—–Nkhaniyi inakopera kuchokeraMedpageToday
Kuchotsa mazira onse asanayambe kusamba kumagwirizanitsidwa ndi mwayi waukulu wa matenda aakulu komanso kuchepa kwa thupi patatha zaka zambiri, makamaka kwa amayi omwe anachitidwa opaleshoni kale, kafukufuku wosiyanasiyana wapeza.
Poyerekeza ndi gulu la zaka zofananira, amayi osakwana zaka 46 omwe adachitidwapo opaleshoni ya premenopausal bilateral oophorectomy (PBO) chifukwa cha zinthu zomwe sizinali zowopsa - ndi kapena popanda hysterectomy - sanachite bwino pakuyezetsa kwa mphindi zisanu ndi chimodzi komwe kunachitika m'chipatala chakunja zaka makumi awiri pambuyo pake. kukhala ndi matenda osatha:
mphumu: kapena 1.74 (95% CI 1.03-2.93)
Nyamakazi: kapena 1.64 (95% CI 1.06-2.55)
Obstructive sleep apnea: kapena 2.00 (95% CI 1.23-3.26)
Kusweka: kapena 2.86 (95% CI 1.17-6.98)
"Zotsatirazi zikuwonetsa zotsatira zoyipa zomwe zingakhalepo kwa nthawi yayitali chifukwa cha oophorectomy kwa amayi omwe ali ndi vuto lodziwika bwino kapena opanda ovarian omwe ali pachiwopsezo cha khansa ya m'mimba," adamaliza ofufuza motsogozedwa ndi Michelle Mielke, MD, PhD, wa Wake Forest University School of Mankhwala ku Winston-Salem, NC, m'nkhani ya Menopause.Zotsatirazi ndizofunika poganizira ngati mungapangire ovariectomy (PBO) ndi hysterectomy.
Stephanie Faubion, MD, MBA, mkulu wa zachipatala wa Menopause Society, adanena kuti zomwe apeza, zomwe zimadalira Mayo Clinic's Tubectomy ndi Aging Cohort Study-2 (MOA-2), zimatsimikizira kufunikira kwa madokotala kuti asinthe machitidwe awo.
"Izi zimangowonjezera zolemba zomwe zilipo kale kuti kuchotsa mazira ochuluka ali aang'ono, makamaka osakwana zaka 46, kumakhudzana ndi zotsatira za thanzi labwino," Faubion adauza MedPage Today.Pakadali pano, ndikuganiza kuti tingofunika kuchitapo kanthu. ”
Faubion, yemwenso ndi mkulu wa Center for Women's Health ku Mayo Clinic ku Rochester, Minnesota, koma yemwe sanachite nawo kafukufuku wamakono, adanena kuti kukwatira pambuyo pake (akazi azaka zapakati pa 46 ndi 49) nawonso "si vuto. lingaliro labwino,” malinga ndi kafukufukuyu.Pagululi, panali zovuta zambiri za nyamakazi ndi kugona tulo poyerekeza ndi anzawo olingana ndi zaka zawo, ndipo PBO idapangitsa kuti pakhale zovuta zambiri za matenda osachiritsika am'mapapo m'gulu lonse.
Mu gulu la PBO, pafupifupi 90 peresenti adalandiranso hysterectomy, ndipo 6 peresenti anali ndi hysterectomy isanachitike;mu gulu lofananira lazaka lomwe silinachite PBO, 9 peresenti anali ndi hysterectomy.
Mielke anauza MedPage Masiku ano kuti kuchotsa mazira pa nthawi ya hysterectomy (opaleshoni yachiwiri ya amayi) ndizozoloŵera kwa amayi, mwa zina chifukwa zimachotsa chiopsezo cha khansa ya ovari.
“M’mbiri yakale,” Mielke akufotokoza motero, “zinali kukhulupirira kuti chiberekero chikangochotsedwa, sipadzakhalanso mphamvu ya kuberekana, choncho sipadzakhalanso chifukwa chochotsa mazirawo.”Komabe, m’kupita kwa nthaŵi, kufufuza kowonjezereka kwasonyeza kuti kuchotsa mazira onse aŵiri m’mimba musanayambe kupita kwachibadwa kukhoza kukhala ndi zotulukapo zanthaŵi yaitali kapena ngozi zanthaŵi yaitali za matenda ena.
Ngati mazira achotsedwa asanasiye kusintha kwachilengedwe, Mkaka anati, "ndikovomerezeka kwambiri" kuti amayi azikhalabe ndi mankhwala a estrogen mpaka zaka 50.
Ofufuzawo adawona kuti kafukufuku wapano akuphatikizanso kuwunika kwathunthu kwa amayi omwe ali ndi mbiri yolembedwa ya PBO, pomwe maphunziro ena pa PBO ndi zotsatira zaumoyo adalira makamaka pakutoleretsa kwapang'onopang'ono kwa zolembedwa zamankhwala, kulephera kujambula "madera enaake. za kugwira ntchito kwa thupi kapena njira zina zokhudzana ndi ukalamba.”
Phunzirani zambiri
Mielke ndi anzake adagwiritsa ntchito deta yochokera ku Rochester Epidemiology Project's (REP) Medical Record Linkage System ndi kafukufuku wa MOA-2, omwe adazindikira amayi a ku Olmsted County, Minnesota, omwe adalandira chithandizo cha PBO chifukwa cha matenda omwe sanali owopsa pakati pa 1988 ndi 2007 komanso omwe sanalipo. chiopsezo chachikulu cha khansa ya ovary.Otsatira a MOA-2 anafananizidwa ndi gulu lachidziwitso la amayi omwe sanalandire PBO anaphatikizidwa ndi gulu lachidziwitso la amayi omwe sanalandire PBO.
Pofika chaka cha 2018, pamene phunziro la maso ndi maso lidayamba, ambiri mwa omwe ali mu PBO ndi magulu owonetsera anali amoyo (91.6% ndi 93.1%, motsatana).
Gulu lofufuza lidapeza azimayi olankhula Chingerezi a 274 ochokera ku MOA-2 omwe adatsatiridwa ndi PBO pambuyo pazaka zapakati pa 22, kuphatikiza odwala 161 omwe adachita njirayi msanga (asanakwanitse zaka 46) (59%) ndi odwala 113. omwe adachita njirayi mochedwa (zaka 46 mpaka 49) (41%).
Ophunzira amayenera kukhala azaka za 55 kapena kupitilira apo polembetsa ndipo sanaphatikizidwe ngati matenda akuwonetsa zilonda mu PBO yawo kapena ngati sanawonekere mu REP m'zaka zapitazi za 5.Iwo anali ofananira ndi zaka 240 omwe anali nawo mu gulu lofotokozera omwe analibe PBO.
Ponseponse, azimayiwa anali ndi zaka zapakati pa 67, anali oyera 97% -99%, ndipo pafupifupi 60% anali asanasutepo.
Matenda osachiritsika adawunikidwa ndi zolemba zamankhwala.Kuphatikiza pa mayanjano omwe tawatchula kale, ofufuzawo sanapeze mayanjano aliwonse pakati pa PBO ndi khansa, shuga, dementia, hypertension, hyperlipidemia, mtima arrhythmia, impso, chithokomiro, kapena matenda a chiwindi, osteoporosis, kapena kuukira kwanthawi yochepa kwa ischemic.
Kufufuza kwakuthupi kunaphatikizapo miyeso ya mphamvu ndi kuyenda.Poyerekeza ndi gulu lofananira lazaka, amayi omwe adadwala PBO anali ndi chithokomiro / pteronavicular mafuta chiŵerengero chapamwamba cha mafuta ndipo sanachite bwino pamayeso oyenda mphindi 6 (-14 mamita), pamene amayi omwe anadutsa PBO oyambirira anachita bwino pamphindi 6. kuyenda mayeso (-18 mamita).Azimayi kumapeto kwa gulu la PBO anali ndi kuchuluka kwamafuta ambiri, minyewa yotsamira, komanso kuchulukira kwa mafupa a msana poyerekeza ndi gulu lofotokozera.
Mielke ndi anzake adanena kuti chifukwa chakuti phunziroli linali laling'ono, chifukwa sichikhoza kuganiziridwa, ndipo maphunziro a nthawi yayitali akulimbikitsidwa.Iwo adanenanso kuti amayi omwe adachita nawo kafukufukuyu angakhale athanzi kusiyana ndi chiwerengero cha anthu ambiri ndipo adanena kuti kuchulukira kwa azungu ndi chimodzi mwa zolephera za phunziroli.
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Nthawi yotumiza: Sep-18-2023