Ina rongo tātou i te kupu "pukupuku" i roto i ō tātou mahunga, ka mataku tonu te katoa, tika? He mea noa tēnā. Engari ko te mea nui me mārama tātou, ehara i te mea he mate pukupuku ngā pukupuku katoa e tupu ana i roto i te mahunga. I tēnei rā ka kōrero tātou mō tētahi pukupuku e tupu ana i roto i tētahi repe iti i raro i tō tātou roro, engari i te nuinga o te wā ehara i te mate pukupuku. Ka kiia tēnei he pituitary adenoma i roto i te pūtaiao hauora. Nō reira, me kōrero tātou mō tēnei me te taipitopito, me te tino māmā.
Tuatahi, kia titiro tātou, he aha te Pituitary Adenoma?
He kupu ngāwari, he pukupuku te pituitary adenoma e tupu ana i runga i tō repe pituitary. Engari he pukupuku pai . Ko te tikanga kāore e horapa ki ētahi atu wāhanga o te tinana pērā i te mate pukupuku. Engari i te tipu haere o ēnei pukupuku, ka taea e rātou te pēhi i ngā kiko me ngā io e karapoti ana. Ko te wā tēnā ka tīmata te puta o ngā tohu rerekē.
Nā, he aha tēnei repe pituitary?
He repe iti te repe pituitary, he rite ki te wheua, kei raro noa iho i te roro, i muri i te ihu. E hono ana ki te hypothalamus i roto i te roro. E rua ngā wāhanga o tēnei repe iti, ko te lobe o mua me te lobe o muri. Ka whakaputahia e ēnei wāhanga e rua ētahi homoni he mea nui mō tō tātou tinana.
He rite ngā homoni ki ngā karere i roto i ō tātou tinana. Ka haere rātou i roto i te toto, ka tohutohu i ō tātou whekau, uaua, me ētahi atu kiko ki te mahi i ngā mahi maha.
Anei ētahi o ngā homoni matua e whakaputaina ana e te repe pituitary:
- Te homoni Adrenocorticotropic (ACTH)
- Hormone ārai-tiuretika (ADH)
- Te homoni whakaoho follicle (FSH)
- Homoni tipu (GH)
- Hormone Luteinizing (LH)
- Oxytocin
- Prolactin
- Te homoni whakaoho tairoi (TSH)
Waihoki, ka tukuna e te repe pituitary he tohu ki ētahi atu repe endocrine i roto i tō tātou tinana kia whakaputa i ngā homoni. He rite ki te tari matua. Nō reira, ina puta he pukupuku i roto i tēnei repe, ka tino rerekē te mahi a tētahi, neke atu rānei o ēnei homoni.
Me pēhea te whakarōpūtanga o ngā adenoma pituitary?
E rua ngā momo matua o ēnei pukupuku e whakarōpūhia ana e ngā tākuta: i runga i te mea ka puta he homoni tāpiri, me te mea hoki ka puta he rahi.
| Te whakarōpūtanga i runga i te hanga homoni | |
|---|---|
| Momo pukupuku | He whakamārama māmā |
| Ngā adenoma mahi (huna) (ngā pukupuku e whakaputa ana i ngā homoni) | Ka whakaputahia e ēnei momo pukupuku ngā homoni pituitary tāpiri. I runga i te nui o te homoni e whakaputaina ana, ka puta pea ngā tohu me ngā āhuatanga rerekē. |
| Ngā adenoma kore mahi (kore e huna) (Ngā pukupuku kore-hormonal) | Kāore ēnei pukupuku e whakaputa homoni. Heoi, i a rātou e tipu ana, ka puta ngā tohu mā te pēhi i ngā io me ngā kiko e karapoti ana. Koinei te momo pukupuku e tino kitea ana. |
| Whakarōpūtia mā te rahi | |
|---|---|
| Momo pukupuku | He whakamārama māmā |
| Ngā microadenoma (Maikoroadenoma) | He nati ēnei he iti iho i te 10 mirimita, arā, 1 henimita te rahi. |
| Ngā Macroadenoma (Adenoma nui) | He pukupuku nui ake ēnei i te 10 mirimita. E rua pea te nui ake o ēnei i ngā microadenomas. Ka taea e ēnei pukupuku nui te kino i te repe pituitary, ka heke iho ngā taumata homoni i raro i te tikanga. Ka kiia tēnei āhuatanga ko te hypopituitarism . |
E kiia ana tēnei he pukupuku roro?
Āe. Ehara te repe pituitary i te wāhanga o te roro, engari he repe endocrine e piri ana ki te roro. Heoi, e whakaaro ana ngā tākuta he pukupuku roro te adenoma pituitary. Tekau ōrau anake o ngā pukupuku e tupu ana i roto i te angaanga e pā ana ki tēnei momo pukupuku.
Ko te mea nui kia maumahara, ahakoa e kiia ana tēnei he "pukupuku roro," ehara i te matepukupuku.
He aha ngā tohu o te adenoma pituitary?
Ka rerekē pea ngā tohu o ēnei pukupuku, ka whakawhirinaki ki ētahi āhuatanga:
- Ahakoa kei te tipu te puku, ā, kei te kino te kiko e karapoti ana, te repe pituitary rānei (e kiia ana tēnei ko te pānga papatipu).
- He pukupuku mahi tēnei e whakaputa ana i ngā homoni, ā, ki te pērā, ko tēhea homoni ka nui rawa te whakaputanga?
Ngā tohu o te pēhanga nā te whakanui o te pukupuku (Mass Effect)
He tino kitea ēnei tohu i roto i ngā macroadenomas (ngā pukupuku nunui).
- Ngā raruraru tirohanga: Koinei te tohu matua. E 40%-60% o ngā tūroro ka pāngia e te ngaronga o te tirohanga (tirohanga pōuri, tirohanga takirua). Nā te mea i te tipu haere o te pukupuku, ka pēhi i te optic chiasm, te wāhi e tūtaki ai ngā io optic mai i ō tātou kanohi. Ka ngaro te tirohanga taha, inā koa i roto i ngā kanohi .
- Ānini: Ka puta te ānini i te pēhitanga o te pukupuku ki ngā kiko e karapoti ana. Heoi, nā te mea he tino noa te ānini, ka puta anō hoki mō ētahi atu take.
- Te ngoikore o te pituitary gland: Ka taea e te pukupuku nui te kino i ngā pūtau o te repe pituitary gland, ka whakaiti i te hanga o tētahi, neke atu rānei o ngā homoni. He rerekē ngā tohu o ia ngoikoretanga homoni.
- Te korenga o te homoni LH me te FSH: Ka iti te taumata o te estrogen i roto i ngā wāhine, ā, ka iti hoki te taumata testosterone i roto i ngā tāne. Ka kiia tēnei ko te hypogonadism . Ko ngā tohu ko ngā huringa paheketanga koretake, te heke o te libido, te ngenge, me te ngoikore o te moepuku i roto i ngā tāne.
- Te korenga o te homoni TSH: Ka heke te hanga o ngā homoni tairoi. Ka kiia tēnei ko te hypothyroidism . Ka pā mai pea te ngenge, te mate kōroke, te kiri maroke, me te puhoi o te tere o te ngakau.
- Te korenga o te homoni ACTH: Ka hua ake tēnei i te hekenga o te hanga o te homoni cortisol. Ka kiia tēnei ko te korenga o te adrenal . Tērā pea ka puta ngā tohu pēnei i te toto toto iti, te whakapairuaki, te ruaki, te mamae o te puku, me te kore hiahia kai.
- Te korenga o te homoni GH: Ka rerekē ngā tohu o te korenga o te homoni tipu i runga i te pakeketanga. Ka pāngia pea ngā pakeke e te ngenge me te ngoikore o ngā uaua.
Ngā tohu i puta mai i ngā pukupuku e whakaputa ana i ngā homoni tāpiri (Ngā Adenoma Mahi)
Ka nui rawa te kotahi, neke atu rānei o ngā homoni e whakaputaina ana e ēnei momo pukupuku, ka ara ake pea ēnei momo mate hauora.
| Momo pukupuku | Te āhua me ngā tohu noa |
|---|---|
| Ngā Prolactinoma (Ka nui rawa te prolactin e puta mai ana) | Koinei te momo pukupuku pituitary e tino kitea ana. Mā te pikinga o te taumata o te homoni prolactin (hyperprolactinemia) ka kore ai e whānau tamariki ngā tāne me ngā wāhine. Hei tāpiri, ka pāngia pea ngā wāhine kāore i te hapu e te wai miraka mai i ō rātou ū (galactorrhea). |
| Ngā adenoma somatotroph (Ka nui ake te homoni tipu e whakaputa ana) | I roto i ngā pakeke, ka puta he āhuatanga e kiia nei ko te acromegaly . Ka puta he nui rawa atu o ngā ringa, ngā waewae, te mata, me te upoko. Mēnā ka puta tēnei āhuatanga i roto i ngā tamariki me ngā taiohi, ka roa rawa atu rātou. Ka kiia tēnei ko te gigantism . |
| Ngā adenoma corticotroph (ka nui ake te ACTH e whakaputaina ana) | Ka nui rawa te ACTH ka piki ake te homoni cortisol, ka hua ake he mate e kiia nei ko te mate Cushing . Ko ngā tohu ko te toto toto tiketike, te ngoikore o te uaua, te ngawari o te marō, ngā tohu totoro, me te mate huka momo 2. |
| Ngā adenoma tirotrophic (Ka nui ake te TSH e whakaputaina ana) | He tino onge ēnei. Ka nui rawa te TSH ka piki ake ngā homoni tairoi, ka puta he mate e kiia nei ko te hyperthyroidism . Ko ngā tohu ko te pikinga o te tere o te ngakau, te hekenga o te taumaha, te werawera, te wiri o ngā ringa, me te kore e okioki. |
He aha te take e whanake ai ngā adenoma pituitary?
Kāore anō kia mōhiotia e ngā kaipūtaiao te tino take, engari e whakaponohia ana he maha ngā wā ka puta mai i ngā huringa matapōkere (ngā whakarerekētanga ira) o tō tātou DNA . Mā ēnei huringa ka tipu haere ngā pūtau i roto i te repe pituitary ka puta he pukupuku.
I ētahi wā ka honoa ēnei ki ngā āhuatanga ira ka tukuna iho i roto i ngā whakatipuranga, engari i te nuinga o te wā ka puta noa mai i te ao tūpono.
Me pēhea te tautuhi i tēnei mate?
Ka whakahau tō tākuta i ngā whakamātautau hei tātaritanga i tēnei i runga i ō tohumate. I ētahi wā, ka kitea pea ēnei pukupuku i te wā o te matawai upoko mō tētahi atu take.
Mena kei te whakapae tō tākuta kei a koe tēnei mate, ka tonoa pea e rātou ngā whakamātautau e whai ake nei:
- Ngā whakamātautau toto: I runga i ō tohu, ka tonoa pea he whakamātautau toto hei tirotiro i ngā taumata homoni rerekē.
- Ngā whakamātautau whakaahua: Mā te matawai MRI (Magnetic Resonance Imaging) CT (Computed Tomography) rānei o te upoko ka taea te whakaū i te aroaro o tēnei pukupuku.
- Whakamātautau kanohi: Mena he raruraru tirohanga tōu, ka whakahaerehia he whakamātautau tirohanga hei tirotiro i te mahi a ō kanohi.
He aha ngā maimoatanga?
E toru ngā kōwhiringa maimoatanga mō tēnei: te pokanga, te rongoā, me te radiotherapy. Mā tō rōpū hauora e whakatau ko tēhea maimoatanga te mea pai mōu i runga i te momo, te rahi, me ngā tohu o tō pukupuku.
1. Pokanga: Mena kei te puta he kore taurite o ngā homoni, he raruraru tirohanga rānei i te puku, ka tūtohu pea te tākuta kia pokangahia hei tango i te katoa, i tetahi wāhanga rānei o te puku.
- Ko te tikanga tino noa (95%) e whakamahia ana mō tēnei ko te pokanga transsphenoidal , e whakaurua ai he kāmera iti me ngā taputapu mā roto i te ihu hei tango i te pukupuku.
- Mena he tino nui te pukupuku, me whakamahi pea i te pokanga transcranial, ka mahia mā roto i te angaanga.
2. Rongoā: Ka taea te rongoā i ētahi momo pukupuku, inā koa ko ngā Prolactinomas . Ka whakaitihia e ēnei rongoā te pukupuku, ā, ka whakahaere i ngā tohumate. I te nuinga o te wā, ka hoatu he rongoā pēnei i te cabergoline , i te bromocriptine rānei mō tēnei. 80% o ngā tūroro ka whiwhi hua pai me ēnei rongoā.
3. Te rongoā irahiko: Ko te whakamahi i ngā hihi-X kaha-teitei hei whakaiti i te pukupuku, hei aukati rānei i tōna tipu. Ka mahia tēnei mā te whakamahi i tētahi tikanga motuhake e kiia nei ko te stereotactic radiosurgery . Ko te arotahi ki te pukupuku me ngā hihi irahiko me te whakaiti i te kino ki ngā kiko hauora e karapoti ana.
He aha ngā mea ka tupu i muri i te maimoatanga?
He tino pai te tirohanga mō tēnei. I muri i te tango katoa o te pukupuku mā te maimoatanga, ka taea e te nuinga o te tangata te ora i te oranga hauora me te whai hua.
I ētahi wā, ka taea e te pokanga, te rongoā irahiko rānei te kino i te repe pituitary, ka iti ai ngā taumata homoni (hypopituitarism). I tēnei wā, me tango pea koe i ngā pire whakakapinga homoni mō te toenga o tō oranga hei whakakapi i ngā taumata iti o ngā homoni.
Ka taea e ēnei pukupuku te hoki mai anō i ētahi wā, nō reira he mea tino nui kia haere ki ngā tirotiro hauora i ia wā ahakoa kua oti te maimoatanga.
He aha ngā raruraru ka puta mai mēnā kāore e rongoatia?
Ki te kore e rongoatia, ka pā mai ngā raruraru hauora nui inā koa ngā pukupuku nui (macropadenomas) me ngā pukupuku whakaputa homoni (ngā adenomas mahi).
He tino onge engari he tino morearea te pituitary apoplexy . He mate tēnei e hiahia ana kia rongoatia wawetia.
Ko te mea e tupu ana i konei, ka puta whakarere mai te toto o te pukupuku ki roto, ki waho rānei i te pukupuku. Ka tupu whakarere te pukupuku, ka kino te repe pituitary. Ka puta whakarere mai ngā tohu o tēnei.
- He mamae upoko tino kino, ohorere.
- Te tirohanga takirua, te kore rānei e taea te whakatuwhera i ngā kamo nā te kore mahi tika o ngā uaua o te kanohi.
- Te ngaronga ohorere o te tirohanga, te ngaronga rānei o te tirohanga taha.
- Te hekenga ohorere o te toto toto, te whakapairuaki me te ruaki.
Ki te pāngia koe e tētahi, e ētahi rānei o ēnei tohu, me haere tonu koe ki te Tari Whawhati Tata (ETU) o te hōhipera tata rawa atu. He āhuatanga whawhati tata tēnei e morearea ai te ora.
He mea noa te mataku ina kitea he adenoma pituitary tōu. Engari kia maumahara, ehara ēnei i te mate pukupuku. Ā, mā ngā maimoatanga matatau o ēnei rā, ka taea te whakaora katoa. Kōrerohia mā te tuwhera ki tō tākuta, me te pātai atu i ō pātai katoa.
Karere Tangohia ki te Kāinga
- He pukupuku pai te pituitary adenoma, nō reira kaua e manukanuka noa.
- Ko te nuinga o ngā tohu ka puta mai i te rahi o te pukupuku, te pēhanga ki ngā io e karapoti ana, ngā panoni rānei o ngā taumata homoni.
- Kaua e warewarehia ngā raruraru tirohanga (ina koa ko te ngoikore o te tirohanga taha) me te mamae tonu o te upoko. Tirohia te tākuta tonu.
- He tino whai hua ngā maimoatanga mō tēnei, pērā i te pokanga, te rongoā, me te radiotherapy.
- Mena kua tāpaetia koe kei te pāngia e tēnei mate, he mea tino nui kia whai koe i ngā tohutohu a tō tākuta, kia haere hoki ki ngā tirotiro hauora auau.
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