—–Le ndatshana ikopishwe kusukaMedpageNamuhla
Ukukhipha kokubili amaqanda ngaphambi kokuya esikhathini kuhlotshaniswa namathuba aphezulu okuba nezinkinga zempilo ezingapheli kanye nokuncipha kokusebenza komzimba ngemva kweminyaka eminingi, ikakhulukazi kwabesifazane abahlinzwa ngaphambili, ucwaningo oluhlukene lwathola.
Uma kuqhathaniswa neqembu elimataniswa neminyaka yobudala, abesifazane abangaphansi kweminyaka engama-46 abahlinzekwe i-oophorectomy (PBO) ye-premenopausal bilateral (PBO) yezimo ezingezona eziyingozi-noma ngaphandle kwe-hysterectomy-basebenze kahle ekuhlolweni kokuhamba imizuzu eyisithupha okwenziwa emtholampilo weziguli ezingalalisiwe emashumini amabili eminyaka kamuva futhi kwakungenzeka kakhulu. ukuba nezimo ezingapheli:
Isifuba somoya: noma 1.74 (95% CI 1.03-2.93)
Isifo samathambo: noma 1.64 (95% CI 1.06-2.55)
I-apnea evimbela ukulala: noma 2.00 (95% CI 1.23-3.26)
Ukuphuka: noma 2.86 (95% CI 1.17-6.98)
"Le miphumela iqokomisa imiphumela emibi engaba khona yesikhathi eside ye-oophorectomy kwabesifazane abanezimpawu ezimbi noma abangenazo i-ovarian abasengozini yofuzo yomdlavuza wesibeletho," kuphetha abacwaningi abaholwa nguMichelle Mielke, MD, PhD, we-Wake Forest University School of Umuthi eWinston-Salem, NC, esihlokweni esithi Menopause.Le miphumela ibalulekile uma kucutshungulwa ukuthi kufanele kwenziwe yini i-ovariectomy (PBO) kanye ne-hysterectomy.
UStephanie Faubion, MD, MBA, umqondisi wezokwelapha we-Menopause Society, uthe okutholakele, okuncike ku-Tubectomy yeMayo Clinic kanye ne-Aging Cohort Study-2 (MOA-2), iqinisekisa isidingo sokuthi odokotela bashintshe imikhuba yabo.
"Lokhu kwengeza ezincwadini ezikhona zokuthi ukususa ama-ovari esemncane, ikakhulukazi ngaphansi kweminyaka engama-46, kuhlotshaniswa nemiphumela emibi yezempilo," kusho uFaubion etshela iMedPage Namuhla.Kuleli qophelo, ngicabanga ukuthi kufanele sithathe isinyathelo. ”
UFaubion, ophinde abe ngumqondisi weSikhungo Sezempilo Yabesifazane eMayo Clinic eRochester, eMinnesota, kodwa obengahlanganyeli ocwaningweni lwamanje, uthe ukushada kamuva (abesifazane abaneminyaka ephakathi kuka-46 no-49) nakho “akukona ukushada. umqondo omuhle,” ngokocwaningo.Kuleli qembu, kube nezingqinamba ezikhulayo ze-arthritis kanye ne-apnea yokulala uma kuqhathaniswa nontanga yabo ehambisana neminyaka yobudala, futhi i-PBO iholele kumathuba aphezulu okuba nesifo samaphaphu esingapheli kulo lonke iqembu.
Eqenjini le-PBO, cishe amaphesenti angu-90 nawo athola i-hysterectomy, kanti amaphesenti angu-6 ayene-hysterectomy ngaphambi kwalokho;eqenjini lereferensi elihambisana neminyaka elingazange lithole i-PBO, amaphesenti angu-9 ayene-hysterectomy.
U-Mielke utshele i-MedPage Namuhla ukuthi ukukhipha ama-ovari ngesikhathi se-hysterectomy (ukuhlinzwa kwesibili okuvame kakhulu kwabesifazane) kuwumkhuba ovamile kwabesifazane, ngokwengxenye ngoba kuqeda ingozi yomdlavuza we-ovarian.
“Ngokomlando,” kuchaza uMelke, “kwakunenkolelo yokuthi lapho isibeletho sesikhishiwe, lalingeke lisaba khona ikhono lokuzala, futhi ngenxa yalokho sasingeke sibe khona isidingo sokukhipha izindlala ezikhiqiza amaqanda.”Nokho, ngokuhamba kwesikhathi, ucwaningo olwengeziwe luye lwabonisa ukuthi ukukhipha kokubili amaqanda ngaphambi kokuya esikhathini kungase kube nemiphumela yesikhathi eside noma izingozi zesikhathi eside zezinye izifo.
Uma ama-ovari ekhishwa ngaphambi kokunqamuka kokuya esikhathini kwemvelo, uMilk uthe, “kutuswa kakhulu” ukuthi abesifazane bahlale besebenzisa i-estrogen therapy kuze kube iminyaka engu-50.
Abacwaningi baqaphele ukuthi ucwaningo lwamanje lubandakanya ukuhlolwa okuphelele komuntu siqu kwabesifazane abanomlando oqoshiwe we-PBO, kuyilapho ezinye izifundo ze-PBO nemiphumela yezempilo zithembele ikakhulukazi ekuqoqweni okungenzi lutho kwemiphumela evela kumarekhodi ezokwelapha, zehluleka ukubamba "izizinda ezithile. yokusebenza komzimba noma ezinye izinyathelo ezihlobene nokuguga.”
Imininingwane yocwaningo
U-Mielke nozakwabo basebenzise idatha evela ku-Rochester Epidemiology Project's (REP) Medical Record Linkage System kanye nocwaningo lwe-MOA-2, oluhlonze abesifazane e-Olmsted County, Minnesota, abelashelwa i-PBO ngenxa yezimo ezingezinhle phakathi kuka-1988 no-2007 futhi ababengekho. ingozi enkulu yomdlavuza wesibeletho.Abahlanganyeli be-MOA-2 baqhathaniswa neqembu lereferensi labesifazane abangazange bathole i-PBO babhangqwe neqembu eliyinkomba labesifazane abangazange bathole i-PBO.
Kusukela ngo-2018, lapho kuqala isifundo sobuso nobuso, iningi lalabo abaku-PBO kanye namaqembu okubhekisela kuwo babesaphila (91.6% kanye ne-93.1%, ngokulandelana).
Ithimba labacwaningi liqashe abesifazane abakhuluma isiNgisi abangama-274 abavela ku-MOA-2 abalandelelwa mathupha ne-PBO ngemva kweminyaka engu-22 ephakathi, kuhlanganise neziguli ezingu-161 ezenze inqubo ngaphambi kwesikhathi (ngaphambi kweminyaka engu-46) (59%) kanye neziguli ezingu-113. owenze inqubo sekwephuzile (abaneminyaka engama-46 kuya kwengama-49) (41%).
Ababambiqhaza kwakudingeka babe neminyaka engu-55 ubudala noma ngaphezulu ekubhaliseni futhi bakhishwe uma i-pathology ibonisa ukonakala ku-PBO yabo noma uma bengazange babonwe ku-REP eminyakeni engu-5 edlule.Babemataniswa neminyaka yabahlanganyeli be-240 eqenjini lezithenjwa ababengenayo i-PBO.
Sekukonke, abesifazane babeneminyaka ephakathi kwengama-67, babemhlophe ngo-97% -99%, futhi cishe u-60% babengakaze babheme.
Izifo ezingamahlalakhona zahlolwa ngamarekhodi ezokwelapha.Ngaphandle kwezinhlangano ezishiwo ngaphambili, abacwaningi abazange bathole noma yiziphi izinhlangano phakathi kwe-PBO nomdlavuza, isifo sikashukela, ukuwohloka komqondo, umfutho wegazi ophakeme, i-hyperlipidemia, i-cardiac arrhythmia, izinso, i-thyroid, noma isifo sesibindi, i-osteoporosis, noma ukuhlasela kwe-ischemic yesikhashana.
Ukuhlolwa ngokomzimba kwakuhlanganisa nezilinganiso zamandla nokuhamba.Uma kuqhathaniswa neqembu lereferensi elimataniswa neminyaka yobudala, abesifazane abathola i-PBO babenesilinganiso esiphezulu samafutha egilo/i-pteronavicular futhi benza kabi ekuhlolweni kokuhamba kwemizuzu engu-6 (-14 amamitha), kuyilapho abesifazane abadlule i-PBO yokuqala benza kangcono ngemizuzu engu-6. isivivinyo sokuhamba (-18 amamitha).Abesifazane abaseqenjini le-PBO elingasekho babenesilinganiso esiphezulu sephesenti lesisindo samafutha, i-appendicular lean mass, kanye nokuminyana kwamaminerali amathambo omgogodla uma kuqhathaniswa neqembu lereferensi.
U-Mielke nozakwabo baphawule ukuthi ngenxa yokuthi ucwaningo belunezigaba ezihlukene, i-causality ayikwazanga ukuchazwa, futhi kunconywa izifundo ze-longitudinal.Baphinde baphawula ukuthi abesifazane ababambe iqhaza kulolu cwaningo kungenzeka ukuthi babephile saka uma kuqhathaniswa nomphakathi jikelele futhi bakhomba ukudlondlobala kwabamhlophe njengeminye yemikhawulo yocwaningo.
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Isikhathi sokuthumela: Sep-18-2023