Hypopituitarism: izimpawu, izindlela ukuxilongwa kanye nokwelashwa

Hypopituitarism, izimpawu zazo ngokungabi bikho uphethwe ngalokulingene anga kudidaniswe izimpawu nezinye pathologies sina, ukuphazamiseka ezingavamile indlala pituitary. Kulesi sifo, pituitary indlala noma yenza amahomoni okunganele, noma musa ukukhiqiza eyodwa noma ngaphezulu amahomoni ezidingekile ukusebenza evamile umzimba womuntu.

Pituitary indlala - a, indlala encane emabhontjisi emise sise esesiqwini sobuchopho, ngemuva ekhaleni futhi phakathi ezindlebeni. Naphezu ubukhulu elincane, le ndlala eyenza umsebenzi obalulekile: ilawula ukusebenza kwe-imfihlo kwezitho cishe yonke yangaphakathi nezitho zomzimba. imisebenzi Wokulawula wenziwa hormone - ukuntuleka kubo kungase kubonise hypopituitarism. Izimpawu ezinganeni kuthiwa Ngokuvamile ubonakaliswa isimo sengqondo ngesimo ukungakhuli kahle nokuthuthukiswa ngokomzimba, abadala - ayephuli blood pressure kanye umsebenzi zokuzala.

Kwangathi zibekelwe isikhathi esithile ekwakhiweni kokutshelwa ngokukhubazeka kwengane uphuza imithi, kodwa izimpawu zesifo ingagcinwa ngaphansi kokulawula.

izimpawu

zokugula ihlaziye ezimweni eziningi kuchubekele embili ngokwemvelo. It is hhayi njalo udokotela ngokushesha ukuxilonga "hypopituitarism": izimpawu ezinganeni nakubantu abadala ungakwazi kokubili kwenzeka ngokuzuma noma kancane kancane eminyakeni eminingana. Ngokuvamile izimpawu zokuguga futhi enza uhlamvu oluncane ukuze isiguli isikhathi eside nje akazange akhokhe sibanake ngokwanele.

Ngezimpawu zesifo iyashiyana ngesikhathi hormone okuthiwa awunazo umzimba ngenxa pituitary ukungasebenzi. Ngaphezu kwalokho, kubalulekile ukuthi abukhali ukungabi into ethize. Isiguli bangezwa:

• umuzwa ukukhathala okungamahlalakhona;
• kwehle libido;
• anda ukuzwela okushisa aphansi, abandayo;
• esesuthi ukulahlekelwa.

Ngaphezu kwalezi emizweni izimpawu zokugula yilezi:

• ukuncipha komzimba ngokungenasizathu;
• puffiness ebusweni;
• anaemia;
• ukungazali;
• abesifazane - komzimba, esikhathini okungajwayelekile, noma itlhogeko, pubic nezinwele, ukungakwazi nasekwenzeni ubisi lwebele lokondla izinsana;
• wesilisa - iqothukile ezikhulayo ebusweni noma umzimba;
• izingane - ukukhula ongaphakeme.

Lapho ukubona udokotela

Uma usola at hypopituitarism, izimpawu ezibalwe ngenhla, ukuhlela kokubonisana lukachwepheshe ofanelekayo.

Uxhumane nodokotela wakho ngokushesha uma kukhona izimpawu zesifo avela ngokuphazima kweso noma ahambisana ubuhlungu bekhanda, angaboni kahle, disorientation ngesikhathi nendawo, noma ukwehla elibukhali blood pressure. Lena akuyona hypopituitarism - izimpawu walolu hlobo kungase kubonise ukuthi le ndlala pituitary wembula ukufohla ukopha (apoplexy), okudinga kokungenela kokulashwa okusheshayo.

izizathu

Lesi sifo kungadalwa kwasekuzalweni, kodwa ngokuvamile uthenge. Ezimweni eziningi, hypopituitarism okubangwa isimila pituitary. Njengoba isimila ekubeni mkhulu, ekucindezela nezicubu umonakalo emzimbeni, nokuba nomphumela omubi phezu ukukhiqizwa kwama-hormone. Ngaphezu kwalokho, isimila kungaba cindezela nezinzwa optic, kanjalo okubangela ezihlukahlukene iziyaluyalu futhi babone izinto ezingekho.

Ezinye izifo, kanye kwezimo ezithile futhi kungalimaza indlala pituitary futhi inhlamvu hypopituitarism (izimpawu, izithombe sethula kulesi sihloko). Ngezimpawu zesifo iyashiyana ezicini kwabangela ukuthuthukiswa zokugula. Lezi zinto zibandakanya:

• ikhanda ukuhlukumezeka;
• Brain noma pituitary isimila;
• imisebenzi kuhlinzwa ebuchosheni;
• Izindlela zokwelapha ngaphandle radiotherapy;
• ukuvuvukala sokuhlasela kwamasosha omzimba (hypophysis);
• unhlangothi;
• izifo ezithathelwanayo ubuchopho (isb meningitis);
• sofuba;
• izifo infiltrative (sarcoidosis - ukuvuvukala kwezitho zomzimba eziningana yangaphakathi, Langerhans cell histiocytosis - ukuphazamiseka lapho amaseli angavamile kubangele izibazi kwezitho zomzimba ahlukahlukene nezitho zomzimba, ikakhulukazi amaphaphu namathambo; hemochromatosis - ekuqongeleleni ngokweqile yensimbi esibindini nezinye izicubu);
• elikhulu ukopha ngesikhathi beteta, okungase kulimaze pituitary anterior (Simmonds izifo Glinski noma kwangemva kokubeletha pituitary necrosis);
• ukuguquka kwezakhi zofuzo ezaholela ukwephula ekukhiqizweni kwama-hormone e indlala pituitary;
• isifo hypothalamic - isinqamu ubuchopho, esemgwaqweni ngenhla nje indlala pituitary - ingabagulisa hypopituitarism.

Izimpawu (isithombe ibonisa inqubo isifo) ziphakame ngoba le ngxenye amahomoni ayo esilawula ukusebenza "engumakhelwane" ndlala emabhontjisi emise.

Kwezinye izimo, nesisekelo sifo ayikaziwa.

Ngaphambi Ukuvakashela udokotela

Isinyathelo sokuqala ukuba ungenele babonisana yezokwelapha nodokotela. Uma kunesidingo, kuyokudlulisela onguchwepheshe iziyaluyalu hormone - the endocrinology.

• Thola kusengaphambili ukuthi udinga nanoma yiziphi imfuneko ukuqinisekisa ukunemba sivivinyo seluhlololucwaningo.
• Yenza uhlu eningilizayo yazo zonke lezi zimpawu isifo ukuthi nigcina ekhaya. Uma usola hypopituitarism, izimpawu zesifo, Uma unganakile ezingahlobene pituitary ukungasebenzi, futhi kufanele kulolu hla.
• ngokubhala ukulungisa idatha key siqu, kuhlanganise nezinguquko ezinkulu empilweni noma abalulekile eshintsha ikhono lakho lokusingatha lokhu kucindezeleka.
• Rekhoda ulwazi oluyisisekelo zempilo, ezihlanganisa ukuhlinzwa yamuva, izihloko njalo kuthatha izidakamizwa kanye nezifo ezingamahlala khona. Udokotela Uyofuna ukwazi uma zidluliselwa yamuva ukulimala ekhanda.
• Letha ilungu lomndeni noma umngane ngeke nje uzimisele ukuhlinzeka ukwesekwa zokuziphatha, kodwa futhi ukukusiza ukukhumbula zonke izincomo uchwepheshe.
• Yenza uhlu lwemibuzo ufuna ukucela udokotela wakho.

imibuzo endocrinology

Kungcono ukwenza uhlu isithakazelo kakhulu zemibuzo yakho kusengaphambili ukuba ngesikhathi kokubonisana akufanele sikhohlwe imininingwane ebalulekile. Uma ukhathazekile hypopituitarism (izimpawu kanye zokwelapha izifo unesithakazelo), faka kuhlu lwakho le mibuzo elandelayo:

• Yini eyenza izimpawu isiyaluyalu nayo isimo lwami lwamanje?
• Kungenzeka yini ukuthi izimpawu Isifo esibangelwa omunye?
• Yini kudingeka kudlule luhlolo?
• Ingabe isimo sami yesikhashana noma okungamahlalakhona?
• Yini ukwelashwa Ingabe uncoma ini?
• Koze kube nini udinga ukuthatha imithi Kunconywa?
• Uyobonisa kanjani wena ukusebenza yokwelapha?
• Mina unesifo esingelapheki. Indlela yokuqinisekisa ukwelashwa ngesikhathi esisodwa zonke iziyaluyalu?
• Ingabe kufanele ngingene kuhambisane nanoma iyiphi imikhawulo?
• Ingabe kukhona analogue ebekiwe wena izidakamizwa?
• Ngingathanda ukuthola ukwaziswa okwengeziwe mayelana nokuthi iyiphi hypopituitarism. Izimpawu kanye ukuxilongwa zicacile; lokho izinto mayelana zokwelapha ezihlukahlukene ungakwazi ukweluleka?

Unganqikazi ukucela eminye imibuzo, uma ngesikhathi kokubonisana ufuna ukwazi okuthile Uchwepheshe ethize.

Yini udokotela uthi

Endocrinologist, kuyobe ukukubuza imibuzo eminingi yalo. Phakathi kwabo, cishe, kuyoba okulandelayo:

• Kungani ucabanga unayo hypopituitarism?
• Izimpawu kanye izimbangela zezifo lapho uzithola, bavumelana incazelo sifo izincwadi zezokwelapha ezisekelwe ekwazisweni?
• Ingabe kukhona izimpawu zokugula zashintsha njengoba isikhathi siqhubeka?
• Ingabe uqaphela ongaboni?
• Ingabe nawe uhlushwa zekhanda ezinamandla?
• Uke washintsha ukubukeka kwakho? Mhlawumbe ulahlekelwe isisindo noma bathole ukwehla ivolumu izinwele emzimbeni?
• Uke engasenandaba ocansini? Ingabe umjikelezo wakho kokuya esikhathini washintsha?
• Kungakhathaliseki ukuthi bayahamba ukuphathwa okwamanje? Noma, mhlawumbe, lidlule yokwelapha esikhathini esidlulileko? Yini izifo ziye kwatholakala?
• Ingabe usanda wabeletha ingane?
• Uke wathola kamuva wathola ukulimala ekhanda? Ingabe ukwelashwa neurosurgical abangu ngaphansi?
• Xilonga ukuthi izihlobo zakho eduze pituitary iziyaluyalu noma ukuphazamiseka kwempilo kwama-hormone?
• Ucabangani, kuyasiza ekudambiseni izimpawu?
• Ucabanga ukuthi uyini yakho, kunomthelela eziya ziba zimbi izimpawu?

ukuhlola

Kungakhathaliseki udokotela kungaba washeshe wasola hypopituitarism? Izimpawu kanye ebangela isimo sakho okungenamsoco push Uchwepheshe othile akubeka, lokhu uphethwe kokuqala, ukuze uqinisekise ukuthi ufuna kudlule kokuhlolwa kaningana ukunquma izinga lama-hormone ezihlukahlukene emzimbeni. Isizathu yokuqondisa kokutshelwa ngokukhubazeka kwengane singasebenza njengesisekelo esiqinile sokufinyelela yamuva ukulimala ekhanda noma inkambo ephelele radiotherapy - Ngaphandle kwalezi zici eziyingozi ziyakwazi impela kungaholela ekwakhiweni kwalesi sifo.

Inombolo ejwayelekile sivivinyo seluhlololucwaningo zihlanganisa:

• Ukuhlolwa kwegazi. Kuqhathaniswa ukuhlola okulula kungathola nokuntuleka kwama-hormone athile, esadaleka ngenxa pituitary ukungasebenzi. Ngokwesibonelo, ukuhlolwa kwegazi kungabonwa emazingeni aphansi hormone ekhiqizwa indlala yegilo, cortex adrenal, noma izitho zangasese, - ukuntuleka lezi zinto ngokuvamile uhlanganiswa ukusebenza kahle kwe-ndlala pituitary.
• Ukukhuthazwa noma ukuhlolwa ashukumisayo. Ngisho ngoba uchwepheshe kunzima ukuqaphela hypopituitarism; izimpawu ingane nhlobo kungase kube khona ukufana izimpawu ezihlukahlukene izifo ezibangelwa ufuzo. Ukuze uthole imiphumela olunembile zokuxilonga, udokotela ngeke cishe ubheke wena kuchwepheshe umtholampilo izifundo endocrinological, lapho uthatha le sipho wokuqala lwemithi ephephile ukuze sikhuthaze ekukhiqizweni kwama-hormone, bese uhlole ukuze ubone ivolumu kanjani lelitfutfukile uketshezi.
• ubuchopho imaging cwaningo. Magnetic resonance imaging (MRI), izithombe zobuchopho kungathola isimila se-pituitary nezinye kwezinso kwesakhiwo.
• Eye izivivinyo. ukuhlolwa Special ukuthi noma ngabe pituitary isimila ukukhula nomthelela ikhono ukubona noma umbono.

ukwelashwa

Hypopituitarism, izimpawu obubekwe ngaphambili futhi achazwe ngenhla, cishe ngaso sonke isikhathi ngenxa kunokuba isifo ahlukile. Ukwelashwa nokuvikelwa impande yawo izimbangela, ezimweni eziningi, aqede zonke izimpawu kuphazamiseka hormone ahlobene ne-ukungasebenzi kwekhono indlala pituitary. Uma kokuqala ukwelashwa ukugula ngasizathu simbe, ekugcineni kwahlaluka ukuthi engenakwenzeka noma ingaphumeleli, ziphathwa elashwe hormone i hypopituitarism. Lapho imiphumela efanayo emzimbeni akuyona ukuphathwa kangaka njengoba esikhundleni izinto ezingekho. Imithamo kufanele ubeke kuphela endocrinology onekhono kakhulu, ngoba kubalwa umuntu ngamunye futhi wambuyisela ngokuqinile labo hormone futhi nenani lapho tiniketwe eSitatimendeni umzimba ube nempilo. replacement therapy eziyohlala phakade.

Uma isimila iye yabangela hypopituitarism, izimpawu, ukwelashwa kanye okwalandela yokwelapha nokuvuselelwa kuzoncika ubunjalo isakhi izimila. Ngokuvamile ebekiwe ukuhlinzwa ukhishwe iseli ongaphilile. Kwezinye izimo, ukwelashwa ngemisebe.

amalungiselelo

Ukuthaka imithi substituents kungenzeka emelelwa imithi ezilandelayo:

• Corticosteroids. Le mithi (izibonelo zingaba hydrocortisone futhi prednisolone) hormone ukufaka endaweni esimweni esejwayelekile ezivezwa cortex adrenal. Abanaso suffice ngenxa ukuntula adrenocorticotropic. Corticosteroids ezithathwe ngomlomo.
• "Levothyroxine" ( "LeVox" et al.). Umuthi ubuyisela hormone yegilo e iziyaluyalu efanele.
• hormone Sex. Njengoba umthetho, ngokuba abantu testosterone kwabesifazane - estrogen noma inhlanganisela estrogen nge progesterone. Uma ucabanga ukuthi unayo hypopituitarism, izimpawu, kanye nokuvimbela izifo indlala pituitary kungase kube khona ukufana izimpawu kanye nezindlela zokugwema izifo ezihlobene hormone ocansini. Uma kwakuphambene nemvelo unomdlavuza udokotela, ukuze esikhundleni olahlekile ama-hormone nemithi esetshenziswayo amafomu ethize: gel noma testosterone umjovo amadoda kanye amaphilisi, si noma nezimagqabhagqabha - kwabesifazane.
• ozokusebenzisa. Ingqikithi ibizwa wezokwelapha wesayensi somatropin nge endocrine neziyaluyalu, engena emzimbeni umjovo ongama. ozokusebenzisa evumela umzimba sikhule, ukuqinisekisa ukukhula evamile ezinganeni. Abadala zimise umjovo ngokuzibona, ngcono isimo jikelele isiguli, kodwa ukukhula evamile ngeke ibuyiselwe.

ukuqapha

I endocrinology uzoqapha amazinga akho hormone egazini, ukuqinisekisa isamba ezanele, kodwa hhayi ngokweqile izinto ezibalulekile.

Ungase udinge ulungise umthamo corticosteroids, uma ugula ubangwa nezibi noma ngeke acindezeleke ngokomzimba okungathí sina. Ngezikhathi ezinjalo, umzimba ukhiqiza i-eminye hormone okuthiwa i-cortisol. Ukushintsha Isikali kungadingwa kulezo zimo, uma umkhuhlane, uzozisola sohudo noma ukuhlanza, noma uzohlupheka ukuhlinzwa noma ukwelashwa kwamazinyo. Iziguli eziningi ebekiwe CT gqwa noma i-MRI.