Kodi mukudziwa za Sheehan Syndrome, yomwe imachitika munthu akabereka?

Kodi mukukumbukira momwe tinkalankhulira za momwe nthawi zina amayi amakumana ndi zizindikiro zachilendo akabereka? Mwina sapereka mkaka wokwanira kwa ana awo, nthawi yawo ya msambo imasiya mwadzidzidzi, kapena amamva kutopa kwambiri tsiku lonse. Izi sizinthu zosayembekezereka chabe, nthawi zina zimatha kukhala zotsatira za mavuto panthawi yobereka. Lero tikambirana za vuto losowa koma lofunika kwambiri lokhudzana ndi kubereka lomwe aliyense ayenera kudziwa.

Kodi Sheehan Syndrome ndi chiyani?

Mwachidule, Sheehan Syndrome ndi vuto losowa lomwe limakhudza pituitary gland yanu. Limachitika pamene pali kutuluka magazi ambiri panthawi yobereka, zomwe zikutanthauza kuti magazi ambiri amatayika m'thupi. Taganizirani izi, pituitary gland yanu ndi gland kakang'ono koma kofunikira kwambiri pansi pa ubongo. Timaitcha "master gland" chifukwa imapanga mahomoni omwe amalamulira machitidwe ambiri ofunikira m'thupi, ndipo imauzanso ma gland ena kuti apange mahomoni. Chifukwa chake, pamene pali kutuluka magazi kwambiri panthawi yobereka, pituitary gland iyi silandira mpweya wokwanira womwe imafuna. Monga momwe mtengo umafera popanda madzi, ikasowa mpweya, minofu ina mu pituitary gland imafa. Pituitary gland iyi imakula pang'ono panthawi ya mimba, kotero imakhala yotheka kuwonongeka. Pituitary gland ikawonongeka mwanjira imeneyi, imatha kukhudza machitidwe osiyanasiyana m'thupi, monga ubongo, njira yoberekera, minofu, khungu, mphamvu, komanso psyche. Sheehan Syndrome iyi imatchedwanso `postpartum hypopituitarism` kapena `postpartum pituitary necrosis`.

Kodi chimachitika ndi chiyani m'thupi la munthu amene ali ndi matenda a Sheehan?

Pamene pituitary gland yawonongeka, imataya mphamvu yake yopangira mahomoni angapo ofunikira omwe thupi limafunikira. Nayi zomwe ali:

• Homoni ya Adrenocorticotrophic (ACTH): Izi zimapangitsa kuti cortisol, yomwe ndi homoni yaikulu ya kupsinjika maganizo m'thupi, ipangidwe. Cortisol ndi homoni yomwe imayang'anira kuthamanga kwa magazi, kuchuluka kwa shuga m'magazi, komanso imathandiza thupi kuthana ndi kupsinjika maganizo.
• Homoni yolimbikitsa chithokomiro (TSH): Izi zimalimbikitsa chithokomiro . Chithokomiro chimayang'anira kagayidwe kachakudya, mphamvu, ndi dongosolo lamanjenje.
• Homoni ya kukula (GH): Imathandiza kusunga kukhuthala kwa mafupa, minofu, ndi kugawa mafuta.
• Homoni yolimbikitsa follicle (FSH): Imalimbikitsa kupanga estrogen m'mazira obereketsa, ndipo imapangitsa dzira kukula mwezi uliwonse.
• Homoni ya Luteinizing (LH):Zimathandiza ndi ovulation, yomwe ndi kutulutsa dzira kuchokera m'maselo obereketsa.
• Prolactin (PRL): Imalimbikitsa kupanga mkaka panthawi ya mimba ndipo imalola mwana kuyamwitsa.

Kotero mwina mungamvetse kuti ngati mahomoni aliwonsewa akusowa, ntchito yoyenera m'thupi sigwira ntchito bwino.

Kodi vutoli ndi lofala bwanji?

Ndi chithandizo chamankhwala chamakono, Sheehan Syndrome ndi vuto losowa kwambiri . Limapezeka pafupifupi ana 5 mwa ana 100,000 aliwonse obadwa. Komabe, likhoza kukhala lofala kwambiri m'madera omwe palibe chithandizo chadzidzidzi choletsa kutuluka magazi kwambiri panthawi yobereka.

Kodi zizindikiro za izi ndi ziti?

Zizindikiro za matenda a Sheehan nthawi zina zimaonekera nthawi yomweyo , kutanthauza kuti, mwana akangobadwa kumene. Komabe, nthawi zina zizindikirozi zimatha kuwonekera pang'onopang'ono, pakatha miyezi kapena zaka . Zizindikiro zazikulu zomwe zingaoneke ndi izi:

• Kuvuta kuyamwitsa kapena mkaka wosabwera mwana akangobadwa.
• Kusiya kwathunthu kusamba kwa mwezi uliwonse ( amenorrhea ) kapena kusakhazikika kwa msambo.
• Makoma a nyini amakhala opyapyala komanso ouma ( vaginal atrophy ), zomwe zingapangitse kugonana kukhala kowawa.
• Kuchepa kwa mabere ndi kutayika kwa tsitsi m'khwapa ndi m'malo obisika.
• Kutopa kwambiri , mphamvu zochepa, komanso kuvutika kuganizira zinthu mozama.
• Kuchepa kwa chilakolako chogonana.
• Kuthamanga kwa magazi pang'ono.
• Khungu louma.

Chofunika kwambiri, nthawi zina simungakhale ndi zizindikiro zazikulu kenako mwadzidzidzi mumakumana ndi vuto lalikulu m'moyo wanu - mwachitsanzo, opaleshoni, matenda aakulu, kapena ngozi - ​​ndipo thupi lanu silingakhale ndi cortisol yokwanira kuti lipirire, zomwe zimapangitsa kuti mukhale ndi zizindikiro. Izi zimatchedwa vuto la adrenal . Uwu ndi vuto lomwe limayambitsa imfa lomwe limafuna chithandizo chamankhwala mwachangu.

Nchifukwa chiyani matenda a Sheehan amapezeka?

Chifukwa chachikulu cha izi ndi kutuluka magazi ambiri panthawi yobereka . Monga ndanenera kale, pituitary gland imakula panthawi ya mimba, nthawi zina kukula kwake kumawirikiza kawiri. Izi zimapangitsa kuti ikhale yosavuta kuvutika ndi mpweya, makamaka ngati magazi akutuluka kwambiri kapena kuthamanga kwa magazi kukutsika mwadzidzidzi. Pakakhala kusowa kwa mpweya, maselo a pituitary gland amawonongeka. Zotsatira zake, pituitary gland sangathe kupanga mahomoni okwanira kuti azitha kuwongolera ntchito zosiyanasiyana m'thupi. Kusowa kwa mahomoni kumeneku kungayambitse kuti njira yoberekera ndi mitsempha isagwire ntchito bwino kapena kuimitsa kwathunthu.

Kodi izi ndi zinthu zomwe zimachokera ku mibadwomibadwo?

Ayi. Matenda a Sheehan si matenda omwe mumatengera kwa makolo anu.

Kodi kutaya magazi ochuluka bwanji kumafunika kuti vutoli likhale pachiwopsezo?

Kawirikawiri, chiopsezo chotenga matenda a Sheehan chimawonjezeka pokhapokha ngati magazi anu atatayika kwambiri, kuthamanga kwa magazi kukuchepa kwambiri, komanso ngati mwagwidwa ndi mantha. Komabe, chifukwa chakuti gulu lanu lachipatala lakonzekera zadzidzidzi izi, chiopsezochi tsopano chatsika kwambiri.

Kodi zinthu zoopsa ndi ziti?

Tsopano tikudziwa kuti matenda a Sheehan amangochitika pamene magazi akutuluka kwambiri panthawi yobereka ndipo kuthamanga kwa magazi kumatsika kwambiri. Chifukwa chake, matenda omwe amawonjezera chiopsezo cha magazi akutuluka kwambiri panthawi yobereka amawonjezeranso chiopsezo cha matenda a Sheehan. Matenda oterewa ndi awa:

• Kubereka ana oposa mmodzi (monga mapasa, atatu).
• Kubereka mwana wamkulu kuposa wachibadwa.
• Kusokonekera kwa placenta .
• Placenta previa (placenta yochepa ).
• Kuthamanga kwa magazi nthawi ya mimba ( preeclampsia ).
• Kutumiza zida (monga forceps kapena vacuum extraction ).

Kodi mavuto a Sheehan syndrome ndi otani?

Ngati matenda a Sheehan amayambitsa vuto la adrenal cortex mtsogolo, akhoza kukhala pachiwopsezo cha moyo. Kuphatikiza apo, mavuto ena a matendawa angaphatikizepo:

• Kuthamanga kwa magazi pang'ono.
• Kutaya thupi kapena minofu.
• Kusasamba kosakhazikika kapena kuvutika kutenganso mimba.

Koma musadandaule, dokotala wanu angakuthandizeni kuthana ndi mavutowa kapena kupewa ndi chithandizo choyenera.

Kodi mumazindikira bwanji izi?

Ngati muli ndi zizindikiro za matenda a Sheehan, dokotala wanu angagwiritse ntchito zotsatirazi kuti adziwe vutoli:

• Mbiri ya zachipatala: Dokotala wanu adzakufunsani za kutuluka magazi ambiri kapena mavuto ena omwe mudakumana nawo panthawi ya mimba yanu. Muyeneranso kukambirana za zizindikiro zilizonse zomwe mudakumana nazo mutabereka (monga kuvutika kuyamwitsa, kapena kulephera kusamba). Fotokozani momveka bwino za zizindikiro zomwe muli nazo panopa, nthawi yomwe zakhalapo, komanso zomwe mumachita kuti zikhale bwino kapena zoipa.
• Kuyezetsa magazi: Chitsanzo cha magazi anu chimatengedwa ndipo kuchuluka kwa mahomoni okhudzana ndi ntchito ya pituitary gland kumayesedwa.
• Mayeso ojambulira: Kujambula kwa MRI (Magnetic Resonance Imaging) kungathetse zifukwa zina zomwe zimayambitsa zizindikiro zanu (monga chotupa cha pituitary). Ngati zotsatira za MRI sizikudziwika bwino, kujambulidwa kwa CT (Computed Tomography scan) kungachitikenso.

Kodi mayeso a magazi amagwiritsidwa ntchito bwanji pozindikira matenda?

Dokotala angayese kuchuluka kwa mahomoni anu mwachindunji, kapena angayang'anenso momwe pituitary gland yanu imayankhira ku chinthu china chake chomwe chimayambitsa vutoli.

• Kuyesa Mlingo wa Mahomoni: Kuchuluka kwa mahomoni monga ACTH, FSH, LH, TSH, T4, estradiol (mtundu wa estrogen), IGF-1, ndi cortisol kungayang'aniridwe.
• Mayeso olimbikitsa: Dokotala wanu angakupatseni mankhwala kapena jakisoni kuti alimbikitse mahomoni ena opangidwa ndi pituitary gland ndikuwona momwe pituitary gland imayankhira nayo.

Kodi imachiritsidwa bwanji?

Kuti muchiritse vutoli, muyenera kumwa mahomoni moyo wanu wonse . Izi zikutanthauza kuti thupi lanu lidzakupatsani mahomoni omwe silipanganso. Izi zimatchedwanso kuti hormone replacement therapy . Mitundu ya mahomoni omwe mukufuna, kuchuluka kwake, ndi momwe mumawagwiritsira ntchito zimasiyana malinga ndi matenda anu komanso zizindikiro zake. Ma mahomoni awa angaphatikizepo:

• Mahomoni ogonana: Estrogen ndi progesterone zitha kugwiritsidwa ntchito powongolera nthawi yanu ya mwezi uliwonse komanso kuthandizira zizindikiro za kusamba msanga. Mahomoni monga LH ndi FSH amathandizira pakutulutsa dzira, zomwe zingakuthandizeninso kutenga pakati kachiwiri.
• Corticosteroids: Mutha kumwa hydrocortisone kapena prednisone kuti muchiritse kusowa kwa ACTH. Mlingo wanu wa mahomoni awa ungafunike kusinthidwa ngati muli ndi nkhawa kwambiri (monga opaleshoni) chifukwa thupi lanu likufunika kupanga cortisol yambiri.
• Mahomoni a chithokomiro: Levothyroxine (monga Synthroid®, Levoxyl®) ingagwiritsidwe ntchito pa vuto la kusowa kwa TSH. Mlingo wa mankhwalawa udzasinthidwa kutengera kuchuluka kwa mahomoni a chithokomiro chanu.
• Mahomoni okula: Kumwa mahomoni okula kungathandize kusunga minofu ndi mafupa.

Nthawi zambiri, mudzalandira chithandizo kuchokera kwa dokotala wa endocrinologist , dokotala yemwe ndi katswiri wa mahomoni. Iyenso adzakupimani nthawi zonse kuti atsimikizire kuti kuchuluka kwa mahomoni anu kuli bwino.

Kodi matenda a Sheehan angapewedwe?

Ayi, palibe chomwe mungachite kuti mupewe matenda a Sheehan. Gulu lanu lachipatala limangoletsa kutuluka magazi ndi kuthamanga kwa magazi panthawi yobereka. Koma kumbukirani kuti matenda a Sheehan ndi vuto losowa kwambiri . Kukhala ndi gulu lachipatala laluso lomwe lingapewe mavuto monga kutuluka magazi kwambiri panthawi yobereka kumachepetsa kwambiri chiopsezo chanu chokhala ndi vutoli.

Kodi chimachitika ndi chiyani ndikakhala ndi matenda a Sheehan?

Ngati munthu ali ndi matenda a Sheehan alandira chithandizo choyenera, angayembekezere kuchira bwino kwambiri.Anthu ambiri sakumana ndi mavuto aakulu. Ndi kuyang'aniridwa mosamala ndi gulu lachipatala, anthu ena atha kutenga pakati bwino atapezeka ndi matendawa. Muyenera kupita kwa dokotala wa matenda a endocrinologist nthawi zonse kuti muwonetsetse kuti mukulandira mankhwala oyenera kuti mukonze kusalinganika kulikonse kwa mahomoni. Kuyezetsa magazi nthawi zonse kuti muwone kuchuluka kwa mahomoni anu ndi gawo la chisamaliro chotsatirachi.

Kodi munthu amene ali ndi vuto la hypopituitarism amakhala ndi moyo wautali bwanji?

Ngati muli ndi matenda a Sheehan, moyo wanu sudzasintha. Ngakhale kuti mudzafunika chithandizo cha moyo wanu wonse, mutha kuyembekezera moyo wabwinobwino.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro za matenda a Sheehan, makamaka ngati munatuluka magazi ambiri panthawi yobereka , pitani kwa dokotala nthawi yomweyo. Dokotala wanu akhoza kuchita mayeso kuti adziwe ngati muli ndi vutoli.

Kodi ndiyenera kupita ku chipinda chadzidzidzi liti?

Ngati muli ndi zizindikiro za vuto la adrenal , muyenera kupita kuchipatala mwamsanga. Izi zitha kukhala zoopsa ngati simulandira chithandizo. Zizindikiro izi ndi izi:

• Kumva chizungulire, ngati kuti watsala pang'ono kutaya chikumbumtima.
• Kupweteka kwambiri m'mimba, pachifuwa chapansi, kapena kumbuyo.
• Malungo.
• Thupi lopanda moyo.
• Kusanza ndi kusanza.
• Kusokonezeka kapena kutaya chidziwitso.

Ngati dokotala wanu akuganiza kuti muli pachiwopsezo, angakupempheni kuti muvale chibangili chochenjeza zachipatala kuti mupeze chithandizo mwachangu pakagwa ngozi.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Mungathe kufunsa dokotala wanu mafunso monga:

• Kodi matenda a Sheehan amakhudza bwanji thupi langa?
• Kodi chithandizo chidzathandiza bwanji zizindikiro zanga?
• Kodi mungatenge mimba ndi matenda a Sheehan?
• Kodi ndiyenera kuyezetsa magazi kangati?
• Ndi mankhwala kapena mankhwala ati omwe mumalimbikitsa?

Kuwonongeka kwa pituitary gland kungakhudze njira zambiri za thupi zomwe zimadalira kuchuluka kwa mahomoni abwino. Chithandizo chobwezeretsa mahomoni chingathandize kuthana ndi zotsatira zina za kusowa kwa mahomoni. Lankhulani ndi dokotala wanu za momwe matenda a Sheehan angakhudzire moyo wanu komanso thanzi lanu lonse. Komanso, kambiranani kangati dokotala wanu amafufuza kuchuluka kwa mahomoni anu kuti atsimikizire kuti mukupeza mankhwala oyenera pa thanzi lanu.

Pomaliza, zinthu zoti muzikumbukira

Matenda a Sheehan ndi vuto losowa lomwe limayamba chifukwa cha kuwonongeka kwa pituitary gland chifukwa cha kutuluka magazi ambiri panthawi yobereka. Izi zingayambitse kusowa kwa mahomoni osiyanasiyana, ndi zizindikiro monga kuvutika kuyamwitsa, kusiya kusamba, komanso kutopa kwambiri.

Chabwino kwambiri ndichakuti vutoli lingathe kuthetsedwa bwino ndi mankhwala a mahomoni a moyo wonse ndipo moyo wabwinobwino ukhoza kukwaniritsidwa.

Ngati muli ndi zizindikiro izi, makamaka ngati mwakhala ndi mavuto panthawi yobereka, ndikofunikira kwambiri kufunafuna upangiri wa dokotala. Ngati mwazindikira msanga, mutha kuyamba kulandira chithandizo ndikukhalabe ndi thanzi labwino.

---

Matenda a Sheehan , pituitary gland, kubereka, kutuluka magazi, mahomoni, thanzi la amayi, chisamaliro cha pambuyo pobereka