Uma sizwa igama elithi "isimila" ekhanda lethu, wonke umuntu uyasaba ngokushesha, akunjalo? Lokho kuvamile. Kodwa into ebaluleke kakhulu okudingeka siyiqonde ukuthi akuzona zonke izimila ezakha ekhanda lethu ezibangela umdlavuza. Namuhla sizokhuluma ngesimila esakha endlaleni encane ngaphansi kobuchopho bethu, kodwa ngokuvamile esingesona umdlavuza. Lokhu kubizwa ngokuthi i-pituitary adenoma kwezesayensi yezokwelapha. Ngakho-ke ake sixoxe ngalokhu ngokuningiliziwe, kalula kakhulu.
Okokuqala, ake sibone, iyini i-Pituitary Adenoma?
Kalula nje, i-pituitary adenoma iyisimila esikhula endlaleni yakho ye-pituitary. Kodwa iyisimila esingenabungozi . Lokho kusho ukuthi asisabalali kwezinye izingxenye zomzimba njengomdlavuza. Kodwa njengoba lezi zimila zikhula, zingacindezela izicubu nezinzwa ezizungezile. Yilapho izimpawu ezahlukahlukene ziqala khona ukuvela.
Ngakho-ke, iyini le ndlala ye-pituitary?
I-pituitary gland iyi-gland encane, emise okwethambo etholakala ngaphansi kobuchopho, ngemuva kwekhala. Ixhunywe ne -hypothalamus ebuchosheni. Le gland encane inezingxenye ezimbili, i-anterior lobe kanye ne-posterior lobe. Zombili lezi zingxenye zikhiqiza ama-hormone amaningana abalulekile emzimbeni wethu.
Ama-hormone afana nezithunywa emizimbeni yethu. Ahamba egazini futhi ayala izitho zethu, imisipha, kanye nezinye izicubu ukuba zenze imisebenzi eyahlukahlukene.
Nazi ezinye zama-hormone ayinhloko akhiqizwa yi-pituitary gland:
- I-hormone ye-Adrenocorticotropic (ACTH)
- I-hormone yokulwa nokukhipha isisu (i-ADH)
- I-hormone evuselela i-follicle (i-FSH)
- I-hormone yokukhula (GH)
- I-hormone ye-luteinizing (LH)
- I-Oxytocin
- I-Prolactin
- I-hormone ekhuthaza i-thyroid (TSH)
Futhi, i-pituitary gland itshela ezinye izindlala ze-endocrine emzimbeni wethu ukuthi zikhiqize ama-hormone. Kufana nehhovisi elikhulu. Ngakho-ke lapho kwakheka isimila kule ndlala, umsebenzi we-hormone eyodwa noma ngaphezulu ungashintsha nakanjani.
I-adenomas ye-pituitary ihlukaniswa kanjani?
Odokotela bahlukanisa la mathumba ngezinhlobo ezimbili eziyinhloko: ngokusekelwe ekutheni akhiqiza ama-hormone engeziwe noma cha, kanye nosayizi wawo.
| Ukuhlukaniswa okusekelwe ekukhiqizweni kwama-hormone | |
|---|---|
| Uhlobo lwesimila | Incazelo elula |
| Ama-adenoma asebenzayo (akhipha) (izimila ezikhipha ama-hormone) | Lezi zinhlobo zezimila zikhiqiza ama-hormone e-pituitary engeziwe. Kuye ngokuthi i-hormone eningi kangakanani ekhiqizwayo, kungase kube nezimpawu nezimo ezahlukahlukene. |
| Ama-adenoma angasebenzi (angakhiphi) (Amathumba angewona ama-hormone) | Lezi zimila azikhiqizi ama-hormone. Kodwa-ke, njengoba zikhula, zingadala izimpawu ngokucindezela imizwa nezicubu ezizungezile. Lolu uhlobo lwesimila oluvame kakhulu. |
| Hlunga ngosayizi | |
|---|---|
| Uhlobo lwesimila | Incazelo elula |
| Ama-Microadenoma (I-Microadenoma) | Lawa amantongomane amancane kune-10 millimeters, noma isentimitha elilodwa. |
| Ama-Macroadenoma (I-adenoma enkulu) | Lezi yizimila ezinkulu kune-10 millimeters. Zivame cishe kabili kune-microadenomas. Lezi zimila ezinkulu zingalimaza i-pituitary gland, okubangela amazinga ama-hormone ehle ngaphansi kwejwayelekile. Lesi simo sibizwa ngokuthi i-hypopituitarism . |
Ingabe lokhu kubhekwa njengesimila sobuchopho?
Yebo. I-pituitary gland ayiyona ingxenye yobuchopho, kodwa iyingxenye ye-endocrine gland exhunywe ebuchosheni. Kodwa-ke, odokotela babheka i-pituitary adenoma njengesimila sobuchopho. Lolu hlobo lwesimila lubangela u-10% kuphela wezimila ezikhula ngaphakathi kwekhanda.
Into ebaluleke kakhulu okufanele uyikhumbule ukuthi yize lokhu kubizwa ngokuthi "isimila sobuchopho," akusona umdlavuza.
Ziyini izimpawu ze-adenoma ye-pituitary?
Izimpawu zalezi zimila zingahluka kakhulu, kuye ngezici eziningana:
- Kungakhathaliseki ukuthi isimila siyakhula futhi siyalimaza izicubu ezizungezile noma i-pituitary gland uqobo (lokhu kubizwa ngokuthi i-mass effect).
- Ingabe yi-tumor esebenzayo ekhipha ama-hormone, futhi uma kunjalo, iyiphi i-hormone ekhishwa ngokweqile?
Izimpawu zokucindezeleka okubangelwa ukukhulisa isimila (Umphumela Omkhulu)
Lezi zimpawu zivame kakhulu kuma -macroadenomas (izimila ezinkulu).
- Izinkinga zokubona: Lesi yisibonakaliso esiyinhloko. 40%-60% weziguli zilahlekelwa umbono (umbono ofiphele, umbono ophindwe kabili). Lokhu kungenxa yokuthi njengoba isimila sikhula, sicindezela i-optic chiasm, lapho imizwa yamehlo ethu ihlangana khona. Lokhu kubangela ukulahlekelwa umbono ongaphandle, ikakhulukazi emehlweni .
- Ikhanda elibuhlungu: Ikhanda elibuhlungu lingaba khona njengoba isimila sicindezela izicubu ezizungezile. Kodwa-ke, njengoba ikhanda elibuhlungu livame kakhulu, lingaba khona nangezinye izizathu.
- I-Hypopituitarism: Isimila esikhulu singalimaza amaseli e-pituitary gland, sinciphise ukukhiqizwa kwe-hormone eyodwa noma ngaphezulu. Izimpawu zokuntuleka kwe-hormone ngayinye ziyahlukahluka.
- Ukuntuleka kwe-hormone ye-LH ne-FSH: Lokhu kubangela amazinga aphansi e-estrogen kwabesifazane kanye namazinga aphansi e-testosterone kwabesilisa. Lokhu kubizwa ngokuthi i-hypogonadism . Izimpawu zifaka phakathi imijikelezo yokuya esikhathini engajwayelekile, ukwehla kwesifiso sobulili, ukukhathala, kanye nokungasebenzi kahle kocansi kwabesilisa.
- Ukuntuleka kwe-hormone ye-TSH: Lokhu kuholela ekunciphiseni ukukhiqizwa kwama-hormone e-thyroid. Lokhu kubizwa ngokuthi i-hypothyroidism . Lokhu kungabangela ukukhathala, ukuqunjelwa, isikhumba esomile, kanye nokushaya kwenhliziyo okuhamba kancane.
- Ukuntuleka kwe-hormone ye-ACTH: Lokhu kuholela ekunciphiseni ukukhiqizwa kwe-hormone i-cortisol. Lokhu kubizwa ngokuthi ukungasebenzi kahle kwe-adrenal . Izimpawu ezifana nomfutho wegazi ophansi, isicanucanu, ukuhlanza, ubuhlungu besisu, kanye nokulahlekelwa yisifiso sokudla zingase zibe khona.
- Ukuntuleka kwe-GH hormone: Izimpawu zokuntuleka kwe-growth hormone ziyahlukahluka ngokweminyaka. Abantu abadala bangase babe nokukhathala kanye nobuthakathaka bemisipha.
Izimpawu ezibangelwa izimila ezikhiqiza ama-hormone engeziwe (ama-Adenoma asebenzayo)
Lezi zinhlobo zezimila zikhiqiza i-hormone eyodwa noma ngaphezulu ngokweqile, okungaholela ezimeni ezahlukene zempilo.
| Uhlobo lwesimila | Isimo kanye nezimpawu ezivamile |
|---|---|
| Ama-prolactinoma (Ikhiqiza i-prolactin eningi kakhulu) | Lezi yizinhlobo ezivame kakhulu zesimila se-pituitary. Amazinga aphezulu e-hormone prolactin (hyperprolactinemia) angabangela ukungazali kwabesilisa nabesifazane. Ngaphezu kwalokho, abesifazane abangakhulelwe bangase bathole uketshezi olufana nobisi oluvela emabeleni abo (galactorrhea). |
| I-Somatotroph adenomas (Ikhiqiza i-hormone yokukhula eyengeziwe) | Kwabantu abadala, lokhu kubangela isimo esibizwa ngokuthi i-acromegaly . Lokhu kubangela ukuthi izandla, izinyawo, ubuso kanye nekhanda kube kukhulu ngendlela engavamile. Uma lesi simo senzeka ezinganeni nakubantu abadala abasebasha, baba bade ngendlela engavamile. Lokhu kubizwa ngokuthi i-gigantism . |
| Ama-adenoma e-corticotroph (ikhiqiza i-ACTH eyengeziwe) | I-ACTH eningi kakhulu ibangela ukwanda kwe-cortisol hormone, okuholela esimweni esibizwa ngokuthi i-Cushing's syndrome . Izimpawu zifaka phakathi umfutho wegazi ophakeme, ubuthakathaka bemisipha, ukuphuka kalula, izimpawu zokwelula, kanye nesifo sikashukela sohlobo lwesibili. |
| I-Thyrotroph adenomas (Ikhiqiza i-TSH eyengeziwe) | Lokhu akuvamile kakhulu. I-TSH eningi kakhulu ibangela ukwanda kwama-hormone e-thyroid, okubangela isimo esibizwa ngokuthi i-hyperthyroidism . Izimpawu zifaka phakathi ukushaya kwenhliziyo okuphezulu, ukwehla kwesisindo, ukujuluka, izandla ezithuthumelayo, kanye nokungaphumuli. |
Kungani kuvela ama-adenoma e-pituitary?
Ososayensi abakayazi imbangela eqondile, kodwa kukholakala ukuthi ivame ukubangelwa izinguquko ezingahleliwe (ukuguqulwa kwezakhi zofuzo) ku-DNA yethu . Lezi zinguquko zibangela ukuba amangqamuzana e-pituitary gland akhule ngendlela engalawuleki futhi akhe isimila.
Ngezinye izikhathi lokhu kungahlotshaniswa nezimo zofuzo ezidluliselwa ezizukulwaneni ngezizukulwane, kodwa isikhathi esiningi zenzeka ngokungahleliwe.
Ungasithola kanjani lesi simo?
Udokotela wakho uzoyala ukuhlolwa ukuze kutholakale lokhu ngokusekelwe ezimpawini zakho. Ngezinye izikhathi, lawa mathumba angatholakala ngengozi ngesikhathi sokuhlolwa kwekhanda ngesinye isizathu.
Uma udokotela wakho esola lesi simo, angase acele ukuhlolwa okulandelayo:
- Ukuhlolwa kwegazi: Kuye ngezimpawu zakho, ukuhlolwa kwegazi kungacelwa ukuhlola amazinga ahlukahlukene ama-hormone.
- Ukuhlolwa kwezithombe: I-MRI (Magnetic Resonance Imaging) noma i-CT (Computed Tomography) scan yekhanda ingaqinisekisa ukuba khona kwalesi simila.
- Ukuhlolwa kwamehlo: Uma unezinkinga zokubona, kuzokwenziwa ukuhlolwa kwendawo yokubona ukuze kuhlolwe ukusebenza kwamehlo akho.
Yiziphi izindlela zokwelapha?
Ngokuvamile kunezindlela ezintathu zokwelapha lokhu: ukuhlinzwa, imithi, kanye nokwelashwa ngemisebe. Ithimba lakho lezokwelapha lizonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe ngokusekelwe ohlotsheni, usayizi, kanye nezimpawu zesimila sakho.
1. Ukuhlinzwa: Uma isimila sibangela ukungalingani kwamahomoni noma izinkinga zokubona, udokotela angase ancome ukuhlinzwa ukuze kususwe sonke noma ingxenye yaso.
- Indlela evame kakhulu (95%) esetshenziswa kulokhu ukuhlinzwa kwe-transsphenoidal , lapho kufakwa khona ikhamera encane kanye namathuluzi ngekhala ukuze kususwe isimila.
- Uma isimila sikhulu kakhulu, kungadingeka ukuthi uhlinzwe nge-transcranial surgery, okwenziwa nge-skull.
2. Imithi: Ezinye izinhlobo zezimila, ikakhulukazi ama-Prolactinoma , zingelashwa ngemithi. Le mithi inciphisa isimila futhi ilawule izimpawu. Ngokuvamile, kunikezwa imithi efana ne -cabergoline noma i-bromocriptine ngenxa yalokhu. Ama-80% eziguli athola imiphumela emihle ngale mithi.
3. Ukwelashwa ngemisebe: Lokhu kuhilela ukusebenzisa ama-X-ray anamandla aphezulu ukunciphisa isimila noma ukuvimba ukukhula kwaso. Lokhu kwenziwa kusetshenziswa inqubo ekhethekile ebizwa ngokuthi i-stereotactic radiosurgery . Lokhu kuhilela ukuqondisa isimila ngemisebe yemisebe ngenkathi kunciphisa umonakalo ezicutshini eziphilile ezizungezile.
Kwenzekani ngemva kokwelashwa? Ukubikezela
Umbono walokhu muhle kakhulu. Ngemva kokuba isimila sesisusiwe ngokuphelele ngokwelashwa, abantu abaningi bangaphila impilo egcwele nenempilo.
Ngezinye izikhathi, ukuhlinzwa noma ukwelashwa ngemisebe kungalimaza indlala ye-pituitary, okubangela amazinga aphansi ama-hormone (hypopituitarism). Kulesi simo, kungadingeka ukuthi uphuze amaphilisi okufaka esikhundleni sama-hormone impilo yakho yonke ukuze ufake esikhundleni samazinga aphansi ama-hormone.
Lezi zimila zingaphinde zibuye ngezinye izikhathi, ngakho-ke kubaluleke kakhulu ukuya njalo ekuhlolweni kwezokwelapha ngisho nangemva kokwelashwa.
Yiziphi izinkinga ezingaba khona uma zingelashwa?
Uma ingelashwa, ikakhulukazi izimila ezinkulu (ama-macropadenoma) kanye nezimila ezikhiqiza ama-hormone (ama-adenoma asebenzayo) zingabangela izinkinga ezinkulu zempilo.
Inkinga engavamile kodwa eyingozi kakhulu yi -pituitary apoplexy . Lesi yisimo esidinga ukwelashwa okuphuthumayo.
Okwenzekayo lapha ukuthi isimila siphuma noma singene ngaphakathi noma siphume esimila. Isimila sikhula ngokuzumayo futhi sonakalise indlala ye-pituitary. Izimpawu zalokhu zivela ngokuzumayo.
- Ikhanda elibuhlungu kakhulu, elizumayo.
- Ukubona kabili noma ukungakwazi ukuvula amehlo ngenxa yokungasebenzi kahle kwemisipha yamehlo.
- Ukulahlekelwa umbono ngokuzumayo noma ukulahlekelwa umbono ohlangothini.
- Ukwehla okungazelelwe komfutho wegazi, isicanucanu nokuhlanza.
Uma uhlangabezana nesinye noma ngaphezulu salezi zimpawu, kufanele uye eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU) ngokushesha. Lesi yisimo esiphuthumayo esisongela ukuphila.
Kuvamile ukuzizwa wesaba uma kutholakala ukuthi une-pituitary adenoma. Kodwa khumbula, lezi zivame ukungabi nomdlavuza. Futhi, ngemithi ethuthukisiwe yanamuhla, zingelapheka ngokuphelele. Khuluma ngokukhululekile nodokotela wakho bese ubuza yonke imibuzo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-pituitary adenoma ivame ukuba yisisu esingenabungozi, ngakho-ke ungakhathazeki ngokungadingekile.
- Izimpawu zibangelwa kakhulu ukuvuvukala kwesimila, ukucindezeleka kwemizwa ezungezile, noma izinguquko emazingeni ama-hormone.
- Ungazinaki izinkinga zokubona (ikakhulukazi ukwehla kokubona okuseceleni) kanye nekhanda elibuhlungu elingapheli. Bonana nodokotela ngokushesha.
- Kunezindlela zokwelapha eziphumelela kakhulu kulokhu, njengokuhlinzwa, imithi, kanye nokwelashwa ngemisebe.
- Uma uke watholakala unalesi simo, kubaluleke kakhulu ukulandela iseluleko sikadokotela wakho futhi uye kohlolwa njalo.
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