I-Hypophysectomy

-Delile

• Yiziphi izinhlobo ezahlukahlukene zale nqubo?
• Le nqubo yenziwa kanjani?
• Yini ukululama okuvela kule nqubo?
• Yini okufanele ngiyenze lapho ngilulama?
• Yiziphi izinkinga ezingaba khona zale nqubo?
• Umbono

Ukubuka konke

I-hypophysectomy wukuhlinzwa okwenziwe ukukhipha indlala ye-pituitary.

Indlala ye-pituitary, ebizwa nangokuthi i-hypophysis, iyindlala encane efakwe ngaphansi kobuchopho bakho. Ilawula amahomoni akhiqizwa kwezinye izindlala ezibalulekile, kufaka phakathi izindlala ze-adrenal ne-thyroid.

I-Hypophysectomy yenziwa ngezizathu eziningi, kufaka phakathi:

• ukususwa kwezimila ezizungeze i-pituitary gland
• ukususwa kwe-craniopharyngiomas, izicubu ezenziwe ngezicubu ezisuka emhlabeni wonke
• ukwelashwa kwe-Cushing's syndrome, okwenzeka lapho umzimba wakho uvezwa i-hormone i-cortisol eningi kakhulu
• ukwenza ngcono umbono ngokususa izicubu ezengeziwe noma uquqaba oluzungeze indlala

Ingxenye kuphela yendlala ingasuswa lapho kukhishwa izicubu.

Yiziphi izinhlobo ezahlukahlukene zale nqubo?

Kunezinhlobo eziningi ze-hypophysectomy:

• I-Transsphenoidal hypophysectomy: Indlala ye-pituitary ikhishwa ngamakhala akho nge-sphenoid sinus, umgodi osondele ngemuva kwekhala lakho. Lokhu kuvame ukwenziwa ngosizo lwe-microscope yokuhlinza noma ikhamera ye-endoscopic.
• Vula craniotomy: Indlala ye-pituitary ikhishwa ngokuyikhipha ngaphandle ngaphansi kobuchopho bakho ngembobo encane okhakhayini lwakho.
• Ama-Radiosurgery we-Stereotactic: Amathuluzi esigqoko sokuzivikela afakwa ngaphakathi kogebhezi ngokuvuleka okuncane. Indlala ye-pituitary kanye nezicubu noma izicubu ezizungezile ziyabhujiswa, kusetshenziswa imisebe ukususa izicubu ezithile ngenkathi kugcinwa izicubu ezinempilo ezizungezile. Le nqubo isetshenziswa kakhulu kwizicubu ezincane.

Le nqubo yenziwa kanjani?

Ngaphambi kwenqubo, qiniseka ukuthi usukulungele ngokwenza okulandelayo:

• Thatha izinsuku ezimbalwa emsebenzini noma eminye imisebenzi ejwayelekile.
• Yiba nomuntu okuyisa ekhaya lapho usululeme enkambisweni.
• Hlela ukuhlolwa kwezithombe nodokotela wakho ukuze bazi izicubu ezizungeze indlala yakho yebhinqa.
• Khuluma nodokotela ohlinzayo mayelana nokuthi hlobo luni lwe-hypophysectomy oluzokusebenzela kangcono kakhulu.
• Sayina ifomu lokuvuma ukuze wazi zonke izingcuphe ezihilelekile kule nqubo.

Lapho ufika esibhedlela, uzongeniswa esibhedlela bese ucelwa ukuthi ushintshe ube yingubo yesibhedlela. Udokotela wakho uzobe esekuyisa egumbini lokuhlinzeka futhi akunikeze i-anesthesia ejwayelekile ukuze uhlale ulele ngesikhathi senqubo.

Inqubo ye-hypophysectomy incike ohlotsheni enivumelana ngalo nodokotela wakho ohlinzayo.

Ukwenza i-transsphenoidal hypophysectomy, uhlobo oluvame kakhulu, udokotela wakho ohlinzayo:

1. ikubeka esimeni sokuhlala kancane lapho ikhanda lakho liqinisiwe ukuze lingakwazi ukunyakaza
2. yenza ukusikeka okuncane okuningana ngaphansi kwendebe yakho engenhla nangaphambi kwesikhala sakho sesono
3. ifaka i-speculum ukugcina umgodi wakho wamakhala uvulekile
4. ifaka i-endoscope ukubuka izithombe ezihlongozwayo zomlomo wakho wamakhala esikrinini
5. ifaka amathuluzi akhethekile, njengohlobo lwe-forceps olubizwa nge-pituitary rongeurs, ukususa isimila nengxenye noma yonke indlala ye-pituitary
6. isebenzisa amanoni, amathambo, uqwanga, nezinye izinto zokuhlinza ukwakha kabusha indawo lapho kukhishwe khona isimila nendlala
7. ifaka i-gauze elashwe ngomuthi wama-antibacterial emakhaleni ukuvimbela ukopha nokutheleleka
8. ithunga ukusikeka emgodini wesono nasodebeni eliphezulu ngama-sutures

Yini ukululama okuvela kule nqubo?

I-hypophysectomy ithatha ihora elilodwa kuya kwamabili. Ezinye izinqubo, njenge-stereotaxis, zingathatha imizuzu engama-30 noma ngaphansi.

Uzochitha cishe amahora amabili ululama egumbini lokunakekelwa kwangemva kokuhlinzwa esibhedlela. Ngemuva kwalokho, uzothathwa uyiswe egumbini lasesibhedlela uphumule ubusuku bonke ngomugqa we-intravenous (IV) fluid okukugcina unamanzi ngenkathi usalulama.

Ngenkathi ululama:

• Usuku olulodwa kuya kwezimbili, uzohambahamba ngosizo lomhlengikazi uze ukwazi ukuzihambela futhi. Inani olichamayo lizobhekwa.
• Ezinsukwini ezimbalwa zokuqala ngemuva kokuhlinzwa, uzohlolwa igazi nokuhlolwa kombono ukuze uqiniseke ukuthi umbono wakho awuthintekanga. Igazi kungenzeka liphume emakhaleni akho ngezikhathi ezithile.
• Ngemuva kokuphuma esibhedlela, uzobuya cishe emavikini ayisithupha kuya kwayisishiyagalombili ukuthola i-aphoyintimenti yokulandelela. Uzohlangana nodokotela wakho kanye nodokotela we-endocrinologist ukubona ukuthi umzimba wakho uphendula kanjani ekuguqulweni okungenzeka kube khona ekukhiqizeni ama-hormone. Lokhu kuqokwa kungafaka ukuskena ikhanda kanye nokuhlolwa kwegazi nokubona.

Yini okufanele ngiyenze lapho ngilulama?

Kuze kube yilapho udokotela wakho ethi kulungile ukwenza kanjalo, gwema ukwenza okulandelayo:

• Ungashayi, uhlanze, noma unamathisele lutho emakhaleni akho.
• Musa ukugoba phambili.
• Ungaphakamisi noma yini esinda ngaphezu kwamakhilogremu ayi-10.
• Ungabhukudi, ugeze, noma ubeke ikhanda lakho ngaphansi kwamanzi.
• Ungashayeli noma usebenzise noma imiphi imishini emikhulu.
• Ungabuyeli emsebenzini noma emisebenzini yakho ejwayelekile yansuku zonke.

Yiziphi izinkinga ezingaba khona zale nqubo?

Ezinye izimo ezingabangelwa yilokhu kuhlinzwa zifaka:

• Uketshezi lweCerebrospinal (CSF) ukuvuza: Uketshezi lwe-CSF oluzungeze ubuchopho bakho nomgogodla ukuvuza kuhlelo lwakho lwezinzwa. Lokhu kudinga ukwelashwa ngenqubo ebizwa ngokuthi i-lumbar puncture, okubandakanya ukufaka inaliti emgogodleni wakho ukukhipha uketshezi oluningi.
• I-Hypopituitarism: Umzimba wakho awukhiqizi kahle ama-hormone. Lokhu kungadinga ukwelashwa nge-hormone replacement therapy (HRT).
• Isifo sikashukela insipidus: Umzimba wakho awulawuli kahle inani lamanzi emzimbeni wakho.

Bheka udokotela wakho ngokushesha uma ubona noma yiziphi izinkinga ezilandelayo ngemuva kwenqubo yakho:

• ukopha kaningi
• imizwa eyeqile yokoma
• ukulahleka kombono
• kukhipha uketshezi olucacile emakhaleni akho
• ukunambitheka okunosawoti ngemuva komlomo wakho
• achame kakhulu kunokujwayelekile
• ikhanda elingapheli ngemithi yezinhlungu
• umkhuhlane omkhulu (101 ° noma ngaphezulu)
• ukuzwa ukulala njalo noma ukhathele ngemuva kokuhlinzwa
• ukuphonsa njalo noma uhudo

Umbono

Ukususwa kwendlala yakho ye-pituitary inqubo enkulu engathinta amandla omzimba wakho wokukhiqiza ama-hormone.

Kepha lokhu kuhlinzwa kungasiza ekwelapheni izingqinamba zezempilo ezingaba nezinkinga ezinzima.

Kunezindlela zokwelashwa eziningi ezikhona zokushintsha ama-hormone umzimba wakho ongeke usakwazi ukukhiqiza wona ngokwanele.