—–Eli nqaku likhutshelwe ukusukaMedpageNamhlanje
Ukususa zombini ii-ovari ngaphambi kokuyeka ukuya exesheni kunxulunyaniswa nokuba nokwenzeka okuphezulu kweengxaki zempilo ezingapheliyo kunye nokuncipha kokusebenza komzimba kwiminyaka kamva, ngakumbi kubasetyhini abaye benza utyando ngaphambili, isifundo esinqamlezayo sifunyenwe.
Xa kuthelekiswa neqela elihambelana nobudala, abasetyhini abangaphantsi kweminyaka engama-46 abaye benza i-oophorectomy ye-premenopausal bilateral (PBO) kwiimeko ezingezizo-kunye okanye ngaphandle kwe-hysterectomy-baqhube kakuhle kuvavanyo lokuhamba lwemizuzu emithandathu oluqhutywa kwiklinikhi yezigulane ezingalaliswanga kumashumi amabini eminyaka kamva kwaye kwakunokwenzeka ngakumbi. ukuba nezigulo ezingapheliyo:
Umbefu: okanye 1.74 (95% CI 1.03-2.93)
I-arthritis: okanye i-1.64 (95% CI 1.06-2.55)
I-apnea yokuthintela ukulala: okanye i-2.00 (95% CI 1.23-3.26)
Ukuqhekeka: okanye i-2.86 (95% CI 1.17-6.98)
"Ezi ziphumo zigxininisa iziphumo ezibi zexesha elide ze-oophorectomy kubasetyhini abaneempawu ezintle okanye abangenazo i-ovarian abasengozini yomhlaza we-ovarian," baqukumbela abaphandi abakhokelwa nguMichelle Mielke, MD, PhD, we-Wake Forest University School of Iyeza eWinston-Salem, NC, kwinqaku elithi Menopause.Ezi ziphumo zibalulekile xa kucingwa ukuba ngaba i-ovariectomy (PBO) kunye ne-hysterectomy.
UStephanie Faubion, MD, MBA, umlawuli wezonyango we-Menopause Society, uthe iziphumo, ezixhomekeke kwi-Tubectomy ye-Mayo Clinic kunye ne-Aging Cohort Study-2 (MOA-2), iqinisekisa imfuneko yokuba oogqirha batshintshe izenzo zabo.
"Oku kongeza nje kuncwadi olukhoyo olususa ama-ovari emncinci, ngakumbi iminyaka engaphantsi kwe-46, inxulunyaniswa neziphumo zempilo ezimbi," uFaubion uxelele iMedPage Namhlanje.Okwangoku, ndicinga ukuba kufuneka sithathe inyathelo. ”
UFaubion, okwangumalathisi weZiko lezeMpilo yabasetyhini kwiKliniki yaseMayo eRochester, eMinnesota, kodwa owayengabandakanyekanga kuphononongo lwangoku, wathi ukutshata kamva (abafazi abaphakathi kweminyaka engama-46 nama-49 ubudala) nako “akuyondlwan’ iyanetha. umbono olungileyo,” ngokutsho kophononongo.Kweli qela, kukho ukwanda kwamathuba e-arthritis kunye ne-apnea yokulala xa kuthelekiswa neontanga zabo ezihambelana nobudala, kwaye i-PBO yakhokelela kumngcipheko ophezulu wesifo esingapheliyo se-pulmonary kwi-cohort yonke.
Kwiqela le-PBO, malunga neepesenti ze-90 nazo zafumana i-hysterectomy, kwaye i-6 ipesenti yayine-hysterectomy ngaphambi koko;kwiqela lereferensi elihambelana neminyaka elingazange lingene kwi-PBO, ipesenti ze-9 zine-hysterectomy.
U-Mielke utshele i-MedPage Namhlanje ukuba ukususa ama-ovari ngexesha le-hysterectomy (utyando lwesibini oluqhelekileyo lwabasetyhini) luyinto eqhelekileyo kubasetyhini, ngenxa yokuba kuphelisa umngcipheko womhlaza we-ovari.
UMelke ucacisa esithi: “Ngokwembali kwakukholelwa ukuba emva kokuba isibeleko sisusiwe, akusayi kuphinda kubekho amandla okuzala, yaye ngenxa yoko kwakungayi kubakho mfuneko yokukhupha amaqanda.”Nangona kunjalo, ekuhambeni kwexesha, uphando oluninzi lubonise ukuba ukususa zombini ii-ovari ngaphambi kokuyeka ukuya esikhathini kunokuba nemiphumo ehlala ixesha elide okanye imingcipheko yexesha elide yezinye izifo.
Ukuba ii-ovari ziyasuswa ngaphambi kokuyeka ukuya exesheni kwendalo, ubisi uthe, “kucetyiswa ngamandla” ukuba abasetyhini bahlale kunyango lwe-estrogen de babe neminyaka engama-50.
Abaphandi baqaphele ukuba uphononongo lwangoku lubandakanya uvavanyo olubanzi lomntu ngokwasemzimbeni wabasetyhini abanembali ebhaliweyo ye-PBO, ngelixa ezinye izifundo kwi-PBO kunye neziphumo zempilo ziye zathembela ngokuyintloko ekuqokeleleni iziphumo ezivela kwiirekhodi zonyango, zisilela ukubamba "imimandla ethile. yokusebenza komzimba okanye amanye amanyathelo anxulumene nokwaluphala.
Iinkcukacha zokufunda
U-Mielke kunye noogxa basebenzise idatha evela kwiProjekthi ye-Rochester Epidemiology Project's (REP) yeNkqubo yoQhagamshelwano lwezoNyango kunye nesifundo se-MOA-2, esichonge abafazi base-Olmsted County, eMinnesota, abaye baphathwa nge-PBO kwiimeko ezingezizo phakathi kwe-1988 kunye ne-2007 kwaye babengekho. ingozi enkulu yomhlaza we-ovari.Abathathi-nxaxheba be-MOA-2 bafaniswa neqela elibhekiselele labasetyhini abangazange bafumane i-PBO badityaniswe neqela elibhekiselele labasetyhini abangazange bafumane i-PBO.
Ukususela kwi-2018, xa uphando olujongene nobuso luqala, uninzi lwaba kwi-PBO kunye namaqela okubhekisela ayesaphila (91.6% kunye ne-93.1%, ngokulandelanayo).
Iqela lophando laqesha abafazi be-274 abathetha isiNgesi abavela kwi-MOA-2 abaye bafumana ulandelelwano lomntu kunye ne-PBO emva kweminyaka eyi-22, kubandakanywa nezigulane ze-161 eziye zaqhuba inkqubo kwangaphambili (ngaphambi kweminyaka eyi-46) (59%) kunye nezigulane ze-113. abathe balandela inkqubo emva kwexesha (abaneminyaka engama-46 ukuya kuma-49) (41%).
Abathathi-nxaxheba babefanele babe neminyaka eyi-55 ubudala okanye ngaphezulu ekubhaliseni kwaye babengabandakanywa ukuba i-pathology ibonise ubugwenxa kwi-PBO yabo okanye ukuba ayizange ibonwe kwi-REP kwiminyaka eyi-5 edlulileyo.Baye bahambelana nobudala kubathathi-nxaxheba be-240 kwiqela lereferensi ababengenayo i-PBO.
Ngokubanzi, abasetyhini babeneminyaka yobudala engama-67 ubudala, bengama-97% -99% abamhlophe, kwaye malunga ne-60% abazange batshaye.
Izifo ezingapheliyo zavavanywa ngeerekhodi zonyango.Ukongeza kwimibutho ekhankanywe ngaphambili, abaphandi abazange bafumane nayiphi na imibutho phakathi kwe-PBO kunye nomhlaza, isifo sikashukela, isifo sengqondo esixhalabisayo, i-hypertension, i-hyperlipidemia, i-cardiac arrhythmia, intso, i-thyroid, okanye isifo sesibindi, i-osteoporosis, okanye ukuhlaselwa kwe-ischemic yesikhashana.
Uvavanyo lomzimba lwalubandakanya imilinganiselo yamandla kunye nokuhamba.Xa kuthelekiswa neqela lereferensi elihambelana neminyaka, abafazi abaye bafumana i-PBO babenomlinganiselo ophezulu we-thyroid / pteronavicular fat ratio kwaye baqhuba kakubi kwi-6-minute yovavanyo lokuhamba (-14 metres), kanti abafazi abahamba phambili kwi-PBO benza ngcono kwi-6-minute. uvavanyo lokuhamba (-18 yeemitha).Abasetyhini abakwiqela le-PBO lokugqibela babenomlinganiselo ophezulu weepesenti zamafutha, ubunzima be-appendicular lean, kunye ne-spinal bone mineral density xa kuthelekiswa neqela lereferensi.
U-Mielke kunye noogxa bakhe baqaphele ukuba ngenxa yokuba isifundo sasinqamlekileyo, i-causality ayinakuchazwa, kwaye izifundo ze-longitudinal zinconywa.Baphinde baqaphela ukuba abafazi abathathe inxaxheba kuphononongo banokuthi babe nempilo kunabantu ngokubanzi kwaye bakhomba ukugqithiswa kwabamhlophe njengenye yemida yophando.
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Ixesha lokuposa: Sep-18-2023