Ukususwa kwendlala ye-Parathyroid

I-Parathyroidectomy ukuhlinzwa ukususa izindlala ze-parathyroid noma izicubu ze-parathyroid. Izindlala ze-parathyroid zikhona ngemuva kwendlala yakho yegilo entanyeni yakho. Lezi zindlala zisiza umzimba wakho ukulawula izinga le-calcium egazini.

Uzothola i-anesthesia ejwayelekile (ilele futhi ayinazinhlungu) ngalokhu kuhlinzwa.

Imvamisa izindlala ze-parathyroid ziyasuswa kusetshenziswa ukusika okuhlinzekwayo okungu-2- to 4 (5- to 10-cm) entanyeni yakho. Ngesikhathi sokuhlinzwa:

• Ukusikwa kuvame ukwenziwa maphakathi nentamo yakho ngaphansi nje kwe-apula lika-Adam.
• Udokotela wakho ohlinzayo uzobheka izindlala ezine ze-parathyroid futhi asuse noma yiziphi ezigulayo.
• Ungahlolwa igazi ngokukhethekile ngesikhathi sokuhlinzwa okuzotshela ukuthi ngabe zonke izindlala ezigulayo zisusiwe yini.
• Ezimweni ezingavamile, lapho zonke lezi zindlala zidinga ukususwa, ingxenye eyodwa ifakwe kwenye ingalo. Noma, ifakwe emsipheni phambi kwentamo yakho eduze kwendlala yegilo. Lokhu kusiza ukuqinisekisa ukuthi izinga le-calcium lomzimba wakho lihlala ezingeni eliphilile.

Uhlobo oluthile lokuhlinzwa luxhomeke lapho kunezindlala ezigulayo ze-parathyroid. Izinhlobo zokuhlinzwa zifaka:

• I-parathyroidectomy encane engahlaseli. Ungathola ukudutshulwa kwenani elincane kakhulu le-tracer enemisebe ngaphambi kwalokhu kuhlinzwa. Lokhu kusiza ukugqamisa izindlala ezinesifo. Uma unalesi sibhamu, udokotela wakho ohlinzayo uzosebenzisa iphenyo ekhethekile, njengekhawunta yeGeiger, ukuthola indlala ye-parathyroid. Udokotela wakho ohlinzayo uzosika kancane (1 kuya 2 amayintshi; noma u-2,5 kuya ku-5 cm) ohlangothini olulodwa lwentamo yakho, bese ususa indlala egulayo ngayo. Le nqubo ithatha cishe ihora elilodwa.
• I-parathyroidectomy esizwa ngevidiyo. Udokotela wakho ohlinzayo uzosika kabili entanyeni yakho. Enye eyezinsimbi zomculo, enye eyekhamera. Udokotela wakho ohlinzayo uzosebenzisa ikhamera ukubuka indawo futhi uzosusa izindlala eziguliswa ngamathuluzi.
• I-Endoscopic parathyroidectomy. Udokotela wakho ohlinzayo uzokwenza ukusikeka okumbili noma kathathu ngaphambili kwentamo yakho nokusika okukodwa ngaphezulu kwesihlangu sakho. Lokhu kunciphisa ukubonakala okubonakalayo, ubuhlungu nesikhathi sokululama. Lokhu kusika kungaphansi kwamasentimitha ama-5 ubude. Inqubo yokususa noma yiziphi izindlala ezigulayo ze-parathyroid iyefana ne-parathyroidectomy esizwa ngevidiyo.

Umhlinzeki wakho wokunakekelwa kwezempilo angancoma lokhu kuhlinzwa uma eyodwa noma ngaphezulu yezindlala zakho ze-parathyroid ikhiqiza i-hormone eningi kakhulu ye-parathyroid. Lesi simo sibizwa ngokuthi yi-hyperparathyroidism. Kuvame ukubangelwa isimila esincane esingenawo umdlavuza (benign) esibizwa nge-adenoma.

Udokotela wakho ohlinzayo uzobheka izinto eziningi lapho ethatha isinqumo sokuthi uzohlinzwa yini nokuthi yiluphi uhlobo lokuhlinzwa olungakulungela. Ezinye zalezi zinto yilezi:

• Iminyaka yakho
• Amazinga e-calcium emchameni nasegazini lakho
• Ukuthi unezimpawu yini

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini noma ezinkingeni zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi ze-parathyroidectomy yilezi:

• Ukulimala kwendlala yegilo noma isidingo sokususa ingxenye yendlala yegilo.
• I-Hypoparathyroidism. Lokhu kungaholela emazingeni aphansi e-calcium ayingozi empilweni yakho.
• Ukulimala kwemizwa okuya emisipheni ehambisa izintambo zakho zezwi. Ungaba nezwi elihoshozelayo noma elibuthakathaka elingaba ngesikhashana noma unomphela.
• Kunzima ukuphefumula. Lokhu akuvamile kakhulu futhi cishe njalo kuyahamba emasontweni noma ezinyangeni ezimbalwa ngemuva kokuhlinzwa.

Izindlala zeParathyroid zincane kakhulu. Ungadinga ukuthi ube nokuhlolwa okukhombisa ngqo ukuthi izindlala zakho zikuphi. Lokhu kuzosiza udokotela wakho ohlinzayo ukuthola izindlala zakho ze-parathyroid ngesikhathi sokuhlinzwa. Izivivinyo ezimbili ongase ube nazo yi-CT scan ne-ultrasound.

Tshela udokotela wakho ohlinzayo:

• Uma ukhulelwe noma kungenzeka ukhulelwe
• Imiphi imithi, amavithamini, amakhambi, nezinye izithako ozithathayo, ngisho naleyo oyithenge ngaphandle kadokotela

Phakathi nesonto ngaphambi kokuhlinzwa kwakho:

• Gcwalisa noma yimiphi imiyalo yomuthi wezinhlungu ne-calcium oyodinga ngemuva kokuhlinzwa.
• Ungacelwa ukuthi uyeke ukuthatha izinciphisi zegazi. Lokhu kufaka ama-NSAID (i-aspirin, ibuprofen), i-vitamin E, i-warfarin (i-Coumadin), i-dabigatran (i-Pradaxa), i-rivaroxaban powder (i-Xarelto), i-apixaban (i-Eliquis), ne-clopidegrel (i-Plavix).
• Buza udokotela wakho ohlinzayo ukuthi yiziphi izidakamizwa okufanele usaziphuza ngosuku lokuhlinzwa kwakho.

Ngosuku lokuhlinzwa kwakho:

• Landela imiyalo mayelana nokungadli nokuphuza.
• Thatha imithi udokotela wakho ohlinzayo akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Fika esibhedlela ngesikhathi.

Imvamisa, abantu bangaya emakhaya ngosuku olufanayo lapho behlinzwa khona. Ungaqala imisebenzi yakho yansuku zonke ezinsukwini ezimbalwa. Kuzothatha cishe i-1 ukuya kumaviki ama-3 ukuthi uphulukise ngokuphelele.

Indawo yokuhlinzwa kufanele igcinwe ihlanzekile futhi yomile. Ungadinga ukuphuza iziphuzo futhi udle ukudla okuthambile kosuku.

Shayela udokotela wakho ohlinzayo uma unenkinga noma ukikiza emlonyeni wakho emahoreni angama-24 kuya kwangu-48 ngemuva kokuhlinzwa. Lokhu kubangelwa i-calcium ephansi. Landela imiyalo yokuthi ungazithatha kanjani izithako zakho ze-calcium.

Ngemuva kwale nqubo, kufanele ube nokuhlolwa kwegazi okujwayelekile ukuhlola izinga lakho le-calcium.

Abantu bavame ukululama ngokushesha ngemuva kwalokhu kuhlinzwa. Ukubuyiselwa kungashesha kakhulu lapho kusetshenziswa amasu amancane angenasifo.

Kwesinye isikhathi, okunye ukuhlinzwa kuyadingeka ukuze kususwe ezinye zezindlala ze-parathyroid.

Ukususwa kwendlala ye-parathyroid; Parathyroidectomy; Hyperparathyroidism - parathyroidectomy; I-PTH - parathyroidectomy

• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• I-Parathyroidectomy
• I-Parathyroidectomy - uchungechunge

UCoan KE, uWang TS. I-Hyperparathyroidism eyinhloko. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 779-785.

I-Quinn CE, Udelsman R. Izindlala ze-parathyroid. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 37.