Zabin da ake yi na ciwon maganin thyroid , da kuma dawowa gida - a maimakon zama a asibitin - ya kasance batun batun karatu da dama, kuma yana wakiltar sauyawar likitoci masu maganin thyroid waɗanda suka dade dabarun amfana da ilimin likita da cututtuka. Bari mu dubi sakamakon rikice-rikice da rikicewa.
Inpatient vs. Outpatient
A al'ada, tiyata don cire ƙwayar thyroid, wanda aka sani da thyroidectomy , ya ƙunshi kwana ɗaya na dare - a mafi ƙanƙanci - kuma sau da yawa har zuwa kwanaki biyu zuwa biyar na ƙarin asibiti.
Wannan aikin tiyata ne har yanzu yana da daidaituwa, duk da cewa akwai rikitarwa ba tare da komai ba bayan da tiyata.
Yawancin lokaci ya kasance yana da tsayayyar damuwa saboda damuwa game da matsalolin kwakwalwa, maganin karoid din da ke kusa da laccocin laryngeal da iska, ban da haɗarin jini.
Amma wasu likitoci sun bayar da shawarar cewa tilasta aikin tiyata ne a matsayin hanyar fitar da kayan aiki, musamman ma idan ka'idodin suna cikin wuri don ba da allurar rigakafi da Vitamin D bayan aikin tiyata don rage hadarin hypocalcemia.
Rikici na Nazarin
A shekara ta 1998, wata takarda a cikin Journal of Clinical Endocrinology and Metabolism ( JCEM) da Dr. Orlo Clark yayi nazari kan hadarin marasa lafiya da suka kamu da tiyata. Wannan bincike ya nuna cewa yawancin cututtuka 94 da ke dauke da kwayar cutar ta hanyar kwantar da hankalinka zai iya hana idan an yi asibiti a asibiti a cikin dare amma ba a yi musu izini ba a cikin sa'o'i shida.
Amma a wannan shekara, wata kasida a JCEM , wadda likitan likitan kwalliyar Paul LoGerfo, MD, ta wallafa ta, ta yi la'akari da wannan da'awar. LoGerfo ya bayar da rahoton cewa ya tafi daga karantar thyroidectomies 10 a cikin shekara ta 1992 zuwa 80 a 1996, ba tare da wata tasiri ba. "Har wa yau, ba ni da damar karanta wani mai haƙuri wanda aka dakatar da shi a wani wuri mai fita," in ji LoGerfo.
Sakamakon binciken da aka gabatar a shekara ta shekara ta 2006 na Cibiyar Nazarin Kasuwanci na Odolaryngology, duk da haka, ya nuna cewa tiyata ne mai lafiya da kuma tasiri ga mafi yawan marasa lafiya, kuma zai iya zama mafi alhẽri ga dakatarwar asibiti na asibiti. Wannan alama alama ce ta Dokta LoGerfo.
Binciken da ba a yi ba ne ya gwada marasa lafiya da ke ɗauke da thyroidectomy a asibitoci biyu a Georgia tsakanin Disamba 2004 da Oktoba 2005. An raba wa marasa lafiya kashi biyu. Wadanda aka shigar da su kuma sun zauna a kalla a cikin dare an dauke su. An bayyana masu bayarwa a matsayin waɗanda aka ba su kyauta daga sashin dawowa.
Masu bincike sun dubi dalilai da dama, ciki har da tsawon lokacin tiyata, lokacin da za a fitar da duk laifin da aka yi wa asibiti. A lokacin nazarin, magunguna 91 sun kamu da tiyata. Mafi yawansu mata ne kuma sun kai kimanin shekaru 45. An hamsin hamsin da biyu a matsayin masu kula da asibitoci, kuma an ba da 39 a asibiti (26 sun zauna dare, yayin da aka shigar da 13 a cikin kwanaki 3).
Saboda damuwa mai girma akan binka ko jimlar thyroidectomy shine hypocalcemia, mai sauƙin haɗari a cikin matakan calcium, dukkanin marasa lafiya sun ba da ƙarin ciwon calcium.
An kuma kula da matakan calcium na tsawon makonni uku bayan tiyata.
Amfanin hanyoyin da aka samo asali daga masu bincike sun hada da:
- Ƙananan kuɗi ga marasa lafiya da masu insurers.
- Saukewa na haƙuri yana faruwa a gida, ba tare da yiwuwar samun nosocomial (asibiti-samu) cututtuka ba.
- Cunkoso na maganin allurar daji yana da tasiri wajen hana ƙwayar allura bayan tiyata.
Har ila yau, masu bincike sun bayar da shawarar yin aikin tiyata, don wa] ansu marasa lafiya, ciki har da:
- Marasa lafiya marasa lafiya saboda rauni ko shekaru.
- Marasa lafiya tare da yanayin haɗuwa ko cututtuka na jini.
- Marasa lafiya da za su yi aiki tare da sauran hanyoyi guda daya da ke buƙatar shigarwa.
- Marasa lafiya waɗanda suka fi son su yarda da su.
- Marasa lafiya tare da musamman manyan raunuka thyroid.
Wani binciken da aka yi a 2009 wanda aka buga a cikin Rahotanni na yau da kullum a cikin Otolaryngologic Head and Neck Neckgery sun yi nazari akan gwaje-gwajen gwaje-gwaje guda 11 da ba su da bambanci a cikin manyan matsaloli tsakanin marasa lafiya wadanda ba su buƙatar raguwa bayan an tilasta su ba, muddin ana ba da marasa lafiya a jiki. Dandalin Vitamin D bayan aikin tiyata don rage hadarin hypocalcemia.
Wani binciken, wanda aka buga a shekara ta 2015 a cikin mujallolin Labaran, ya dubi sakamakon da aka samu na 1,311 ciwon maganin thyroid, wanda 1,026 (kimanin kashi 78%) suka kasance. Masu bincike sun gano cewa:
- Sakamakon karɓan karɓa ga masu bada agaji sun kasance .9% kuma masu karɓar aikin sun karu da yawa sau da yawa (3.5%).
- Babu bambance-bambance a cikin yawan jituwa.
Masu bincike sun yanke shawarar cewa tiyata ne mai lafiya a cikin marasa lafiya wanda aka zaba.
Wani binciken da aka buga a shekara ta 2015 a Jaridar Danish Medical Journal ba ta yarda ba. Wadannan masu bincike sun kalli kudaden da ake yi a lokacin da ake zubar da jini a cikin aikin tiyata, kuma sun gano cewa wannan zub da jini ya faru a cikin sa'o'i 6 na tiyata a cikin kashi 63 cikin 100 na lokuta da suka yi nazarin - dukan marasa lafiya na thyroidectomy a Denmark - kuma a cikin 25% na lokuta tsakanin 6 da 24 hours bayan tiyata da 13% na lokuta bayan 24 hours.
Masu bincike sun yanke shawarar cewa ba za'a iya ba da aikin tiyata na yau da kullum ba, kuma ya kamata a kula da marasa lafiya a kalla 6 hours bayan tiyata kuma ya kasance kusa da asibiti a kalla 24 hours.
Me Menene Majibinci Su Yi?
Yadda kake ci gaba ya dogara ne akan halinka na musamman - nauyinka na musamman da kewayar tiyata, shekarunka, lafiyar lafiya, wasu abubuwan haɗari, da fifiko, da gwaninta na likitan likitanka. Amma idan kana da aikin tiyata na yau da kullum, kuma yana aiki tare da likitan likitan kawo wanda ya bada shawarar aikin tiyata, zai iya zama wani zaɓi mai tasiri da tasiri.
> Sources:
> Clark, Orlo H., MD, et. al. " Magungunan maganin Taroid: Ba dole ba kuma mai hadari" Journal of Clinical Endocrinology & Metabolism Vol. 83, No. 4 1100-1103, 1998.
> Hopkins B, Steward D. "Harkokin maganin maganin kafe da kuma ci gaba da yin hakan." Curr Opin Otolaryngol Head Neck Surg . 2009 Afrilu 17 (2): 95-9. PMID: 19373959
> LoGerfo, Paul, MD, "Outpatient Thyroid Tiyata," Jaridar Clinical Endocrinology & Metabolism, Vol. 83, No. 4 1097-1100, 1998
> Segel JM, et. al. "Harkokin thyroid tiyata: Tsaro na wata yarjejeniya da aka gyara a cikin fiye da 1,000 marasa lafiya." Tiyata . 2015 Oktoba 12. > Kira >: S0039-6060 (15) 00626-1. Doi: 10.1016 / j.surg.2015.08.007. [Epub gaba na buga] PMID: 26471720
> Sørensen KR, Klug TE. "Ba za a iya ba da shawarar yin aikin tiyata ba." Dan Med J. 2015 Feb; 62 (2). > koma >: A5016. PMID: 25634504
> Terris, David J., MD et. al. "Harkokin maganin Thyroid ne mai lafiya da mai ban sha'awa," gabatarwa a 110th Annual Meeting & EXPO na Cibiyar Harkokin Jiki na Otolaryngology na Amurka da kuma Abun Cutar , Satumba 17-20, 2006, Toronto, Kanada