >: A5016. PMID: 25634504
> Terris, David J., MD ndi. al. "Kuchita Opaleshoni ya Chithokomiro Kuchipatala Kumakhala Kosavuta Ndiponso Kofunika," Msonkhano wa Msonkhano Wapachaka wa 110 ndi OTO EXPO wa American Academy of Otolaryngology's Head and Neck Surgery Foundation , September 17-20, 2006, Toronto, Canada