Kodi tikambirane za chotupa chosowa chotchedwa Pheochromocytoma lero?

Kodi nthawi zina mumadwala kuthamanga kwa magazi mwadzidzidzi? Kapena mumangotuluka thukuta? Kodi mutu umapweteka chifukwa cha kugunda kwa mtima? Musafulumire kuganiza kuti zina mwa zinthuzi ndi matenda aakulu. Komabe, ngati zizindikirozi zikupitirira, makamaka ndi kuthamanga kwa magazi komwe kumakhala kovuta kulamulira, ndi bwino kuda nkhawa pang'ono. Lero tikambirana za vuto lomwe ndi losowa pang'ono, koma ngati litapezeka bwino, lingathe kuchiritsidwa bwino. Limenelo limatchedwa pheochromocytoma.

Kodi Pheochromocytoma ndi chiyani? Tiyeni timvetse mosavuta.

Mwachidule, pheochromocytoma ndi chotupa chomwe chimayamba pakati pa glands ya adrenal, adrenal medulla. Zotupa izi zimapangidwa ndi mtundu wapadera wa selo lotchedwa maselo a chromaffin. Maselo awa amapanga ndikutulutsa mahomoni m'magazi omwe ndi ofunikira kuti thupi lathu lichite "nkhondo kapena kuthawa". Taganizirani izi, mukachita mantha mwadzidzidzi kapena mukukumana ndi nkhawa zambiri, kusintha komwe kumachitika m'thupi lanu - kugunda kwa mtima wanu kumawonjezeka, mukutuluka thukuta, thupi lanu limanjenjemera - mahomoni awa ndi omwe amachititsa izi.

Pheochromocytoma nthawi zambiri imapezeka mu gland imodzi yokha ya adrenal. Komabe, nthawi zina imatha kufalikira mu gland zonse ziwiri. N'zotheka kukhala ndi zotupa zingapo mu gland imodzi.

Chofunika kwambiri, ma pheochromocytomas ambiri ndi abwino (osati oopsa) . Izi zikutanthauza kuti safalikira ku ziwalo zina za thupi. Komabe, pakati pa 10% ndi 15% akhoza kukhala khansa. Ngati iyi ndi khansa, imafotokozedwa m'magulu angapo akuluakulu, kutengera momwe yafalikira:

• Pheochromocytoma yodziwika bwino: Chotupacho chili mu gland imodzi yokha kapena zonse ziwiri za adrenal.
• Pheochromocytoma ya m'deralo: Khansa yafalikira ku ma lymph nodes pafupi ndi adrenal glands kapena ku minofu ina.
• Metastatic pheochromocytoma: Khansa yafalikira ku ziwalo zakutali monga chiwindi, mapapo, kapena mafupa.
• Pheochromocytoma yobwerezabwereza: Khansa yabwerera pambuyo pa chithandizo. Ikhoza kukhala pamalo omwewo monga momwe inalili kale kapena pamalo ena.

Kodi ma adrenal glands amenewa m'thupi lathu ndi otani? Kodi ntchito yawo ndi yotani?

Tili ndi ma adrenal glands awiri. Ali kumbuyo kwa mimba yathu, pamwamba pa impso zathu, ngati chivundikiro. Ndi gawo la dongosolo lathu la endocrine. Adrenal gland iliyonse ili ndi zigawo ziwiri zazikulu. Gawo lakunja limatchedwa adrenal cortex, ndipo gawo lapakati limatchedwa adrenal medulla.

Adrenal medulla yathu imapanga gulu la mahomoni otchedwa catecholamines. Ma mahomoni awa amalamulira machitidwe angapo ofunikira kwambiri m'thupi lathu:

• Kugunda kwa mtima
• Kuthamanga kwa magazi
• Mulingo wa shuga m'magazi `(Glucose m'magazi)`
• Momwe thupi lathu limayankhira kupsinjika (yankho la "nkhondo kapena kuthawa")

Mitundu ikuluikulu ya ma catecholamines ndi awa:

• Dopamine
• Epinephrine (Adrenaline) `(Epinephrine / Adrenaline)`
• Norepinephrine (Noradrenaline) `(Norepinephrine / Noradrenaline)`

Pamene pheochromocytoma ilipo, imatha kutulutsa mahomoni ambiri awa, adrenaline ndi noradrenaline, m'magazi kuposa momwe zimafunikira. Pamenepo ndi pomwe zizindikiro zosiyanasiyana zimayamba kuwonekera.

Kodi pali kusiyana kotani pakati pa Pheochromocytoma ndi Paraganglioma?

Izi ndi mitundu iwiri yofanana kwambiri ya zotupa. Zonse ziwiri zimachokera ku maselo omwewo a chromaffin omwe tidakambirana kale. Komabe, pheochromocytoma imapezeka pakati pa adrenal gland (adrenal medulla), pomwe paraganglioma imapezeka m'malo ena kunja kwa adrenal gland .

Kodi ndani amene ali ndi mwayi waukulu wopeza vutoli? Kodi ndi lofala bwanji?

Pheochromocytoma imatha kufalikira pa msinkhu uliwonse, koma imapezeka kwambiri mwa anthu azaka zapakati pa 30 ndi 50. Pafupifupi 10% ya milandu imanenedwa ali ana.

Ichi ndi chotupa chosowa kwambiri . N'zovuta kunena ndendende kuchuluka kwa anthu omwe ali ndi vutoli. Chifukwa anthu ena sasonyeza zizindikiro zilizonse, matendawa sangadziwike. Akuti anthu osakwana 1% omwe ali ndi kuthamanga kwa magazi ali ndi pheochromocytoma.

Kodi munthu amene ali ndi pheochromocytoma amasonyeza zizindikiro ziti?

Zizindikiro za pheochromocytoma zimachitika pamene chotupacho chimatulutsa mahomoni ambiri otchedwa adrenaline (epinephrine) kapena noradrenaline (norepinephrine) m'magazi. Komabe, zotupa zina sizipanga mahomoni ambiri amenewa ndipo zingakhale zopanda zizindikiro.

Zizindikiro zomwe zimaonekera kwambiri ndi izi:

• Kuthamanga kwa magazi (Kuthamanga kwa magazi): Ichi ndiye chizindikiro chachikulu. Nthawi zina zimakhala zovuta kuzilamulira.
• Mutu: Ukhoza kukhala mutu woopsa komanso wadzidzidzi.
• Kutuluka thukuta kwambiri popanda chifukwa.
• Kugunda kwa mtima ndi kumverera kwa kugunda kwa mtima mofulumira, kosasinthasintha, kapena kugunda kwa mtima.
• Kumva ngati thupi lanu likugwedezeka.

Zizindikiro zosazolowereka:

• Kupweteka pachifuwa ndi/kapena m'mimba.
• Khungu limasanduka lofiirira mwadzidzidzi kuposa masiku onse.
• Kusanza ndi/kapena kusanza.
• Kutsegula m'mimba.
• Kudzimbidwa.
• Kutsika kwa magazi m'thupi (orthostatic hypotension) ndi kutsika kwadzidzidzi kwa kuthamanga kwa magazi mukayimirira. Izi zikutanthauza kuti mumamva chizungulire mukayimirira mwadzidzidzi kuchokera pamalo okhala.
• Kuchepetsa thupi popanda chifukwa.

Zizindikirozi zitha kuwoneka kapena kuipiraipira pambuyo pa zochitika zina. Mwachitsanzo:

• Kuchita masewera olimbitsa thupi kwambiri.
• Kuvulala mwakuthupi kapena kupsinjika maganizo kwambiri.
• Kubereka mwana.
• Kupeza mankhwala oletsa ululu.
• Kuchita opaleshoni.
• Kudya zakudya zokhala ndi tyramine yambiri (monga vinyo wofiira, chokoleti, tchizi).

Kodi zizindikirozo zimakhalapo nthawi zonse? Kapena zimabwera n’kutha?

Munthu amene ali ndi pheochromocytoma akhoza kukhala ndi kuthamanga kwa magazi kosalekeza, kapena angabwere ndi kutha .

Anthu ena angakumane ndi "kuukira kwa paroxysmal," kapena kuukira mwadzidzidzi kwa zizindikiro. Izi zikutanthauza kuti pali kuwonjezeka mwadzidzidzi kwa kuthamanga kwa magazi, komwe kumayenderana ndi zizindikiro monga mutu waukulu, kugunda kwa mtima kwambiri, komanso thukuta kwambiri. "Kuukira" kumeneku kumatha kuchitika kangapo patsiku, kapena kamodzi kapena kawiri pamwezi.

Chofunika: Ngati muli ndi zizindikiro izi, makamaka kuthamanga kwa magazi mwadzidzidzi, mutu, thukuta, ndi kugunda kwa mtima, ndikofunikira kwambiri kufunafuna upangiri wa dokotala.

N’chifukwa chiyani pheochromocytoma imayamba? Kodi zimayambitsa chiyani?

Nthawi zambiri, palibe chifukwa chenicheni chomwe chingapezeke cha pheochromocytoma. Zimachitika mwachisawawa.

Komabe, pa 25% mpaka 35% ya milandu, vutoli limakhala chifukwa cha matenda obadwa nawo. Zina mwa zazikulu ndi izi:

• Matenda a Multiple endocrine neoplasia 2, mitundu A ndi B (MEN2A ndi MEN2B)
• Matenda a Von Hippel-Lindau (VHL)
• Mtundu wa Neurofibromatosis 1 (NF1)
• Matenda a paraganglioma obadwa nawo
• Carney-Stratakis dyad [paraganglioma ndi gastrointestinal stromal tumor (GIST)]
• Carney triad (paraganglioma, GIST ndi pulmonary chondroma)

Kuwonjezera pa matenda a majini amenewa, pheochromocytoma imathanso kufalikira chifukwa cha kusintha kwa majini osachepera 10 osiyanasiyana.

Kodi matendawa amapezeka bwanji? (Kuzindikira)

Pheochromocytoma ingakhale yovuta kuizindikira chifukwa ndi chotupa chosowa kwambiri ndipo nthawi zina sichisonyeza zizindikiro. Nthawi zina, chotupacho chimapezeka mwangozi panthawi yoyezetsa matenda pazifukwa zina.

Pali zifukwa zingapo zomwe dokotala angakayikire kuti matendawa ndi awa:

• YanuMbiri yachipatala mwatsatanetsatane, makamaka ngati pali aliyense m'banjamo amene wakhalapo ndi pheochromocytoma.
• Kuyezetsa thupi lonse ndi zachipatala.
• Zizindikiro zinazake , mwachitsanzo "paroxysmal attacks" zomwe tidakambirana komanso kuthamanga kwa magazi komwe sikulamuliridwa ndi mankhwala wamba.

Ndi mayeso amtundu wanji omwe amachitidwa?

Dokotala wanu angakulangizeni mayeso otsatirawa kuti atsimikizire ngati muli ndi pheochromocytoma:

• Kuyesa mkodzo kwa maola 24: Izi zimaphatikizapo kusonkhanitsa mkodzo wanu tsiku lonse ndikuyesa kuchuluka kwa ma catecholamines omwe ali mmenemo. Kumayesanso zinthu zomwe zimapangidwa mahomoniwa akamawonongeka. Ngati kuchuluka kumeneku kuli kwakukulu kuposa kwachibadwa, kungakhale chizindikiro cha pheochromocytoma.
• Mayeso a catecholamine m'magazi: Izi zimayesa kuchuluka kwa ma catecholamine m'magazi. Monga mayeso a mkodzo, amafufuzanso zinthu zomwe zimapangidwa ndi kusweka kwa mahomoni.
• Kujambula kwa CT (Computer Tomography scan): Izi zimatengera ma X-ray angapo kuti apange zithunzi zatsatanetsatane za mkati mwa thupi lanu. Dokotala wanu angakulangizeni izi kuti muwone glands zanu za adrenal.
• Kujambula kwa MRI (MRI - Magnetic Resonance Imaging): Izi zimagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti zipange zithunzi zamkati mwa thupi. Zimagwiritsidwanso ntchito pofufuza ma adrenal glands.

Matendawa akatsimikizika, mayeso ena angachitike kuti adziwe ngati chotupacho ndi cha khansa (choopsa) kapena chosaopsa (chosaopsa), komanso ngati chafalikira mbali zina za thupi.

N’chifukwa chiyani kuyezetsa majini n’kofunika?

Ngati mwapezeka ndi pheochromocytoma, dokotala wanu angakulangizeni kuti mulandire uphungu ndi kuyezetsa majini kuti mudziwe ngati muli ndi matenda obadwa nawo omwe amakuikani pachiwopsezo chotenga khansa zina.

Kuyezetsa majini kungalimbikitsidwe pazochitika ngati izi:

• Ngati inu kapena wina m'banja mwanu ali ndi zizindikiro zokhudzana ndi cholowa cha pheochromocytoma kapena paraganglioma syndrome.
• Ngati muli ndi zotupa m'matenda anu onse awiri a adrenal.
• Ngati pali chotupa choposa chimodzi mu adrenal gland imodzi.
• Ngati pali zizindikiro za kuchuluka kwa ma catecholamine m'magazi.
• Ngati pheochromocytoma yapezeka isanakwanitse zaka 40,

Ngati mayeso a majini apeza kusintha kwa majini, mlangizi wa majini angakulangizeni kuti ena a m'banja mwanu (omwe alibe zizindikiro koma ali pachiwopsezo) nawonso ayesedwe.

Kodi mankhwala a Pheochromocytoma ndi ati?

Chithandizo chabwino kwambiri cha izi ndi kuchotsa chotupacho mwa opaleshoni, ngati n'kotheka .

Kusankha chithandizo kumadalira zinthu zingapo:

• Kukula kwa chotupacho.
• Kaya chotupacho ndi cha khansa (choopsa) kapena chosaopsa (chosavulaza).
• Kaya pali zizindikiro chifukwa cha kuchuluka kwa mahomoni a catecholamine.
• Kodi chotupacho chafalikira mbali imodzi yokha, kapena chafalikira mbali zina za thupi? (Chosakhazikika)
• Kaya matendawa adapezeka koyamba, kapena ngati adabwereranso pambuyo pa chithandizo cham'mbuyomu.

Ngati muli ndi zizindikiro chifukwa cha kuchuluka kwa mahomoni a adrenal, dokotala wanu angakupatseni mankhwala oletsa zizindikirozo. Mwachitsanzo:

• Mankhwala oletsa kuthamanga kwa magazi kukhala bwino, monga alpha-blockers.
• Mankhwala oletsa kugunda kwa mtima kukhala bwino, monga beta-blockers.
• Mankhwala omwe amaletsa mphamvu ya mahomoni omwe amatulutsidwa mopitirira muyeso ndi adrenal gland.

Njira zazikulu zothandizira pheochromocytoma ndi izi:

• Opaleshoni
• Chithandizo cha radiation
• Mankhwala a Chemotherapy
• Chithandizo cha ablation
• Chithandizo cha Embolization
• Chithandizo cholunjika

Pamodzi, inu ndi gulu lanu lachipatala mudzasankha njira yochiritsira yomwe ili yoyenera kwa inu.

Njira zazikulu zochizira

• Opaleshoni:

Uwu ndiye mankhwala akuluakulu a pheochromocytoma. Pafupifupi 90% ya zotupa zimatha kuchotsedwa bwino mwa opaleshoni .

Dokotala wanu angakulangizeni opaleshoni yochotsa gland imodzi kapena zonse ziwiri za adrenal (adrenalectomy). Pa opaleshoniyi, dokotalayo adzayang'ana minofu yozungulira ndi ma lymph nodes kuti awone ngati chotupacho chafalikira. Ngati chafalikira, adzachotsa minofuyo, ngati n'kotheka.

Pambuyo pa opaleshoni, magazi kapena mkodzo wanu udzayesedwa kuti awone ngati muli ndi catecholamine. Ngati kuchuluka kwa catecholamine kukubwerera mwakale, zikutanthauza kuti maselo onse a pheochromocytoma achotsedwa.

Ngati ma adrenal glands onse awiri achotsedwa, muyenera kumwa mankhwala a mahomoni kwa moyo wanu wonse kuti mulowe m'malo mwa mahomoni opangidwa ndi ma adrenal glands.

• Chithandizo cha radiation:

Uwu ndi mankhwala omwe amagwiritsidwa ntchito kupha maselo a khansa kapena kuwaletsa kukula. Izi zimachitika m'njira yosavulaza minofu yathanzi momwe zingathere.

Pali mitundu iwiri ya chithandizo cha radiation:

• Chithandizo cha radiation chakunja: Radiation imaperekedwa kumalo a khansa kuchokera ku makina omwe ali kunja kwa thupi.
• Chithandizo cha radiation yamkati: Mankhwala owopsa amaikidwa mu singano, mbewu, mawaya, kapena ma catheter ndipo dokotala amawaika pamalo kapena pafupi ndi malo omwe khansa yafalikira.

Mtundu wa chithandizo cha radiation umadalira ngati khansayo ndi ya m'deralo, ya m'deralo, yofalikira, kapena yobwerezabwereza. Malignant pheochromocytoma nthawi zambiri imachiritsidwa ndi external beam radiation therapy ndi/kapena 131I-MIBG therapy. 131I-MIBG ndi mankhwala a radiation omwe amamatira ku maselo ena a khansa ndikuwapha.

• Mankhwala a Chemotherapy:

Izi zimagwiritsa ntchito mankhwala kupha maselo a khansa, kuwaletsa kugawikana ndi kuchulukana, kapena kuletsa kukula kwa khansa. Mankhwalawa nthawi zambiri amaperekedwa kudzera m'mitsempha. Ngakhale kuti chithandizochi ndi chothandiza, chingakhale ndi zotsatirapo zake.

• Chithandizo cha ablation:

Uwu ndi mankhwala osavulaza kwambiri. Umagwiritsa ntchito kutentha kwambiri kapena kuzizira kwambiri kuti uwononge zotupa.

• Kuchotsa ma radiofrequency: Kuchotsa ma radiofrequency kumagwiritsa ntchito mafunde a wailesi kutentha ndi kuwononga maselo a khansa ndi maselo olakwika.
• Kuwotcha: Kumagwiritsa ntchito nayitrogeni yamadzimadzi kapena carbon dioxide yamadzimadzi kuti kuziziritse ndikuwononga maselo a khansa ndi maselo olakwika.

• Chithandizo cha Embolization:

Mu izi, mitsempha yamagazi yomwe imapereka magazi ku adrenal gland imatsekedwa. Izi zimaletsa kuyenda kwa magazi kupita ku gland, zomwe zimapha maselo a khansa omwe amakula pamenepo.

• Chithandizo cholunjika:

Izi zimagwiritsa ntchito mankhwala kapena zinthu zina zomwe zimangoukira maselo a khansa okha popanda kuvulaza maselo athanzi. Mankhwalawa amagwiritsidwa ntchito pa matenda opatsirana komanso obwerezabwereza a pheochromocytoma.

Mankhwala oletsa tyrosine kinase otchedwa sunitinib akuphunziridwa kuti apeze pheochromocytoma yomwe yafalikira. Mankhwalawa amaletsa kukula kwa chotupa.

Kodi matendawa angapewedwe?

Mwatsoka, palibe njira yopewera pheochromocytoma. Komabe, ngati muli pachiwopsezo chotenga matendawa chifukwa cha matenda obadwa nawo komanso majini, upangiri wa majini ungathandize pofufuza ndi kuzindikira msanga.

Ngati wachibale wanu wapafupi (abale ndi alongo, makolo) adadwalapo pheochromocytoma, kapena ngati muli ndi vuto la majini monga lomwe tidakambirana kale (Multiple endocrine neoplasia 2 syndrome, Von Hippel-Lindau (VHL) disease, Neurofibromatosis type 1 (NF1), Hereditary paraganglioma syndrome, Carney-Stratakis dyad, Carney triad), ndikofunikira kwambiri kulankhula ndi dokotala wanu za vutoli.

Kodi mwayi wochira pambuyo pa chithandizo ndi wotani? (Zomwe zingachitike mutalandira chithandizo)

Chiyembekezo cha pheochromocytoma nthawi zambiri chimakhala chabwino kwambiri ngati chathandizidwa.Tanena kale kuti pafupifupi 90% ya zotupa zimatha kuchotsedwa bwino mwa opaleshoni.

Komabe, ngati sichichiritsidwa, vutoli lingayambitse mavuto aakulu, omwe angaike moyo pachiswe . Mwachitsanzo:

• Matenda a mtima
• Matenda a mtima (Myocarditis)
• Kutuluka magazi mosalamulirika muubongo (Cerebral hemorrhaging)
• Kuchulukana kwa madzi m'mapapo (Pulmonary edema)

Odwala ena a pheochromocytoma ali pachiwopsezo cha sitiroko kapena matenda a mtima.

Kodi ndiyenera kupita kwa dokotala liti?

• Ngati mwapezeka ndi pheochromocytoma ndipo mukupeza zizindikiro zilizonse zosokoneza, pitani kwa dokotala nthawi yomweyo.
• Ngati muli ndi zizindikiro za pheochromocytoma, monga kuthamanga kwa magazi ndi mutu, lankhulani ndi dokotala wanu. Ngakhale kuti pheochromocytoma ndi yosowa, ndikofunikira kuchiza kuthamanga kwa magazi.
• Ngati mukudziwa kuti m'modzi mwa achibale anu apamtima (abale ndi alongo, makolo) ali ndi vuto la majini monga `Multiple endocrine neoplasia 2 syndrome` kapena `Von Hippel-Lindau (VHL) disease`, mungakhalenso pachiwopsezo chachikulu chotenga pheochromocytoma, choncho pitani kwa dokotala kuti akakambirane za kuyezetsa majini.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Ngati mwapezeka ndi pheochromocytoma, zingakhale zothandiza kufunsa dokotala mafunso awa:

• Nchifukwa chiyani ndinayamba kukhala ndi pheochromocytoma?
• Kodi ana anga ndi/kapena achibale angadwale matenda a pheochromocytoma?
• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi zotsatirapo zake za mankhwala osiyanasiyana ndi ziti?
• Kodi ndingathe bwanji kuthana ndi zizindikiro zanga?

Pomaliza, zinthu zofunika kwambiri kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, ngakhale pheochromocytoma ndi chotupa chosowa, nthawi zambiri chimakhala chosaopsa komanso chochiritsika . Komanso, imatha kuchitika m'mabanja, kotero ngati inu kapena wina m'banja mwanu mwapezeka ndi vutoli, ndikofunikira kukayezetsa majini. Izi zingathandizenso kudziwa ngati muli pachiwopsezo cha mavuto ena azaumoyo.

Kumbukirani, ngati muli ndi mafunso okhudza chiopsezo chanu chotenga pheochromocytoma kapena za matendawa, musaope kulankhula ndi dokotala wanu. Ali pano kuti akuthandizeni. Khalani ndi thanzi labwino!

Pheochromocytoma , adrenal gland, catecholamines, kuthamanga kwa magazi, mutu, thukuta, chotupa, dongosolo la endocrine