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He aha te adenoma pituitary?
He whakarāpopototanga noa iho, he pukupuku kore-matepukupuku (pai) te pituitary adenoma e tupu ana i roto i tō repe pituitary. Kāore e horapa ki ētahi atu wāhanga o te tinana pērā i te matepukupuku. Koinei te mea nui rawa atu. Heoi, i te tipu haere o tēnei adenoma, ka taea e ia te pēhi i ngā mea pērā i ngā io me ngā uaua toto e karapoti ana. Koinei te wā ka tīmata te puta o ngā tohu.Nā, he aha tēnei repe pituitary?
Whakaarohia, i muri i tō tātou ihu, e hono ana ki te pūtake o te roro, te "Hypothalamus", he repe iti te rahi, he rite te rahi ki te pī. Koinei te ingoa o te repe pituitary. Ahakoa he iti, he mahi tino nui tāna i roto i tō tātou tinana. E rua ngā wāhanga matua o tēnei repe:- Lobe o mua
- Te Pūwero o Muri
- Te homoni Adrenocorticotropic (ACTH, Corticotropin rānei)
- Hormone Antidiuretic (ADH, Vasopressin rānei)
- Te homoni whakaoho follicle ( FSH )
- Te homoni tipu (GH)
- Hormone Luteinizing (LH)
- Oxytocin ( Oxytocin )
- Prolactin
- Te homoni whakaoho tairoiti (TSH)
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Check Availability →Me pēhea te wehewehe i ēnei momo adenoma?
E rua ngā momo matua o ngā adenoma pituitary e whakarōpūhia ana e ngā tākuta: 1. I runga i te mea ka whakaputahia e rātou he homoni, kāore rānei:- Adenoma mahi/huna:Hei tāpiritanga, ka puta mai i ēnei momo adenoma tētahi, neke atu rānei, ngā homoni pituitary. Nō reira, ka rerekē pea ngā tohu me ngā āhuatanga i runga i te homoni e nui rawa ana te whakaputa.
- Ngā adenoma kore mahi/kore e huna: Kāore ēnei adenoma e whakaputa homoni. Heoi, ki te nui haere, ka puta ngā tohu mā te pēhi i ngā wāhi roro, i ngā io rānei e tata ana . Koinei te momo adenoma e tūtaki pinepine ana ngā tākuta.
- Ngā microadenoma: He pukupuku ēnei he iti iho i te 10 mirimita (arā, 1 henimita).
- Macroadenomas: He pukupuku nui ake ēnei i te 10 mirimita. E rua ngā wā ka kitea te nui o ngā macroadenomas i ngā microadenomas. He nui ake hoki te tūponotanga ka iti ake te taumata o tētahi, neke atu rānei o ngā homoni pituitary (he āhuatanga e kiia nei ko te hypopituitarism).
E kiia ana tēnei he pukupuku roro?
Ko te repe pituitary he hanganga nō te pūnaha endocrine, ehara i te wāhanga o te roro. E piri ana ki te pūtake o te roro. Heoi, e whakaaro ana ngā tākuta ko ngā adenoma pituitary he momo pukupuku roro . Tekau% noa iho o ngā pukupuku roro tuatahi ko ngā adenoma pituitary.Ko wai ka pāngia pinepinetia e ēnei? He pēhea te auau o tēnei?
Ka taea te whakawhanake i ngā adenoma pituitary i ngā tau katoa. Heoi, ko te nuinga o ēnei ka pā ki te hunga kei roto i ō rātou tau 30 me te 40. He iti ake te tūponotanga ka pāngia ngā wāhine e ēnei i ngā tāne. He tino noa ēnei, ā, ko te 10% ki te 15% o ngā pukupuku katoa e tipu ana i roto i te angaanga. E ai ki ngā tatauranga, tata ki te 77 i roto i te 100,000 tāngata he mate pēnei. Heoi, e whakapono ana ngā kairangahau he maha atu ngā tāngata, tae atu ki te 20% pea, ka pāngia e tētahi i tētahi wā o ō rātou oranga. He maha ngā wā, inā koa ko te hunga he microadenomas ('microadenomas'), kāore he tohu, nō reira kāore e kitea.He aha ngā tohu o te adenoma pituitary?
Ka rerekē ngā tohu o te pituitary adenoma i ia tangata, i ia tangata. He maha ngā āhuatanga e whakawhirinaki ana ki tēnei:- Ahakoa te tipu o te adenoma, ā, ka pakaru te repe pituitary tonu, mehemea rānei ka puta he "pānga papatipu" ki ngā hanganga e karapoti ana.
- He adenoma e whakaputa ana i ngā homoni ('e mahi ana') rānei? Mena koinā, ka whakawhirinaki ngā tohu ki te momo homoni e whakaputaina ana e ia.
Ngā tohu o te 'Mass Effect' i puta mai i ngā 'Macroadenomas' (ngā pukupuku nunui)
Ko ngā adenomas nunui ('Macroadenomas') te pūtake o ngā tohu nā te pēhanga ki ngā kiko e karapoti ana.Whakaarohia, ki te whakanohoia e koe tētahi taonga nui ki roto i tētahi rūma iti, me te mea kāore he wāhi mō ētahi atu mea, ā, he kī tonu i te tangata.
- Ngā raruraru tirohanga:
- Te ngoikore o te homoni:
- Ina heke te taumata o te LH me te FSH ('Hypogonadism'): Ka heke te taumata o te ' Oestrogen' i roto i ngā wāhine me te ' Testerone' i roto i ngā tāne. Ka puta pea ngā tohu pēnei i te werawera nui, te maroke o te tara i roto i ngā wāhine, te 'Pokanga o te ure' i roto i ngā tāne, te hekenga o te tupu o ngā huruhuru o te mata me te tinana, te rerekētanga o te wairua i roto i ngā tāne e rua, te hekenga o te hiahia moepuku, me te tino ngenge.
- Ina heke te taumata o te homoni TSH ('Hypothyroidism'): Ka heke te nui o ngā homoni e hangaia ana e te repe tairoiti. Ka puta pea ngā tohu pēnei i te ngenge, te mate kōroke, te puhoi o te manawa, te kiri maroke, te pupuhi o ngā peka, me te ngoikore o ngā uruparenga.
- Ina iti te homoni ACTH ('Te koretake o te adrenal'): Ka heke te hanga a te tinana i te homoni 'Cortisol'. Ka puta pea ngā tohu pēnei i te toto toto iti, te whakapairuaki, te ruaki, te mamae o te puku, me te kore hiahia kai.
- GH (Te Kore o te Homoni Tipu): Ka rerekē ngā tohu i runga i te tau. Ka pāngia pea ngā pakeke e te ngenge me te ngaronga o te papatipu uaua.
Ngā tohu o ngā adenomas mahi
Haunga te huna i tētahi, neke atu rānei o ngā homoni, ka taea e te adenoma mahi te whakaputa i ngā tohu me ngā āhuatanga e pā ana ki ia homoni.- Ngā Prolactinoma (e mōhiotia ana ko Lactotroph Adenomas):
- Te kore tamariki (te kore tamariki) mō ngā tāne me ngā wāhine.
- He rerenga waiū mai i ngā ū ahakoa kāore i te hapu ('Galactorrhea').
- Ngā Adenoma Somatotroph:
- Ngā Pakeke: Ka puta he mate onge engari he kino, e kiia nei ko te 'Acromegaly'. I roto i tēnei, ka tipu rerekē ngā wheua me ngā kiko o te tinana. I roto i te wā, ka nui haere ngā ringa, ngā waewae, me te upoko, ā, ka rerekē te āhua o te mata. Ka pā hoki ki te whakahaere huka toto, ā, ka taea hoki e te uaua o te ngākau te whakanui.
- Tamariki me ngā taiohi: Ka puta he āhuatanga e kiia nei ko te gigantism. Ka tipu teitei rawa rātou nā te nui rawa o te homoni tipu.
- Ngā Adenoma Corticotroph:
- Te toto toto tiketike.
- Te ngoikore o te uaua.
- Ngāwari te marutanga.
- Ka puta ngā rārangi papura whānui (neke atu i te 1 henemita) ('Tohu Totoro') ki te puku.
- Te osteoporosis.
- Ngā whati pēhanga.
- Mate huka momo 2.
- Ngā Adenoma Thyrotroph:
- Te pikinga o te tere o te ngakau.
- Te ngaronga taumaha me te kore he take.
- Ngā tūtae maha e kore e rere.
- Te werawera.
- Te wiri o ngā ringa.
- Te manukanuka.
He mea nui: He maha atu anō ngā take o te hyperthyroidism. He tino onge te pituitary adenoma.
- Ngā Adenoma Gonadotrophic:
- Ka taea e tēnei te pāngia e ngā huringa paheketanga koretake o ngā wāhine me ngā āhuatanga pēnei i te Ovarian Hyperstimulation Syndrome (OHSS).
- Ka pāngia pea ngā tāne e ngā tohu pēnei i te rahi o ngā raho, te hōhonutanga o te reo, te ngaro o te makawe (i muri i ngā taringa), me te tere o te tupu o te huruhuru kanohi.
- Ka taea hoki e ngā tamariki te pāngia e te pakeketanga wawe.
He aha ngā take o te adenoma pituitary?
Kāore anō kia tino mōhiotia e ngā kaipūtaiao te take o ēnei adenoma. Heoi, e whakaarohia ana ko ētahi adenoma he hononga ki ngā huringa matapōkere ('whakarerekētanga') o ngā ira ('DNA') i roto i ō tātou pūtau. Mā ēnei huringa ira ka tere te tipu o ngā pūtau i roto i te repe pituitary ka hanga he puranga. I ētahi wā ka taea te tuku iho i ēnei huringa ira mai i ngā mātua ki ngā tamariki (tuku iho), ka taea rānei te whanake matapōkere. Hei tāpiri, ka taea hoki te hono i ngā adenoma pituitary ki ētahi āhuatanga ira onge . Ko ētahi tauira ko:- Ngā Neoplasia Endocrine Maha momo 1 (MEN1)''
- Ngā momo neoplasia endocrine maha 4 (MEN4)''
- Te matatini o Carney
- Te mate X-LAG
- Adenoma pituitary whānau e pā ana ki te Succinate dehydrogenase''
- Neurofibromatosis momo 1
- "Te mate a Von Hippel-Lindau"
Me pēhea te tautuhi a ngā tākuta i tēnei mate?
He rerekē te tukanga tātaritanga o te adenoma pituitary i runga i te momo adenoma kei a koe me te mea kei te puta ngā tohu. I te nuinga o te wā, ko te tangata he adenoma whakaputa homoni ('Functioning Adenoma') ka tātaritatia tuatahitia me te kore taurite o te homoni (hei tauira, 'Cushing's Syndrome', 'Acromegaly') i runga i ngā tohu. Kātahi ka kitea te adenoma ina tirotirohia te take. Nā te mea he maha ngā āhuatanga i puta mai i te nui rawa o ngā homoni ka taea te whai take kē atu i tua atu i ngā adenoma pituitary. Ka taea te kī pērā anō mō te korenga o te homoni pituitary ('Hypopituitarism'). I ētahi wā, ka kitea te adenoma pituitary hei 'Incidental Finding' i te wā o te matawai upoko ('Imaging Test') mō tētahi atu āhuatanga. Ko te nuinga o ngā adenoma e kitea pēnei ana he iti te rahi, ā, kāore e mahi.He aha ngā whakamātautau e mahia ana mō tēnei?
Ki te whakapae tō tākuta he pituitary adenoma tōu, ka tirohia e ia ō tohu, ō hītori hauora, ā, ka whakahaerehia he whakamātautau tinana. Hei tāpiri, ka tūtohu pea rātou i tētahi, i ētahi rānei o 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 o ngā homoni pituitary.
- Ngā Whakamātautau Whakaahua: He matawai MRI (Magnetic Resonance Imaging) o te upoko, o teMā te matawai CT (Computed Tomography) ka kitea ngā whakaahua mārama o ngā hanganga i roto i te pane. Ka taea e ēnei whakamātautau te whakaū mēnā kei roto he pituitary adenoma me tōna rahi. Ko te whakamātautau MRI te whakamātautau tino tika, tino tairongo hoki mō tēnei.
- Whakamātautau Kanohi: Mena he raruraru tirohanga tōu, ka tono pea tō tākuta i tētahi whakamātautau tirohanga. He mea nui tēnei whakamātautau nā te mea ka taea e ngā adenoma pituitary nui te whakararu i te tirohanga mā te pēhi i te io whatu, e hono ana i ngā kanohi ki te roro.
Me pēhea te rongoā i te adenoma pituitary?
E toru ngā huarahi matua hei rongoā i ngā adenoma pituitary: te pokanga, te rongoā, me te rongoā irahiko. I ētahi wā ka taea te whakamahi ngātahi i tētahi, i ētahi rānei o ēnei tikanga. Nā te mea he rerekē ngā adenoma me te āhua o ia tangata, ka taea e koe me tō tīma hauora te mahi tahi ki te whakatau i te mahere maimoatanga e pai ana mōu.Te pokanga hei tango i te adenoma
Mena he adenoma tōu e puta ai te kore taurite o ngā homoni, e pā ana rānei ki tō tirohanga, tera pea ka tūtohu tō tākuta kia pokangahia hei tango i te adenoma katoa, i tetahi wāhanga rānei. I runga i te rahi o te adenoma me te kaha o ō tohu, tera pea e hiahiatia kia neke atu i te kotahi te pokanga. He maha ngā wā ka whakahaerehia e ngā taote pokanga tēnei tikanga mā te whakamahi i tētahi tikanga pokanga e kiia nei ko te 'Pokanga Transsphenoidal '. Ko te tikanga o tēnei ko te haere mā te ihu me te sphenoid sinus (he wāhi tuwhera i muri i te kōhao ihu, i raro i te roro) kia tae atu ki te repe pituitary me te tango i te adenoma. Tata ki te 95% o ngā pukupuku pituitary ka tangohia i tēnei ara. He tikanga haumaru tēnei. Heoi, ki te nui rawa te adenoma kāore e taea te tango mā te ihu, kei tētahi wāhi uaua rānei, me mahi pea te taote pokanga transcranial. He tikanga onge tēnei mō ngā adenoma pituitary.Te maimoatanga me te rongoā
Ka taea te whakahaere me te whakaiti i ētahi momo adenoma pituitary, inā koa ko ngā prolactinomas , mā te rongoā. Ko te hunga whai prolactinomas (koinei te momo tino noa) ka rongoatia tuatahitia ki te dopamine agonist, pērā i a Cabergoline (Dostinex®) Bromocriptine (Cycloset® rānei), mō ētahi marama.Ko te rongo pai, i roto i te 80% o ngā take, ka whakaitihia e ēnei rongoā te prolactinoma ka whakahokia ngā taumata o te homoni prolactin ki te noa.Mena kāore e whai hua ngā rongoā, he momo adenoma rānei, ka tūtohu pea tō tākuta kia pokangahia.
Te Whakaora Irahiko
Ka whakamahia e te rongoā irahiko ngā hihi-X kaha-teitei hei whakangaro i ngā pūtau adenoma, hei whakaiti i te pukupuku, hei aukati rānei i tōna tipu. Pokanga Irahiko Stereotactic mō ngā Adenoma Pituitary(hei tauira, Gamma Knife®) Ka whakamahia he tikanga whakaora irahiko motuhake, tino tika. I roto i tēnei, ka arohia ētahi hihi irahiko ki te adenoma mai i ngā ahunga rerekē, kia iti ai te kino ki ngā kiko hauora e karapoti ana. Ka whakamahia tēnei tikanga mō ngā wāhi toenga i muri i te pokanga, i ngā wā rānei kāore e taea te pokanga.He aha ngā pānga taha o te maimoatanga?
Pērā i ngā maimoatanga hauora katoa, ka pā mai ētahi pānga taha ki te pituitary adenoma.- I muri i te pokanga me/ranei te rongoā irahiko, tata ki te 60% o te hunga whai adenoma pituitary ka pāngia e te Hypopituitarism (te hekenga o te hanga o tētahi, neke atu rānei o ngā homoni pituitary). Ahakoa he mate tēnei mō te wā katoa, ka taea e ngā rongoā whakakapinga homoni te āwhina i te tangata kia ora noa.
- Ngā raruraru pea mai i te pokanga:
- Te toto.
- Te turuturu o te Wai Cerebrospinal (CSF) (he wai e puta mai ana i te ihu).
- Te mate kiriuhi roro (he mate pāwera o ngā kiriuhi e kapi ana i te roro).
- Mate huka insipidus (te mimi nui me te matewai nui nā te korenga o te homoni antidiuretic).
- Ko ngā pānga taha noa o ngā rongoā dopamine agonist mō te prolactinoma ko: te ānini, te whakapairuaki, te ruaki, te whanoke, me ētahi whanonga whakahaurangi.
- Ngā pānga taha pea o te rongoā irahiko:
- Te ngoikore o te homoni pituitary (tērā pea ka puta i roto i te wā).
- Te Whakararuraru i te Huarahi Whakaputa.
- Te ngaronga o te tirohanga me te pakaru o te kiko roro (he tino onge).
- Tērā pea ka puta mai tētahi atu pukupuku i te wāhi kotahi i muri i ngā tau o te maimoatanga (he tino onge).
Ka taea te ārai i te hanganga o ēnei adenomas?
Engari, kāore he mea ka taea e koe te mahi hei ārai i ngā adenoma pituitary. I te nuinga o te wā, ka puta noa mai ēnei. Heoi, tera pea e hono ana ki ētahi o ngā āhuatanga ira onge kua whakahuatia i mua ake nei. Mena he āhuatanga ira pēnei kei tētahi mema o te whānau tata (teina, tuahine, mātua rānei), ka taea e koe te kōrero ki tō tākuta mō te tohutohu ira me te whakamātautau kia kite ai mena kei a koe anō te āhuatanga. Mena kei a koe, ka taea e tō tākuta te aroturuki tata i a koe me te kite me te rongoā i ngā adenoma e puta wawe ana.He aha te matapae mō tēnei āhuatanga?
Ko te āhua o te adenoma pituitary, arā, ko tō whakaoranga me tō hauora ā muri ake nei, e whakawhirinaki ana ki te rahi me te momo adenoma, me te maimoatanga ka whiwhi koe .Ko te rongo pai, i te nuinga o te wā, ina tangohia katoatia te adenoma, ina whakahaeretia rānei mā te maimoatanga, ka taea e ngā tūroro te ora hauora anō.I ētahi wā, ka taea e te maimoatanga te whakaiti i te hanga o ngā homoni e te repe pituitary. Mēnā ka tupu tēnei, me tango pea koe i ngā rongoā whakakapinga homoni mō te toenga o tō oranga hei whakakapi i ngā homoni kua whakaitihia. Ka taea e ngā adenoma te hoki mai anō i ētahi wā. Ko te tikanga me rongoā anō i muri i tētahi wā. E whakaatu ana ngā tatauranga tata ki te 18% o te hunga whai adenoma kore mahi me te tata ki te 25% o te hunga whai prolactinoma ka hiahia pea ki te rongoā anō ā muri ake nei. Nō reira, he mea tino nui kia mau tonu te whakapā atu ki tō tākuta me te tirotiro i ngā wā katoa.
Ka taea te ora me te adenoma pituitary?
Āe, ka taea e koe. Mena he iti te pituitary adenoma, ā, kāore he tohu e puta mai ana, ka taea e koe te noho tahi me ia i te āhua noa. Inaa, he maha ngā tāngata ka kitea he adenoma kei a rātou ina tirotirohia te upoko mō tētahi atu take. Heoi, ki te tipu tonu te adenoma, ki te tīmata rānei te puta o ngā tohu, me tino rongoatia koe. Mena he nui, he kaha rānei tō adenoma pituitary (e whakaputa ana i ngā homoni), me tino rongoatia koe. Nā te mea ka pā kino ētahi adenoma pituitary ki tō hauora me tō kounga o te oranga.He aha ngā raruraru ka puta mai mēnā kāore e rongoatia?
Ki te kore e rongoatia, ka taea e ētahi adenoma pituitary – inā koa ko ngā adenoma nunui (Macroadenomas) me ngā adenoma mahi (Secreting) – te whakararu i te hauora . Ko ēnei raruraru hauora e whakawhirinaki ana ki te momo homoni e tukuna ana e te adenoma (i kōrerohia e mātou i mua ake nei i te wāhanga 'Symptoms). Ko tētahi raruraru tino onge engari tino morearea o ngā adenoma pituitary kāore i rongoatia ko te 'Pituitary Apoplexy'. He 'Ohorere Hauora' tēnei. Ka puta tēnei ina he toto kei roto, kei waho rānei i te repe pituitary. Ko te 'Pituitary Apoplexy' te nuinga o te wā ka puta mai i te toto ki roto i te adenoma pituitary. Ka nui haere te pukupuku, ka kino te repe pituitary. Ko te nui ake o te adenoma, ko te nui ake o te tūponotanga ki te whakawhanake i te 'Pituitary Apoplexy'. Ko ngā tohu o te 'Pituitary Apoplexy' ka puta wawe tonu , ā, ka morearea pea te ora . Ko ngā tohu matua ko:- He mamae upoko tino kino (pēnei i te mamae upoko kino rawa atu kua pā ki ahau i roto i tōku ao).
- Te tirohanga takirua, te kore rānei e taea te hiki i te kamo nā te kore mahi tika o ngā uaua o te kanohi.
- Te ngaronga o te tirohanga taha, te ngaronga katoa rānei o te tirohanga o tētahi, o ngā kanohi e rua rānei.
- Ka puta te toto toto iti, te whakapairuaki, me te ruaki i te koretake o te repe adrenal.
- Ngā panonitanga o te tuakiri (hei tauira, te pōhēhē) nā te whaiti ohorere o te uaua roro o mua i roto i te roro.
He mate onge te pituitary apoplexy, engari he tino kino. Mēnā ka pāngia koe e tētahi, e ētahi rānei o ēnei tohu, waea atu ki ngā ratonga hauora ohorere (pēnei i te 911) tonu atu, me tono rānei kia haria koe e tētahi ki te rūma ohorere o te hōhipera tata.
Āhea koe me toro atu ki te tākuta?
- Mena he raruraru tirohanga āu (tirohanga pōuri, tirohanga takirua, tirohanga taha iti) me/ranei he ānini roa, he ānini hoki e hokihoki ana (ina koa ki te rae), tirohia he tākuta ka kōrero ki a ia.
- Mena kua tāpaetia kētia koe he pituitary adenoma, me toro atu koe ki tō tākuta i ia wā, i ia wā, kia aroturukitia ai te āhua o te adenoma, kia mōhio ai hoki kei te tika te mahi a te maimoatanga.
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