Ðe ʋu si le wò ta me la do zi kpataa? (Pituitary Apoplexy) Mina míanɔ ŋudzɔ!

Ðe ta ɖu wò kpata, si nu sẽ ŋutɔ, wò ŋku megakpɔa nu nyuie o, èkpɔa nu zi eve, alo wò ŋkume gbã kpɔa? Togbɔ be esia mebɔ o hã la, nu vevi aɖe ate ŋu anɔ megbe nɛ. Emae nye nɔnɔme kpata si ŋu míele nu ƒom tsoe egbea, si woyɔna be ``Pituitary Apoplexy''. Mègavɔ̃ o, mina míaƒo nu tso nya sia ŋu bɔbɔe.

Nukae Nye Pituitary Apoplexy?

Kpuie ko la, `(Pituitary Apoplexy)` nye nɔnɔme si me ʋu ƒe sisi yi pituitary gland , si nye lãkusi sue aɖe le míaƒe ahɔhɔ̃ me, nu tsona zi ɖeka (i.e., ʋu ƒe sisi xe), alo ʋu dona le lãkusia me (`(Hemorrhage)`). Esia ate ŋu anye nɔnɔme sesẽ aɖe, eyata ɣeyiɣi aɖewo li siwo me wòhiãna be woawɔ atike na ame kpata .

Eyata nukae nye pituitary gland sia?

Bu eŋu kpɔ, le míaƒe ahɔhɔ̃ titina tututu, le míaƒe ŋɔti ƒe tɔdzisasrã megbe la, lãkusi sue aɖe si lolo abe pea ene la le afima. Emae nye nusi míeyɔna be pituitary gland. Esia nye lãkusi vevi siwo le míaƒe ŋutilã ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ me la dometɔ ɖeka . Eyae nye esi wɔa lãmetsiŋusẽ siwo nye atikewo ƒe dɔla siwo wɔa dɔ vevi aɖe ŋutɔ le míaƒe ŋutilã me hekpɔa wo dzi.

Míaƒe ŋutilã ƒe dɔwɔwɔ geɖe nɔ te ɖe lãmetsiŋusẽ siawo dzi. Kpɔɖeŋu ʋɛ aɖewoe nye esi:

• Míaƒe ʋu ƒe sisi dzi ɖuɖu .
• Vidzidzi kple gbɔdɔdɔ ƒe dɔwɔwɔ.
• Ŋutilã ƒe tsitsi kple eƒe tsitsi.

Lãmetsiŋusẽ siwo pituitary gland ɖena dona la ɖoa dzesiwo ɖe lãmenugbagbeviwo ƒe lãkusi bubuwo be woawɔ woƒe lãmetsiwo. Ewɔa nu abe aʋafia sue aɖe ene le míaƒe ŋutilã me.

Nukae nye Pituitary Adenoma?

Zi geɖe la, nɔnɔme sia si woyɔna be ``Pituitary Apoplexy'' dzɔna le amesiwo ŋu dɔdzẽ nyui (si menye kansa o) le le pituitary gland me, si nye ``Pituitary Adenoma''.

Ke hã, ame geɖe menya gɔ̃ hã be `(Pituitary Adenoma)` le yewo ŋu o. Ɣeaɖewoɣi la, wokpɔa dɔdzẽ sia le vome le `(Imaging Test)` si wowɔ le susu bubu aɖe ta me. Le ame aɖewo gome la, nɔnɔme sia si woyɔna be `(Pituitary Apoplexy)` nye dzesi gbãtɔ si fia be `(Pituitary Adenoma)` le wo ŋu.

Ne wole ``Pituitary Adenomas`` siawo ƒom ɖe hatsotsowo me la, wotu wo ɖe nenye be woɖea lãmetsiwo alo womeɖea wo ɖe go o dzi.

• Dɔdzẽ siwo ɖea lãmetsiŋusẽwo ɖa: Esiawo ate ŋu ana lãmetsi aɖewo nasɔ gbɔ akpa.
• Adrenocorticotropic hormone (ACTH): Esia ʋãa míaƒe adrenal glandwo be woawɔ lãmetsi aɖe si woyɔna be cortisol . Cortisol nye lãmetsi aɖe si kpena ɖe ame ŋu wòwɔa nu ɖe ​​nuteɖeamedzi ŋu, wɔa avu kple dɔlékuiwo, eye wòɖua ʋu ƒe sisi, sukli, kple lãmenugbagbeviwo ƒe dɔwɔwɔ dzi.
• Prolactin:Togbɔ be ekpɔa gome le ŋutilã ƒe dɔwɔwɔ geɖe me hã la, eƒe vevienyenye koŋ na no me lãkusi ƒe tsitsi kple notsi wɔwɔ. Ne edzi ɖe edzi la, ate ŋu ana nyɔnuwo natsi dzinu edziedzi eye wòaɖe gbɔdɔdɔ ƒe dzodzro dzi akpɔtɔ le ŋutsuwo me.
• Tsitsi ƒe Lãmetsiŋusẽ: Ekpɔa ɖeviwo ƒe tsitsi dzi eye wòkpɔa ami, sukli si le ʋu me, kple lãmenugbagbeviwo ɖɔɖɔɖo dzi le ame tsitsiwo me.
• Nonfunctioning Pituitary Adenomas: Esiawo meɖea lãmetsiŋusẽwo ɖe go o. Wokpɔa Pituitary Apoplexy zi geɖe le amesiwo ŋu pituitary adenomas siawo siwo mewɔa dɔ o le ŋu.

Amekae ate ŋu axɔ Pituitary Apoplexy wu?

Nɔnɔme sia ate ŋu adzɔ le ŋutsuwo me wu nyɔnuwo zi gbɔ zi eve. Edzea amesiwo xɔ tso ƒe 37 va ɖo ƒe 58 dzi wu.

Aleke gbegbee nɔnɔme sia bɔe?

Nukpɔsusu vovovowo li ku ɖe alesi Pituitary Adenoma bɔe ŋu. Esia le alea elabena ame geɖe meɖea dzesi aɖeke fiana o. Eŋutinunyalawo ƒe nukpɔsusu si bɔ enye be wobɔ vie. Ame siwo ŋu Pituitary Adenoma le ƒe 2% va ɖo 12% ate ŋu axɔ Pituitary Apoplexy.

Nukawoe nye Pituitary Apoplexy ƒe dzesiwo?

Nɔnɔme sia ƒe dzesiwo nɔ te ɖe:

• Ʋu ƒe dodo ƒe agbɔsɔsɔme.
• Lãmetsi agbɔsɔsɔme si le pituitary gland me si kuna le ʋu ƒe sisi ta.
• Le alesi vuvu (edema) la le nu.

Dzesi si bɔ wue nye taɖuame sesẽ kpata. Ame siwo wu afã hã toa ŋku ƒe kuxiwo me . Esia tso nyaƒoɖeamenu si le dzidzim ɖe edzi ɖe lãmeka siwo tso ahɔhɔ̃a me yia ŋkuwo gbɔ (nukpɔkpɔ ƒe lãmekawo) dzi gbɔ. Esiawo ate ŋu anye:

• Nukpɔkpɔ eve .
• Ŋku ƒe ʋuʋudedi si le gegem ɖe anyi .
• Nukpɔkpɔ ƒe bu keŋkeŋ alo eƒe akpa aɖe le ŋku ɖeka alo evea siaa me.

Dzesi bubuwo tsoa tɔtrɔ siwo vaa ahɔhɔ̃a me gbɔ. Esiawo ate ŋu aɖi ahɔhɔ̃mekawo ƒe dɔléle bubuwo abe taɖuame ene ɣeaɖewoɣi. Dzesi siawo dometɔ aɖewoe nye:

• Tɔtɔ.
• Ðeɖiteameŋu sesẽ.
• Asrã.
• Aɖuɖɔtoe kple ʋuʋudedi.
• Kekeli ƒe seselelãme (Photophobia).

Ðe pituitary apoplexy ate ŋu akpɔ ŋusẽ ɖe lãmetsiŋusẽ ƒe dɔwɔwɔ dzia?

Ẽ, keŋkeŋ. Ne ƒunukpeƒetetedɔ gblẽ la, ekpɔa ŋusẽ ɖe lãmenugbagbeviwo ƒe dɔlékui bubu siwo dzi wòkpɔ ŋusẽ ɖo ƒe dɔwɔwɔ dzi, lãmetsi siwo wowɔna, eye ŋutilãa wɔa dɔ tso lãmetsi mawo dzi.

Lãmetsiŋusẽ ƒe dɔléle si bɔ enye adrenocorticotropic hormone (ACTH) ƒe anyimanɔmanɔ. Esia gblẽa nu le adrenal glands ƒe dɔwɔwɔ ŋu eye ate ŋu ade ame ƒe agbe afɔku me ɣeaɖewoɣi. Eƒe dzesiwo dometɔ aɖewoe nye:

• Ʋu ƒe sisi le lãme na ame (Hypotension).
• Sukli ƒe agbɔsɔsɔ si le ʋu me (Hypoglycemia).
• Sodium ƒe agbɔsɔsɔ si bɔbɔ ɖe ʋu me (Hyponatremia).
• Aɖuɖɔtoe kple ʋuʋudedi.

Nukawoe hea Pituitary Apoplexy vɛ?

Ne míagblɔe tututu la, susu si tututu tae wòle alea ɖo la me mekɔ haɖe o.

Numekuku aɖewo ɖee fia be dɔléleawo ƒe 10% va ɖo 40% do ƒome kple atikewɔwɔ ƒe mɔnu aɖewo, lãmesẽnyawo, kple atikewo. Kpɔɖeŋu aɖewoe nye esi:

• Wonaa atike siwo tsia ʋumenugbagbeviɣidɔ nu amesiwo ŋu vein deep thrombosis kple pulmonary embolism le.
• Atike siwo doa ŋusẽ dopamine siwo wozãna na Parkinson ƒe dɔlélea kple afɔ siwo meɖea dzi ɖi o ƒe dɔléle.
• Dɔlékuiwutikewo ƒe dɔwɔwɔ dodokpɔ nye dodokpɔ si wowɔna tsɔ dea dzesi dɔléle siwo le lãmenugbagbeviwo ƒe dɔwɔwɔ me.
• Gonadotropin-releasing hormone (GnRH) dɔdamɔnu, si wonaa nyɔnu aɖewo siwo ŋu no me dɔdzẽ le la ɖea azigolo ƒe dɔwɔwɔ dzi kpɔtɔna.
• Ta ƒe abixɔxɔ (abe anyidzedze, ʋufɔku ene).
• Amekoko, vevietɔ ƒumeŋuɖui kple dzidɔ.

Eŋutinunyalawo gale agbagba dzem be yewoase nusita nu siawo do ƒome kple ``Pituitary Apoplexy ɣeaɖewoɣi.`` Numekuku sia ateŋu akpeɖe ɖɔktawo ŋu woaxe mɔ ɖe apoplexy nɔnɔme sia nu ne wole amesiwo ŋu pituitary adenomas le la dzi kpɔm.

Aleke wokpɔa Pituitary Apoplexy ƒe dɔlélea?

Wò ɖɔkta ado wò kpɔ (Ŋutilãme Dodokpɔ), ada wò dzesiwo kpɔ, eye wòaɖe gbe be woawɔ dodokpɔwo abe (Nɔnɔmetata Dodokpɔwo) ene.

Le alesi wò dɔlélea nu sẽe nu la, ahiã be woawɔ atike na wò kpata . Le xɔ si me wokpɔa dɔnɔwo gbɔ kpata le me la, ɖɔktawo awɔ CT-dɔdamɔnu elabena ate ŋu ana woakpɔ dɔlélea kaba eye wòaɖe nɔnɔme bubuwo abe ʋusɔgbɔdɔ ene ɖa. Gake ne ɣeyiɣia ɖe mɔ la, MRI ye nye tiatia nyuitɔ kekeake. Ate ŋu ana nyatakaka tsitotsito wu tso nusiwo gblẽ le pituitary gland ŋu.

Aleke wodaa Pituitary Apoplexy ƒe dɔléleae?

Atikewo kple amekokowo li abe esia ƒe atike ene.

Corticosteroids (atike siwo woano) hiã vevie be woatsɔ axe mɔ ɖe adrenocorticotropic hormone (ACTH) ƒe anyimanɔmanɔ nu. Zi geɖe la, dɔnɔwo ƒe lãme sẽna ne wozã atikewo.

Gake ne wò dzesiawo gagblẽ ɖe edzi la, wò ɖɔkta ate ŋu aɖo aɖaŋu be nàwɔ dɔ na wò . Zi geɖe la, wozãa mɔnu si me womedea ame dzi boo o tsɔ wɔa esiae. Ema fia be wò ɖɔkta awɔ:

• Woade mɔ̃ sue aɖe wò ŋɔti ɖeka me.
• Wowɔa do sue aɖe ɖe ƒua me si ma ŋɔti kple ahɔhɔ̃a dome.
• Wodea fotoɖemɔ̃ aɖe to mɔ̃ ma me eye wodoa dɔdzẽa kpɔna.
• Emegbe, woɖea dɔdzẽa alo lãkusi si gblẽ la to mɔ̃ ma dzi.

Woyɔa mɔnu sia be amekoko to no me.Wogayɔnae be `(Transnasal surgery)`.

Ðe mate ŋu axe mɔ ɖe Pituitary Apoplexy nua?

Nublanuitɔe la, mɔ aɖeke meli si ŋu kakaɖedzi le si dzi woato axe mɔ ɖe nɔnɔme sia nu o.

Gake ne ``Pituitary Adenoma'' le ŋuwò la, ele be nànya alesi apoplexy nɔnɔme sia ate ŋu adzɔ. Ne taɖuame sesẽ aɖe le ŋuwò kasia alo wò ŋku trɔ la, di atikewɔwɔ kpata enumake.

Nukae nye Pituitary Apoplexy ƒe mɔkpɔkpɔ?

Ele vevie ŋutɔ be woakpɔ dɔlélea kaba eye woadze edada gɔme . Ame siwo kuna le nɔnɔme sia ta anɔ abe 2% ene.

Le ame geɖe gome la, woate ŋu ana ŋku ƒe kuxiwo nanyo ɖe edzi ne wozã atike alo amekoko. Wogakpɔa nu bliboe le nɔnɔme siwo ade 40% me. Gake ame siwo ade 80% hiã na lãmetsiŋusẽtikewo zazã ɣeyiɣi didi . Esia le alea elabena pituitary gland la mewɔa dɔ nyuie o. Lãmetsiŋusẽtike sia le mɔ vovovowo nu:

• Gel ƒomeviwo.
• Atike siwo wodona ɖe lãme na ame.
• Elɔ̃na le nu me.
• Atike siwo wotsɔna ƒua gbe ɖe ŋɔti me.
• Patchwo ƒe akpa aɖewo.
• Pellets siwo wotsɔ dea ŋutigbalẽa te.
• Atikekui siwo wozãna edziedzi.

Ne Pituitary Apoplexy le ŋuwò kpɔ la, ahiã be atikewɔlawo nayi edzi akpɔ dziwò (Follow-up care). Esiawo dometɔ aɖewoe nye:

• Da wò ŋutega kpɔ.
• Kpɔ egbɔ be woɖe dɔdzẽa ɖa keŋkeŋ.
• Lé ŋku ɖe wò lãmetsiŋusẽ ƒe agbɔsɔsɔ ŋu.

Ɣekaɣie wòle be mayi xɔ si me wowɔa dɔ kpata le?

Di atikewɔla kpata enumake ne ŋku ƒe kuxi yeyewo alo taɖuame sesẽ kpata . Ame aɖewo ɖɔ taɖuame sia be enye "taɖuame vɔ̃ɖitɔ kekeake si mekpɔ kpɔ."

Esi wònye be Pituitary Apoplexy va dona kpata ta la, ele vevie be nàwɔ nu kaba ne dzesiwo abe taɖuame sesẽ kple ŋku ƒe tɔtrɔ ene le ŋuwò.

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata fifia èse nusi ŋu míeƒo nu tsoe, Pituitary Apoplexy, gɔme nyuie wu. Ðo ŋku edzi be nɔnɔme sia nye esi dzɔna kpata. Gake nya nyuiae nye be atike aɖe li na esia. Zi geɖe la, atikewɔwɔ ate ŋu ana ame nakpɔ nu ake. Gake ame geɖe ate ŋu axɔ lãmetsiŋusẽ ƒe dɔmawɔmawɔ nyuie ɣeyiɣi didi.

Eyata wò ɖɔkta ƒe mɔfiamewo dzi wɔwɔ, ɖɔkta gbɔ yiyi ɖe game dzi, kple atike si woŋlɔ na wò zazã akpe ɖe ŋuwò nàɖu wò lãmetsiŋusẽ ƒe agbɔsɔsɔ dzi eye nàlé agbe nyui me ɖe asi. Mègatsi dzodzodzoe o, gake ne èkpɔ dzesi siawo dometɔ aɖe la, kpɔ egbɔ be yedi atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

` Pituitary apoplexy, pituitary gland, lãmetsiwo, taɖuame, ŋku ƒe kuxiwo, ahɔhɔ̃ me ʋu ƒe dodo, pituitary tumors