Patinonzwa izwi rekuti "bundu" mumusoro medu, munhu wese anobva atya, handiti? Izvozvo zvakajairika. Asi chinhu chakakosha chatinofanira kunzwisisa ndechekuti haasi mabundu ese anokura mumusoro ane kenza. Nhasi tichataura nezvebundu rinokura mugland diki riri pasi peuropi hwedu, asi kazhinji harisi kenza. Izvi zvinonzi pituitary adenoma musainzi yekurapa. Saka ngatitaurei nezvazvo zvakadzama, zviri nyore.
Kutanga, ngationei, chii chinonzi Pituitary Adenoma?
Zvichitaurwa zviri nyore, pituitary adenoma ibundu rinokura pagland rako repituitary. Asi ibundu risina njodzi . Izvi zvinoreva kuti haripararire kune dzimwe nhengo dzemuviri senge kenza. Asi sezvo bundu iri richikura, rinogona kudzvanya nyama dzakakomberedza netsinga. Ndipo panotanga kuoneka zviratidzo zvakasiyana-siyana.
Saka, chii chinonzi pituitary gland iyi?
Gland repituitary igland diki, rakaita semapfupa riri pasi pehuropi, kuseri kwemhino. Rakabatana nehypothalamus muuropi. Gland diki iri rine zvikamu zviviri, chikamu chepamberi nechikamu cheshure. Zvikamu izvi zvose zvinogadzira mahormone akati wandei akakosha mumuviri wedu.
Mahormone akafanana nevatumwa mumiviri yedu. Anofamba nemuropa uye anorayira nhengo dzedu, tsandanyama, nedzimwe nhengo dzemuviri kuti dziite mabasa akasiyana-siyana.
Heano mamwe emahormone makuru anogadzirwa negland repituitary:
- Adrenocorticotropic hormone (ACTH)
- Homoni inorwisa diuretic (ADH)
- Hormone inokurudzira follicle (FSH)
- Homoni yekukura (GH)
- Hormone yeLuteinizing (LH)
- Oxytocin
- Prolactin
- Homoni inokurudzira thyroid (TSH)
Uyewo, pituitary gland inoudza mamwe ma endocrine glands mumuviri wedu kuti agadzire mahormone. Zvakafanana nehofisi huru. Saka kana bundu rikavapo mugland iyi, mashandiro eimwe kana akawanda emahormone aya anogona kuchinja zvechokwadi.
Ma adenoma epituitary anotsanangurwa sei?
Vanachiremba vanoisa mabundu aya mumapoka maviri makuru: zvichienderana nekuti anoburitsa mahormone akawandisa here kana kuti kwete, uye zvichienderana nehukuru hwawo.
| Kupatsanura kwakavakirwa pakugadzirwa kwemahomoni | |
|---|---|
| Rudzi rwebundu | Tsananguro iri nyore |
| Adenomas inoshanda (inoburitsa) (mabundu anoburitsa mahormone) | Mhando idzi dzemabundu dzinoburitsa mamwe mahormone epituitary. Zvichienderana nehuwandu hwemahormone anogadzirwa, zviratidzo zvakasiyana-siyana zvinogona kuitika. |
| Ma adenoma asingashande (asingabudisi) (Matumbu asiri mahormone) | Mabundu aya haaburitse mahormone. Zvisinei, sezvaanokura, anogona kukonzera zviratidzo nekudzvanya tsinga nematishu akaapoteredza. Iri ndiro rudzi rwebundu rinowanzoonekwa. |
| Ronga nehukuru | |
|---|---|
| Rudzi rwebundu | Tsananguro iri nyore |
| Microadenomas (Microdenoma) | Idzi nzungu diki pane mamirimita gumi, kana sendimita imwe chete. |
| Macroadenomas (Adenoma hombe) | Aya mabundu akakura kupfuura mamirimita gumi. Anowanikwa kaviri kupfuura ma microadenomas. Mabundu aya makuru anogona kukuvadza pituitary gland, zvichiita kuti huwandu hwemahormone hudzike pasi penguva yakatarwa. Chirwere ichi chinonzi hypopituitarism . |
Izvi zvinoonekwa segomarara remuuropi here?
Ehe. Gland repituitary harisi chikamu cheuropi, asi igland re endocrine rakabatana neuropi. Zvisinei, vanachiremba vanoona pituitary adenoma segomarara reuropi. Rudzi urwu rwegomarara runongokonzera 10% yemagomarara anokura mukati medehenya.
Chinhu chinonyanya kukosha chekurangarira ndechekuti kunyangwe ichi chichinzi "bundu remuuropi," hachisi kenza.
Ndezvipi zviratidzo zve pituitary adenoma?
Zviratidzo zvemamota aya zvinogona kusiyana zvikuru, zvichienderana nezvinhu zvakawanda:
- Kunyangwe bundu riri kukura uye richikuvadza nyama yakapoteredza kana kuti pituitary gland pachayo (izvi zvinonzi mass effect).
- Ibundu rinoshanda here rinoburitsa mahormone, uye kana zvakadaro, ihormone ipi inoburitswa yakawandisa?
Zviratidzo zvekumanikidzwa kunokonzerwa nekukura kwebundu (Mass Effect)
Zviratidzo izvi zvinonyanya kuitika mu macroadenomas (matumbu makuru).
- Matambudziko ekuona: Ichi ndicho chiratidzo chikuru. 40%-60% yevarwere vanorasikirwa nekuona (kuona kusina kujeka, kuona kaviri). Izvi zvinokonzerwa nekuti bundu richikura, rinodzvanya optic chiasm, uko tsinga dzemaziso dzinosangana. Izvi zvinokonzera kurasikirwa nekuona kwekunze, kunyanya mumaziso .
- Musoro: Musoro unogona kuitika kana bundu richidzvanya nyama yakapoteredza. Zvisinei, sezvo misoro ichinyanya kuwanda, inogonawo kuitika nekuda kwezvimwe zvikonzero.
- Hypopituitarism: Bundu guru rinogona kukuvadza masero egland repituitary, zvichideredza kugadzirwa kwehomoni rimwe chete kana akawanda. Zviratidzo zvekushaikwa kwehomoni rimwe nerimwe zvinosiyana.
- Kushaikwa kwehomoni yeLH neFSH: Izvi zvinokonzera mazinga eestrogen akaderera muvakadzi uye mazinga etestosterone akaderera muvarume. Izvi zvinonzi hypogonadism . Zviratidzo zvinosanganisira kushaikwa kwekuenda kumwedzi kusina kurongeka, kudzikira kwelibido, kuneta, uye kusagadzikana pabonde muvarume.
- Kushaikwa kwehomoni yeTSH: Izvi zvinokonzeresa kudzikira kwekugadzirwa kwehomoni yethyroid. Izvi zvinonzi hypothyroidism . Izvi zvinogona kukonzera kuneta, kuvimbiwa, ganda rakaoma, uye kurova kwemoyo kunononoka.
- Kushaikwa kwehomoni yeACTH: Izvi zvinokonzeresa kudzikira kwekugadzirwa kwehomoni yecortisol. Izvi zvinonzi adrenal insufficiency . Zviratidzo zvakaita se low blood pressure, kuda kurutsa, kurutsa, kurwadziwa mudumbu, uye kushaya chido chekudya zvinogona kuitika.
- Kushaikwa kweGH hormone: Zviratidzo zvekushaya kukura kwehomoni zvinosiyana nezera. Vakuru vanogona kuneta uye kushaya simba kwetsandanyama.
Zviratidzo zvinokonzerwa nemabundu anogadzira mahormone ekuwedzera (Functional Adenomas)
Mhando idzi dzemabundu dzinoburitsa mahormone akawanda kana akawanda, izvo zvinogona kukonzera matambudziko akasiyana-siyana ehutano.
| Rudzi rwebundu | Mamiriro acho ezvinhu uye zviratidzo zvakajairika |
|---|---|
| Prolactinomas (Inogadzira prolactin yakawandisa) | Idzi ndidzo mhando dzegomarara repituitary dzinonyanya kuzivikanwa. Kuwedzera kwehomoni inonzi prolactin (hyperprolactinemia) kunogona kukonzera kushaya mbereko kuvarume nevakadzi. Pamusoro pezvo, vakadzi vasina pamuviri vanogona kubuda ropa rakaita semukaka kubva mumazamu avo (galactorrhea). |
| Somatotroph adenomas (Inogadzira mamwe mahormone ekukura) | Muvanhu vakuru, izvi zvinokonzera chirwere chinonzi acromegaly . Izvi zvinokonzera kuti maoko, tsoka, chiso, nemusoro zvive zvakakura zvisingawanzoitiki. Kana chirwere ichi chikaitika kuvana nevechidiki, vanoreba zvisingawanzoitiki. Izvi zvinonzi gigantism . |
| Corticotroph adenomas (inogadzira ACTH yakawanda) | ACTH yakawandisa inokonzera kuwedzera kwehomoni yecortisol, zvichikonzera chirwere chinonzi Cushing's syndrome . Zviratidzo zvinosanganisira BP yakakwira, kushaya simba kwetsandanyama, mavanga ari nyore, mavanga ekutambanudza, uye chirwere cheshuga cherudzi rwechipiri. |
| Thyrotroph adenomas (Inogadzira TSH yakawanda) | Izvi hazviwanzoitiki. TSH yakawandisa inokonzera kuwedzera kwemahormone ethyroid, zvichikonzera chirwere chinonzi hyperthyroidism . Zviratidzo zvinosanganisira kurova kwemoyo zvakanyanya, kudzikira uremu, kudikitira, kudedera maoko, uye kusagadzikana. |
Sei pituitary adenomas ichikura?
Masayendisiti haasati aziva chikonzero chaicho, asi zvinofungidzirwa kuti chinowanzo kukonzerwa nekuchinja-chinja kweDNA yedu . Kuchinja uku kunoita kuti masero ari mugland repituitary akure asingadzoreki uye agadzire bundu.
Dzimwe nguva izvi zvinogona kusanganiswa nemamiriro ezvinhu emumajini anopfuudzwa kubva kuzvizvarwa zvichienda mberi, asi kazhinji kacho zvinoitika zvisina tsarukano.
Nzira yekuongorora chirwere ichi sei?
Chiremba wako acharaira bvunzo kuti aongorore izvi zvichienderana nezviratidzo zvako. Dzimwe nguva, bundu iri rinogona kuwanikwa netsaona panguva yekuongororwa kwemusoro nekuda kwechimwe chikonzero.
Kana chiremba wako achifungidzira kuti une chirwere ichi, anogona kuraira bvunzo dzinotevera:
- Kuongororwa kweropa: Zvichienderana nezviratidzo zvako, kuongororwa kweropa kunogona kurairwa kuti utarise mazinga akasiyana emahormone.
- Kuongororwa kwemifananidzo: Kuongororwa kwemusoro neMRI (Magnetic Resonance Imaging) kana CT (Computed Tomography) kunogona kusimbisa kuvapo kwebundu iri.
- Kuongororwa kwemaziso: Kana uine matambudziko ekuona, bvunzo yekuona ichaitwa kuti utarise mashandiro emaziso ako.
Ndezvipi zviri kurapwa?
Kazhinji pane nzira nhatu dzekurapa izvi: kuvhiyiwa, mishonga, uye kurapwa nemwaranzi. Chikwata chenyu chekurapa chichasarudza kuti ndeipi nzira yekurapa yakakunakirai zvichienderana nerudzi, saizi, uye zviratidzo zvebundu renyu.
1. Kuvhiyiwa: Kana bundu iri richikonzera kusawirirana kwemahormone kana matambudziko ekuona, chiremba anogona kukurudzira kuvhiyiwa kuti bundu rese kana chikamu charo chibviswe.
- Nzira inonyanya kushandiswa (95%) pakuita izvi ndeyekuvhiyiwa kwe transsphenoidal , apo kamera diki nemidziyo zvinoiswa nemumhino kuti bundu ribviswe.
- Kana bundu racho rakakura zvikuru, zvingava zvakakosha kushandisa transcranial surgery, iyo inoitwa kuburikidza nedehenya.
2. Mishonga: Mamwe marudzi emabundu, kunyanya maProlactinoma , anogona kurapwa nemishonga. Mishonga iyi inoderedza bundu uye inodzora zviratidzo. Kazhinji, mishonga yakaita secabergoline kana bromocriptine inopiwa nekuda kweizvi. 80% yevarwere vanowana mhedzisiro yakanaka nemishonga iyi.
3. Kurapa nemwaranzi: Izvi zvinosanganisira kushandisa maX-ray ane simba guru kuderedza bundu kana kumisa kukura kwaro. Izvi zvinoitwa uchishandisa nzira yakakosha inonzi stereotactic radiosurgery . Izvi zvinosanganisira kunanga bundu nemwaranzi yemwaranzi uku uchideredza kukuvara kwenyama yakakomberedza ine hutano.
Chii chinoitika mushure mekurapwa?
Tariro yeizvi yakanaka kwazvo. Kana bundu rabviswa zvachose nekurapwa, vanhu vazhinji vanogona kurarama hupenyu hwakazara uye hune hutano.
Dzimwe nguva, kuvhiyiwa kana kurapwa nemwaranzi kunogona kukuvadza pituitary gland, zvichikonzera kudzikira kwemahormone (hypopituitarism). Muchiitiko ichi, ungangoda kutora mapiritsi ekutsiva mahormone kweupenyu hwako hwese kuti utsive kudzikira kwemahormone.
Mapundu aya anogona kudzoka dzimwe nguva, saka zvakakosha zvikuru kuenda kunoongororwa nachiremba nguva nenguva kunyangwe mushure mekurapwa.
Ndezvipi zvinetso zvinogona kuitika kana zvikasarapwa?
Kana zvikasarapwa, kunyanya mapundu makuru (macropadenomas) uye mapundu anogadzira mahormone (adenomas anoshanda) zvinogona kukonzera matambudziko makuru ehutano.
Dambudziko risingawanzoitiki asi rine njodzi zvikuru idambudziko repituitary apoplexy . Iri idambudziko rinoda kurapwa nekukurumidza.
Chinoitika apa ndechekuti bundu rinongoerekana rabuda ropa richipinda kana kubuda mubundu. Bundu rinongoerekana rakura uye rakuvadza pituitary gland. Zviratidzo zveizvi zvinongoerekana zvaonekwa.
- Musoro wakakomba zvikuru, unongoerekana waitika.
- Kuona kaviri kana kutadza kuvhura maziso nekuda kwekusashanda zvakanaka kwetsandanyama dzemaziso.
- Kurasikirwa kamwe kamwe kwekuona kana kurasikirwa nekuona parutivi.
- Kudzikira kweBP kamwe kamwe, kuda kurutsa uye kurutsa.
Kana ukaona chimwe chezviratidzo izvi kana kupfuura, unofanira kuenda kuchipatara chiri pedyo neEmergency Department (ETU) nekukurumidza. Iyi iemergency inouraya.
Zvakajairika kuti unzwe kutya kana waonekwa uine pituitary adenoma. Asi yeuka, kazhinji izvi hazvisi zvegomarara. Uye, nekurapwa kwazvino uno, zvinogona kurapwa zvizere. Taura pachena nachiremba wako uye bvunza mibvunzo yako yese.
Mharidzo Yekuenda Nayo Kumba
- Kubuda kwepituitary adenoma kunowanzova bundu risina njodzi, saka usazvidya mwoyo zvisina kufanira.
- Zviratidzo zvinonyanya kukonzerwa nekukura kwebundu, kumanikidzwa kwetsinga dzakaripoteredza, kana kuchinja kwemazinga emahormone.
- Usaregeredza matambudziko ekuona (kunyanya kusaona zvakanaka) uye kurwadziwa nemusoro nguva dzose. Enda kuna chiremba nekukasika.
- Kune nzira dzekurapa dzinoshanda zvikuru dzeizvi, dzakadai sekuvhiyiwa, mishonga, uye kurapwa nemwaranzi.
- Kana wakaonekwa uine chirwere ichi, zvakakosha kuti utevedzere zano rachiremba wako uye uende kunoongororwa nguva nenguva.
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