Iro sarudzo yekuita chirwere cheroid , uye kudzokera kumusha - panzvimbo yekugara muchipatara-yakange iri nyaya yezvidzidzo zvakasiyana-siyana, uye inomiririra shanduko yezvechirwere chetroji iyo yakambotaurirana kwenguva refu nezvekubatsira kwechirwere chepachirwere kana chirwere chekurapa. Ngatitarisei mhinduro dzinopikisana uye dzinopesana.
Inpatient vs. Outpatient
Nenzira, kuvhiyiwa kubvisa utachiona, inozivikanwa seyroidroidectomy , kwakabatanidzwa neusiku husiku - panguva shoma - uye kazhinji kwemazuva maviri kusvika mashanu ekuwedzerwa mamwe mahara.
Ichi chirwere chekurapa chinenge chisina kumira, pasinei nokuti zvinetso zvinowanzoitika mushure mekuvhiyiwa kwetachiona.
Iyo yakagara kwenguva refu yekucherechedza-yekuvhiya kazhinji yakanzwisiswa nekunetseka pamusoro pematambudziko ekuzorora-shure, chirwere chetachiona chiri pedyo nemhepo yakasvibiswa uye mhepo inoenda kune dzimwe nyika, kuwedzera kune ngozi yekubuda ropa.
Asi vamwe vanachiremba vanokurudzira kuti chirwere chepurogiramu chinogara chichiitwa sechirongwa chekubuda kunze, kunyanya kana zvirongwa zviri panzvimbo kuti ugare upa calcium uye Vitamin D supplementation mushure mekuvhiyiwa kuti uderedze ngozi ye hypocalcemia.
Conflicting Studies
Muna 1998, imwe nyaya mu Journal of Clinical Endocrinology uye Metabolism ( JCEM) naDkt. Orlo Clark vakaongorora zviitiko zvevarwere vakanga vambovhiyiwa. Kuongorora kwacho kwakaratidza kuti vazhinji vanokwana makumi mapfumbamwe nemapfumbamwe ekufa kwehutachiona nehutachiona hwehutachiona hwe 100 000 vangadzivirirwa kana varwere vapinda muchipatara usiku humwe pane kusunungurwa mune zvishoma zvishoma maawa matanhatu.
Asi mugore rimwe chete, imwe nyaya iri muJCEM , yakabudiswa nerechiremba chiremba anonzi Paul LoGerfo, MD, akazvinyora. LoGerfo akarovera kuti akafamba kubva pakuita utachiona hwetachiona gumi kubva muna 1992 kusvika muna 80 muna 1996, pasina kuipa. "Kusvikira zuva rino, handina kumbobvumidza kutumira chero munhu ane mwoyo murefu uyo akabudiswa mutirongwa huri kunze," LoGerfo akanyora.
Migumisiro yekudzidza yakataurwa pamusangano wegore negore ra2006 weAmerican Academy yeOtolaryngology, asi, yakaratidza kuti kurapwa kwetachiona kunze kwekuchengetedzwa kwakachengeteka uye kunoshanda kuvarwere vakawanda, uye kunogona kuva yakanakisisa kune zvechipatara zvisingagone kugara muchipatara. Izvi zvinoratidzika kusimbisa zvakataurwa naDo. LoGerfo.
Kuongorora kusina kutsvaga kwakaongororwa varwere vane chirwere chetroroidectomy mumazvipatara maviri eGeorgia pakati peDecember 2004 naOctober 2005. Varwere vakapatsanurwa kuva mapoka maviri. Avo avo vakabvumirwa uye vakagara kweusiku usiku vaifungidzirwa kuti varwere. Zvipembenene zvakatsanangurwa sezvo izvo zvakabudiswa zvakananga kubva pakunamata.
Vatsvakurudzi vakatarisa pane zvimwe zvinhu, kusanganisira nguva yekuvhiya, nguva yekubudisa uye zvikwereti zvacho zvakabhadharwa kuchipatara. Penguva yekudzidza, vatatu 91 vakavhiyiwa chiroyi. Vazhinji vaiva vakadzi uye vaiva nemakore makumi mashanu nemashanu. Makumi makumi mashanu nemaviri aibatwa sevanorapwa, uye makumi matatu nemakumi matatu nemana vakapiwa chirwere chekushaya varwere (26 vakagara usiku hwose, apo 13 vakabvumirwa kwemazuva matatu).
Nokuti chinonyanya kukosha chinotevera mushure mehutachiona kana kuti chetrotectomy zvachose is hypocalcemia, doro rinogona kutyisa mumakirinium, varwere vose vakapiwa calcium supplement.
Mazinga eCalcium akaongororwawo kwemavhiki matatu mushure mekuvhiyiwa.
Zvikwereti zvekubuda kunze kwezvirongwa zvakataurwa nevanotsvakurudza zvinosanganisira:
- Mari yakaderera kune vose varwere nevatsigiri.
- Kurapa kwevarwere kunowanikwa pamba, kure nekubvira nosocomial (chipatara-chakawana) zvirwere.
- Oral calcium supplements zvinobudirira mukudzivirira kukwana kwe calcium mushure mekuvhiyiwa.
Vatsvakurudzi vachiri kukurudzira kurapwa kwehutachiona hwevarwere kune vamwe varwere, kusanganisira:
- Varwere vane utera hwehutano nemhaka yekushaya simba kana zera.
- Varwere vane mamiriro ekugara pamwe chete kana zvirwere zveropa.
- Varwere vachave vari mune dzimwe nzira panguva imwechete iyo inoda kubvumirwa.
- Varwere vanonyanya kuda kushandiswa.
- Varwere vane zvirwere zvikuru zvetachiona zvikuru.
Chidzidzo che2009 chakabudiswa muZvino Opinions muOtolaryngologic Head uye Neck Surgery yakaita meta-kuongorora mimwe miedzo 11 yakasiyana-siyana isina kuwanikwa uye haina kuwana kusiyana kwezvinetso zvakakura pakati pevarwere vaisada kubudiswa mushure mekuvhiyiwa, chero bedzi varwere vaigara vachipiwa calcium uye Vitamin D supplementation mushure mekuvhiyiwa kuti kuderedze njodzi ye hypocalcemia.
Chimwe chidzidzo, chakabudiswa muna 2015 mubhuku rinonzi Surgery , yakatarisa zviitiko zvekuvhiya kwetrusiki 1,311, iyo iyo026 (inenge 78%) yakabuda kunze. Vatsvakurudzi vakawana kuti:
- Kuvepo kwehuwandu hwevanhu vakabuda kunze kwaive .9% uye varwere vakanyoreswa kakawanda (3.5%).
- Kwakange kusina kusiyana pakati pematambudziko.
Vatsvakurudzi vakagumisa kuti kunze kwekuvhiya kwetroji kwakachengeteka muvarwere vakasarudzwa zvakakodzera.
Chimwe chidzidzo chakabudiswa muna 2015 mune Danish Medical Journal hachina kubvumirana, zvakadaro. Ava vatsvakurudzi vakatarisa mitezo yehutachiona hwehutachiona huchibuda mukati mekuvhiya kwetroji, uye wakawana kuti kubuda ropa uku kwakaitika mukati maawa matanhatu ekuvhiya muna 63 muzana yematambudziko avakadzidza - vose vane utachiona hwetachiona muDenmark - uye mu25% yemhosva pakati pe6 uye Maawa makumi maviri mushure mekuvhiyiwa uye 13% yematambudziko mushure maawa makumi maviri nemaviri.
Vatsvakurudzi vakagumisa kuti chirwere chepurogiramu chepachirwere chisingaiti, uye varwere vanofanira kuchengetwa kwemaawa matanhatu mushure mekuvhiyiwa uye vanofanira kugara pedyo nechipatara kwemaawa makumi mana anotevera.
Chii Chinofanira Kuitwa Murefu?
Maitiro aunoita anofanira kuvimba nemamiriro ako ezvinhu - yako chaiwo uye mararamiro ekuvhiya kwetachiona, makore ako, hutano hutano, zvimwe zvipingamupinyi, zvaunofarira, uye unyanzvi hwechiremba wako wechiroyi. Asi kana iwe uine chirwere chetachiona chekuronga, uye uri kushanda nechiremba wezvechirwere ane ruzivo anokurudzira chirwere chekurapa, chinogona kunge chiri chekuchengetedza uye chinoshanda chauri iwe.
> Sources:
> Clark, Orlo H., MD, uye. al. "Kuvhiringidzika kweTyroid Inobatsira: Hazvibviri uye Inokuvadza" Journal of Clinical Endocrinology & Metabolism Vol. 83, Nha. 4 1100-1103, 1998.
> Hopkins B, Steward D. "Kunze kwekuropwa kwetroji uye kufambira mberi kunoita kuti zvive nyore." Curr Opin Otolaryngol Head Neck Surg . 2009 Apr; 17 (2): 95-9. PMID: 19373959
> LoGerfo, Paul, MD, "Outpatient Thyroid Surgery," Journal of Clinical Endocrinology & Metabolism, Vol. 83, Nha. 4 1097-1100, 1998
> Segel JM, et. al. "Kuvhiyiwa kwehutachiona kunze kwepachiviriro: Kuchengetedzwa kweprotocol yakagadziriswa mune vanopfuura 1 000 varwere." Kuvhiya . 2015 Oct 12. > pii >: S0039-6060 (15) 00626-1. doi: 10.1016 / j.surg.2015.08.007. [Epub mberi kwechinyorwa] PMID: 26471720
> Sørensen KR, Klug TE. "Nguva dzose chirwere chetachiona chinenge chiri kunze kunze hachigoni kukurudzirwa." Dan Med J. 2015 Feb; 62 (2). > pii >: A5016. PMID: 25634504
> Terris, David J., MD uye. al. "Kuparara kweTroyoyo yeHyroid yakachengeteka uye inofadza," Mharidzo paGumi reMutambo wegore negore uye OTO EXPO weAmerican Academy yeOtolaryngology's Head uye Neck Surgery Foundation , Septemba 17-20, 2006, Toronto, Canada