Ua kiʻekiʻe anei kou pae calcium? He adenoma parathyroid paha ia?

I kou nānā ʻana i nā hopena o kāu hoʻāʻo koko, ua haʻi aku anei kāu kauka iā ʻoe ua kiʻekiʻe iki kou pae calcium? ʻAʻole paha ʻoe i ʻike i kekahi mea ʻē a ʻokoʻa paha i loko o kou kino. Ua manaʻo paha ʻoe, "Ua maikaʻi wau, no ke aha i kiʻekiʻe wale ai kēia calcium?" ʻOiaʻiʻo, ua ʻike ka poʻe he nui e pili ana i kēia maʻi ma o ka ulia pōpilikia. No laila, ma kēia ʻatikala i kēia lā, e kamaʻilio mākou e pili ana i nā kumu nui a me nā kumu maʻamau no ka piʻi ʻana o nā pae calcium i loko o ke koko ma ke ʻano maʻalahi a maopopo hoʻi.

ʻO ka mea mua, e nānā kākou, he aha kēia mau kelepa parathyroid?

Ke lohe ʻoe i kēia inoa, manaʻo kekahi poʻe he ʻāpana kēia o ke kelepa thyroid ponoʻī. Akā, ʻaʻole pēlā. He ʻano kelepa ʻokoʻa kēia. Aia lākou ma ko kākou ʻāʻī, a puni ke kelepa thyroid, me he mea lā e ʻapo ana iā ia. ʻEhā o kēia mau mea i loaʻa i ka hapa nui o ka poʻe. ʻEhā mau kelepa ʻano oval, e like me ka nui o kahi pī liʻiliʻi.

No laila he aha ka hana a kēia mau ʻāpana liʻiliʻi ʻehā i ko mākou kino? ʻO kēia nā mea hoʻoponopono calcium o ko mākou kino. Hana lākou e like me ka pōpō e hoʻomalu ana i ka pae wai i loko o kā mākou pahu wai ma ka home. Ke hāʻule ka pae calcium i loko o ko mākou koko, hoʻokuʻu kēia mau ʻāpana i kahi kemika i kapa ʻia ʻo Parathyroid Hormone (PTH) . Ke haʻi aku nei kēia hormone i ko mākou mau iwi, "ʻAe, e hāʻawi i kekahi calcium i ke koko." Ke haʻi aku nei hoʻi ia i ko mākou mau puʻupaʻa a me nā ʻōpū e hoʻopili hou i ka calcium i loko o ke kino ma kahi o ka hoʻonele ʻana. Ke hoʻi ka pae calcium i loko o ko mākou koko i ka pae kūpono, hoʻōki kēia mau ʻāpana i ka hoʻokuʻu ʻana i ka hormone. ʻAʻole anei he ʻano hana kupaianaha?

He mea nui ka kalipuna no kēlā me kēia ʻāpana o ko kākou lolo, puʻuwai, ʻōnaehana nerve, iwi, a me ka ʻōnaehana hoʻoheheʻe e hana pono ai. No laila, ʻo ka mālama ʻana i kēlā pae kalipuna kūpono ke kuleana nui o kēia mau ʻōpū liʻiliʻi ʻehā.

No laila he aha kēia adenoma parathyroid?

I ka ʻōlelo maʻalahi, he puʻupuʻu liʻiliʻi ka adenoma, ʻaʻole maʻi kanesa (benign) . Hiki i kēia ʻano puʻupuʻu ke kū i loko o kekahi o nā ʻehā parathyroid glands a mākou i kamaʻilio ai ma mua (i kekahi manawa ʻoi aku ma mua o hoʻokahi).

I kēia manawa, e noʻonoʻo i ka mea e hana ʻia ke ulu ʻana o kahi puʻupuʻu e like me kēia ma kekahi o kēlā mau kelepa ʻehā. Hoʻomaka ka kelepa me ka puʻupuʻu e hana me ka hoʻomalu ʻole ʻia, me ka hana nui ʻole. Ua like ia me kahi mīkini me kahi kuapo on/off i haki e hoʻomau mau ana i ka huli ʻana. A laila hana ka kelepa i ka nui o ka parathyroid hormone (PTH). I ka lāʻau lapaʻau, kapa mākou i kēia ʻano ʻo Primary Hyperparathyroidism .

Ke hana nui ʻia kēia hormone, lawe mau ia i ka calcium mai nā iwi a hoʻokomo i loko o ke koko. Hoʻonui pū ia i ka omo ʻana o ka calcium mai nā puʻupaʻa a me nā ʻōpū. ʻO ka hopena hope loa, ʻoi aku ka kiʻekiʻe o ka pae calcium i loko o ke koko ma mua o ka mea e pono ai. Kāhea mākou i kēia he hypercalcemia .

He aha nā hōʻailona o ke kiʻekiʻe o ka calcium koko (Hypercalcemia)?

ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona i nā pae mua. ʻO ia ke kumu i ʻōlelo mua ai mākou he nui ka poʻe i loaʻa i kēia ma ka ulia pōpilikia. Akā i ka wā e kiʻekiʻe ai nā pae calcium i loko o ke koko no ka manawa lōʻihi, hiki ke ʻike ʻia nā hōʻailona like ʻole. E nānā kākou i ke ʻano o lākou.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​mai manaʻo he adenoma parathyroid maoli nō ia. Hiki ke hana ʻia kēia mau hōʻailona e nā kūlana ʻē aʻe. No laila, ʻo ka mea nui loa, ʻo ia ke ʻike i kāu kauka a kamaʻilio e pili ana.

No ke aha e kū mai ai kēia mau puʻupuʻu? ʻO wai ka mea i ʻoi aku ka pilikia?

ʻO kaʻoiaʻiʻo, i loko o 90% o nā hihia , ʻaʻohe kumu maopopo i loaʻa no ka ulu ʻana o kēia mau adenomas. He mea hiki wale mai ia. Akā i loko o kahi pakeneka liʻiliʻi, ma kahi o 10%, hiki ke hana ʻia kēia e kahi kumu genetic i hoʻoili ʻia ma o nā hanauna.

Eia kekahi, ua ʻike ʻia kekahi mau kumu ʻē aʻe e hoʻonui i ka pilikia:

• Makahiki: ʻIke pinepine ʻia kēia ʻano i nā poʻe ma waena o 50 a me 70 mau makahiki.
• Kāne: ʻOi aku ka nui o nā wahine i kēia maʻi ma mua o nā kāne ma kahi o ʻekolu manawa.
• Ka ʻike ʻia ʻana i ka radiation: Inā ua loaʻa iā ʻoe ka lāʻau radiation ma ka ʻāʻī a me ke poʻo i kou wā kamaliʻi a ʻōpio paha, hiki ke hoʻonui iki ʻia kou pilikia.
• Ka nele o ka kalipuna: ʻO ka loaʻa ʻole o ka nui o ka kalipuna mai ka ʻai no ka manawa lōʻihi ua manaʻo ʻia he kumu pilikia.

He aha ka mea e hana ʻia inā ʻaʻole mālama ʻia kēia maʻi?

ʻOiai ʻaʻole kēia he maʻi kanesa, inā waiho ʻole ʻia no ka manawa lōʻihi, hiki ke loaʻa nā pilikia like ʻole ma muli o ka hoʻomau ʻana o ka piʻi ʻana o nā pae calcium i loko o ke koko.

• ʻO ka Arrhythmia Cardiac: Hiki ke lilo ka puʻuwai i mea ʻē.
• ʻO ka pilikia Parathyroid: He kūlana kakaikahi kēia akā koʻikoʻi. Piʻi nui ka pae o ka calcium i loko o ke koko, e alakaʻi ana i ka huikau noʻonoʻo a me ka coma.
• Eia kekahi, aia nā pilikia lōʻihi e like me nā pōhaku puʻupaʻa a me nā haki iwi, a mākou i kūkākūkā ai ma mua.

No laila, ʻoiai inā ʻaʻohe hōʻailona, ​​​​inā ʻike ke kauka i kēia maʻi, he mea nui loa ia e mālama pono iā ia.

Pehea e ʻike ai nā kauka i kēia? (Diagnosis)

He maʻalahi loa ke kaʻina hana o ka ʻike ʻana i kēia maʻi.

1. Nā hoʻāʻo koko: ʻO ka mea mua e hana ai, ʻo ia ke nānā i ka pae calcium i loko o ke koko. Inā kiʻekiʻe, a laila e nānā ʻia ka pae hormone parathyroid (PTH) i loko o ke koko. Inā kiʻekiʻe nā mea ʻelua, ua maopopo ka hōʻailona he 99%. Inā he mau hōʻailona a ʻaʻole paha, ʻo kēia mau hoʻāʻo koko ʻelua nā mea nui e hōʻoia i ka maʻi.

2. Nā hoʻokolohua ʻē aʻe:Ke hōʻoia ʻia ka hōʻailona, ​​​​hiki i ke kauka ke kuhikuhi i kekahi mau hoʻokolohua hou aʻe. Hana ʻia kēia mau mea e nānā i nā pilikia ʻē aʻe a e hoʻolālā mua no ke ʻoki ʻana.

• ʻO ke scan Ultrasound o ka ʻāʻī: Hoʻohana ʻia kēia e hoʻāʻo e ʻimi i ka gland i hoʻonui ʻia i hana nui ʻia.
• ʻO Sestamibi Scan: He ʻano scan kūikawā kēia. Hoʻokomo ʻia kahi liʻiliʻi o ke kemika i loko o ke kino, a hoʻoholo ʻia kahi kikoʻī o ka puʻupuʻu ma ka nānā ʻana i ke ʻano o kona hoʻopaʻa ʻana i ka gland hana.
• ʻO ke Densitometry o ka iwi (DEXA scan): Ke ana i ka nāwaliwali o nā iwi.
• He hoʻāʻo mimi 24-hola: Ke ana kēia i ka nui o ka calcium i hoʻokuʻu ʻia i loko o ka mimi.

He aha nā lāʻau lapaʻau? He aha ka hopena maikaʻi loa?

ʻO ka lāʻau lapaʻau maikaʻi loa, kūpono loa, a mau loa no kēia ʻano, ʻo ia ke ʻoki ʻana e wehe i ke kelepaʻa a i ʻole nā ​​kelepaʻa ʻē. Ua kapa ʻia kēia ʻoki ʻana he parathyroidectomy . Ma hope o ke ʻoki ʻana, ua ho'ōla loa ʻia ka maʻi ma mua o 95% o nā hihia.

Inā ʻaʻohe oʻu hōʻailona, ​​pono anei iaʻu ke ʻoki ʻana?

He nīnau kēia a ka poʻe he nui. ʻAe, ʻōlelo pinepine ʻia ke ʻoki ʻana inā ʻaʻohe hōʻailona. No ke aha mai ia? No ka mea, inā ʻaʻohe hōʻailona, ​​ʻo ka piʻi ʻana o ka calcium i loko o ke koko ke kumu o ka hōʻino ʻana i ke kino mai loko mai. ʻO ke ʻoki ʻana ka hopena maikaʻi loa e pale aku ai i nā pōhaku puʻupaʻa a me ka osteoporosis i ka wā e hiki mai ana.

Pehea e hana ʻia ai ke ʻoki kino?

ʻAʻole kēia he hana nui a paʻakikī.

• Ma lalo o ka anesthesia piha, hana ʻia kahi ʻoki liʻiliʻi loa ma ke alo o ka ʻāʻī.
• Nānā ke kauka lapaʻau i nā ʻōpū ʻehā, ʻike i ke ʻōpū i hoʻonui ʻia a ʻano ʻē, a wehe aku.
• I kekahi manawa aia paha nā puʻupuʻu i loko o ʻelua mau kelepa. I kēlā hihia, e wehe ʻia nā mea ʻelua. Inā hoʻonui ʻia nā kelepa ʻehā a pau (ua kapa ʻia kēia he hyperplasia), e wehe ʻia he 3 1/2 o nā kelepa a waiho ʻia ka hapalua i koe i loko o ke kino. ʻO kēia no ka mea pono ke kino i kahi liʻiliʻi o ka ʻiʻo parathyroid e kāohi i ka calcium.
• Nānā ʻia ka pae o ka hormone PTH i loko o ke koko i ka wā o ke ʻoki ʻana. Inā emi ka pae ma kahi o 50% ma hope o ka wehe ʻia ʻana o ke kelepaʻi ʻano ʻē, ʻo ia hoʻi ua holomua ke ʻoki ʻana.

Aia kekahi mau pilikia i ke ʻoki kino?

E like me nā ʻoki kino āpau, aia kekahi mau pilikia liʻiliʻi. ʻO ka mea nui ka emi ʻana o ka nui o ka calcium koko no kekahi manawa (hypocalcemia) ma hope o ke ʻoki kino.. Hiki paha i kēia ke hoʻoulu i ka mae ʻana o nā manamana lima a puni ka waha, a me ka manaʻo o ka ʻūlū ʻana o nā ʻiʻo. Akā, ʻaʻohe mea e hopohopo ai. E hāʻawi ke kauka iā ʻoe i nā papa calcium a me ka wikamina D no kekahi mau pule. Inā ʻoe e lawe pololei iā lākou, e pale ʻia kēia ʻano maʻi.

He aha ka mea e hana ʻia ma hope o ke ʻoki kino?

Ma kahi o hoʻokahi mahina ma hope o ke ʻoki ʻana, e aneane nalowale loa kāu mau hōʻailona (e like me ka luhi a me nā ʻeha kino). E hoʻomaka ʻoe e ʻike i kahi manaʻo nui o ka hōʻoluʻolu a me ka hoʻoulu hou ʻana.

ʻO nā pōmaikaʻi lōʻihi o ke ʻoki kino:

• Hoʻi hou ka nui o ka iwi.
• Hoʻemi ʻia ka pilikia o ka haki ʻana o ka iwi.
• Hoʻopau i ka pilikia o nā pōhaku puʻupaʻa.