Musaope chotupa cha pituitary (Pituitary Adenoma)! Tiyeni tikambirane za izi

Tikamva mawu oti "chotupa" m'mutu mwathu, aliyense amachita mantha nthawi yomweyo, eti? Zimenezo n'zachibadwa. Koma chofunika kwambiri chomwe tiyenera kumvetsetsa ndichakuti si zotupa zonse zomwe zimayamba m'mutu zomwe zimakhala ndi khansa. Lero tikambirana za chotupa chomwe chimayamba m'chiwalo chaching'ono pansi pa ubongo wathu, koma nthawi zambiri sichimakhala ndi khansa. Izi zimatchedwa pituitary adenoma mu sayansi ya zamankhwala. Choncho tiyeni tikambirane za izi mwatsatanetsatane, mosavuta.

Choyamba, tiyeni tiwone, kodi Pituitary Adenoma ndi chiyani?

Mwachidule, pituitary adenoma ndi chotupa chomwe chimayamba pa pituitary gland yanu. Koma ndi chotupa chosaopsa . Izi zikutanthauza kuti sichifalikira ku ziwalo zina za thupi monga khansa. Koma pamene zotupazi zikukula, zimatha kukanikiza minofu ndi mitsempha yozungulira. Pamenepo ndi pomwe zizindikiro zosiyanasiyana zimayamba kuwonekera.

Ndiye, kodi pituitary gland iyi ndi chiyani?

Kachiwalo ka pituitary ndi kachiwalo kakang'ono kooneka ngati fupa komwe kali pansi pa ubongo, kumbuyo kwa mphuno. Kachiwalo kameneka kamagwirizana ndi hypothalamus mu ubongo. Kachiwalo kakang'ono aka kali ndi magawo awiri, kachiwalo ka anterior ndi kachiwalo ka posterior. Zigawo zonsezi zimapanga mahomoni angapo ofunikira m'thupi lathu.

Mahomoni ali ngati amithenga m'matupi athu. Amayenda m'magazi ndipo amalangiza ziwalo zathu, minofu, ndi minofu ina kuti igwire ntchito zosiyanasiyana.

Nazi zina mwa mahomoni akuluakulu opangidwa ndi pituitary gland:

• Homoni ya adrenocorticotropic (ACTH)
• Homoni yoletsa diuretic (ADH)
• Homoni yolimbikitsa follicle (FSH)
• Homoni ya kukula (GH)
• Homoni ya Luteinizing (LH)
• Oxytocin
• Prolactin
• Homoni yolimbikitsa chithokomiro (TSH)

Komanso, pituitary gland imauza ma endocrine glands ena m'thupi lathu kuti atulutse mahomoni. Zili ngati ofesi yayikulu. Chifukwa chake chotupa chikapangidwa mu gland iyi, ntchito ya mahomoni amodzi kapena angapo imatha kusintha.

Kodi adenomas ya pituitary imagawidwa bwanji?

Madokotala amagawa zotupa izi m'magulu awiri akuluakulu: kutengera ngati zimapanga mahomoni owonjezera kapena ayi, komanso kutengera kukula kwake.

Kodi izi zimaonedwa ngati chotupa cha muubongo?

Inde. Chiwalo cha pituitary sichili mbali ya ubongo kwenikweni, koma ndi chiwalo cha endocrine chomwe chimalumikizidwa ku ubongo. Komabe, madokotala amaona kuti pituitary adenoma ndi chotupa cha muubongo. Mtundu uwu wa chotupa umangokhala 10% yokha ya zotupa zomwe zimayamba mkati mwa chigaza.

Kodi zizindikiro za adenoma ya pituitary ndi ziti?

Zizindikiro za zotupa izi zimatha kusiyana kwambiri, kutengera zinthu zingapo:

• Kaya chotupacho chikukula ndikuwononga minofu yozungulira kapena pituitary gland yokha (izi zimatchedwa mass effect).
• Kodi ndi chotupa chomwe chimagwira ntchito chomwe chimatulutsa mahomoni, ndipo ngati ndi choncho, ndi mahomoni ati omwe amatulutsidwa mopitirira muyeso?

Zizindikiro za kupanikizika chifukwa cha kukula kwa chotupa (Mass Effect)

Zizindikiro zimenezi zimapezeka kwambiri mu macroadenomas (zotupa zazikulu).

• Mavuto a masomphenya: Ichi ndiye chizindikiro chachikulu. 40%-60% ya odwala amataya masomphenya (kuona zinthu molakwika, kuona zinthu ziwiri). Izi zili choncho chifukwa chotupa chikamakula, chimakankhira pa optic chiasm, komwe mitsempha ya maso athu imakumana. Izi zimapangitsa kuti masomphenya asamayende bwino, makamaka m'maso .
• Mutu: Mutu ukhoza kuchitika pamene chotupa chikukankhira minofu yozungulira. Komabe, popeza mutu ndi wofala kwambiri, ukhozanso kuchitika pazifukwa zina.
• Hypopituitarism: Chotupa chachikulu chingawononge maselo a pituitary gland, kuchepetsa kupanga kwa mahomoni amodzi kapena angapo. Zizindikiro za kusowa kwa mahomoni aliwonse zimasiyana.
• Kusowa kwa mahomoni a LH ndi FSH: Izi zimayambitsa kuchepa kwa estrogen mwa akazi komanso kuchepa kwa testosterone mwa amuna. Izi zimatchedwa hypogonadism . Zizindikiro zake ndi monga kusakhazikika kwa msambo, kuchepa kwa chilakolako cha kugonana, kutopa, komanso kusagwira bwino ntchito zogonana mwa amuna.
• Kusowa kwa mahomoni a TSH: Izi zimapangitsa kuti mahomoni a chithokomiro achepe. Izi zimatchedwa hypothyroidism . Izi zingayambitse kutopa, kudzimbidwa, khungu louma, komanso kugunda kwa mtima pang'onopang'ono.
• Kusowa kwa mahomoni a ACTH: Izi zimapangitsa kuti cortisol ipangidwe pang'ono. Izi zimatchedwa adrenal insufficiency . Zizindikiro monga kuthamanga kwa magazi, nseru, kusanza, kupweteka m'mimba, komanso kusowa chilakolako cha chakudya zitha kuchitika.
• Kusowa kwa mahomoni a GH: Zizindikiro za kusowa kwa mahomoni okhwima zimasiyana malinga ndi zaka. Akuluakulu amatha kutopa komanso kufooka kwa minofu.

Zizindikiro zomwe zimayambitsidwa ndi zotupa zomwe zimapanga mahomoni owonjezera (Functioning Adenomas)

Mitundu iyi ya zotupa imapanga mahomoni ambiri, zomwe zingayambitse matenda osiyanasiyana.

Chifukwa chiyani ma pituitary adenomas amakula?

Asayansi sakudziwabe chomwe chimayambitsa vutoli, koma amakhulupirira kuti nthawi zambiri limayamba chifukwa cha kusintha kwa DNA mwachisawawa . Kusintha kumeneku kumapangitsa maselo a pituitary gland kukula mosalamulirika ndikupanga chotupa.

Nthawi zina izi zitha kulumikizidwa ndi matenda a majini omwe amapatsiridwa m'mibadwo yambiri, koma nthawi zambiri amapezeka mwangozi.

Kodi mungazindikire bwanji vutoli?

Dokotala wanu adzayitanitsa mayeso kuti adziwe izi kutengera zizindikiro zanu. Nthawi zina, zotupa izi zimapezeka mwangozi mukamazifufuza mutu pazifukwa zina.

Ngati dokotala wanu akukayikira vutoli, akhoza kulamula mayeso otsatirawa:

• Kuyezetsa magazi: Kutengera ndi zizindikiro zanu, mayeso a magazi angapangidwe kuti aone kuchuluka kwa mahomoni osiyanasiyana.
• Mayeso ojambulira: Kujambula mutu ndi MRI (Magnetic Resonance Imaging) kapena CT (Computed Tomography) kungatsimikizire kupezeka kwa chotupachi.
• Kuyezetsa maso: Ngati muli ndi vuto la maso, mudzayesedwa kuti muwone momwe maso anu akuyendera.

Kodi mankhwala ake ndi otani?

Kawirikawiri pali njira zitatu zochizira izi: opaleshoni, mankhwala, ndi chithandizo cha radiation. Gulu lanu lachipatala lidzasankha chithandizo chomwe chili chabwino kwa inu kutengera mtundu, kukula, ndi zizindikiro za chotupa chanu.

1. Opaleshoni: Ngati chotupacho chikuyambitsa kusalingana kwa mahomoni kapena mavuto a maso, dokotala angakulimbikitseni opaleshoni kuti muchotse chotupa chonse kapena gawo lake.

• Njira yodziwika kwambiri (95%) yomwe imagwiritsidwa ntchito pa izi ndi opaleshoni ya transsphenoidal , pomwe kamera yaying'ono ndi zida zimayikidwa kudzera mumphuno kuti zichotse chotupacho.
• Ngati chotupacho ndi chachikulu kwambiri, kungakhale kofunikira kuchita opaleshoni ya transcranial, yomwe imachitidwa kudzera mu chigaza.

2. Mankhwala: Mitundu ina ya zotupa, makamaka Prolactinomas , imatha kuchiritsidwa ndi mankhwala. Mankhwalawa amachepetsa chotupa ndikuletsa zizindikiro zake. Nthawi zambiri, mankhwala monga cabergoline kapena bromocriptine amaperekedwa pa izi. 80% ya odwala amapeza zotsatira zabwino ndi mankhwalawa.

3. Chithandizo cha radiation: Izi zimaphatikizapo kugwiritsa ntchito ma X-ray amphamvu kwambiri kuti achepetse chotupacho kapena kuletsa kukula kwake. Izi zimachitika pogwiritsa ntchito njira yapadera yotchedwa stereotactic radiosurgery . Izi zimaphatikizapo kuyang'ana chotupacho ndi ma radiation beams pamene akuchepetsa kuwonongeka kwa minofu yathanzi yozungulira.

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Chiyembekezo cha izi n'chabwino kwambiri. Pambuyo poti chotupacho chachotsedwa kwathunthu ndi chithandizo, anthu ambiri amatha kukhala ndi moyo wathanzi komanso wathanzi.

Nthawi zina, opaleshoni kapena chithandizo cha radiation chingawononge pituitary gland, zomwe zimapangitsa kuti mahomoni azichepa (hypopituitarism). Pankhaniyi, mungafunike kumwa mapiritsi olowa m'malo mwa mahomoni kwa moyo wanu wonse kuti mulowe m'malo mwa mahomoni otsika.

Zotupa zimenezi nthawi zina zimatha kubwereranso, choncho ndikofunikira kwambiri kupita kukayezetsa kuchipatala nthawi zonse ngakhale mutalandira chithandizo.

Ndi mavuto otani omwe angachitike ngati sanachiritsidwe?

Ngati sanalandire chithandizo, makamaka zotupa zazikulu (macropadenomas) ndi zotupa zomwe zimapanga mahomoni (ma adenomas ogwira ntchito) zingayambitse mavuto aakulu azaumoyo.

Chomwe chimachitika apa ndichakuti chotupacho chimatuluka mwadzidzidzi mkati kapena kunja kwa chotupacho. Chotupacho chimakula mwadzidzidzi ndikuwononga pituitary gland. Zizindikiro za izi zimaonekera mwadzidzidzi.

• Mutu woopsa kwambiri, mwadzidzidzi.
• Kuona kawiri kapena kulephera kutsegula maso chifukwa cha kulephera kugwira ntchito kwa minofu ya maso.
• Kutaya mwadzidzidzi masomphenya kapena kutayika kwa masomphenya am'mbali.
• Kutsika mwadzidzidzi kwa kuthamanga kwa magazi, nseru ndi kusanza.

Ngati mukukumana ndi chimodzi mwa zizindikiro izi, muyenera kupita ku chipatala chapafupi cha Emergency Department (ETU) mwamsanga. Izi ndi ngozi zoopsa kwambiri.

Ndizachibadwa kuchita mantha mukapezeka ndi pituitary adenoma. Koma kumbukirani kuti nthawi zambiri izi si khansa. Ndipo, ndi mankhwala apamwamba amakono, amatha kuchiritsidwa kwathunthu. Lankhulani momasuka ndi dokotala wanu ndipo funsani mafunso anu onse.