Uyazi yini nge-Sheehan Syndrome, engenzeka ngemva kokubeletha?

Uyakhumbula ukuthi sasivame ukukhuluma ngokuthi ngezinye izikhathi omama baba nezimpawu ezingavamile ngemva kokubeletha? Mhlawumbe abakhiqizi ubisi olwanele lwezingane zabo, ukuya esikhathini kwabo kuyeka ngokuzumayo, noma bazizwa bekhathele kakhulu usuku lonke. Lezi akuzona nje izinto ezingahleliwe, ngezinye izikhathi zingaba umphumela wezinkinga ngesikhathi sokubeletha. Namuhla sizokhuluma ngesimo esingavamile kodwa esibaluleke kakhulu esihlobene nokubeletha okufanele wonke umuntu asiqaphele.

Iyini i-Sheehan Syndrome?

Kalula nje, i-Sheehan Syndrome yisimo esingavamile esithinta i-pituitary gland yakho. Kwenzeka lapho kunokopha ngokweqile ngesikhathi sokubeletha, okusho ukuthi kulahleka igazi eliningi emzimbeni. Cabanga ngakho, i-pituitary gland yakho iyi-gland encane kodwa ebaluleke kakhulu esisekelweni sobuchopho. Siyibiza ngokuthi "i-master gland" ngoba ikhiqiza ama-hormone alawula izinqubo eziningi ezibalulekile emzimbeni, futhi itshela nezinye izindlala ukuthi zikhiqize ama-hormone. Ngakho-ke, lapho kunokopha ngokweqile ngesikhathi sokubeletha, le-pituitary gland ayitholi inani lomoya-mpilo eliwudingayo. Njengoba nje isihlahla sifa ngaphandle kwamanzi, lapho siphela ngaphandle komoya-mpilo, ezinye izicubu eziku-pituitary gland ziyafa. Le-pituitary gland iba nkulu kancane ngesikhathi sokukhulelwa, ngakho-ke kungenzeka ukuthi yonakale. Lapho i-pituitary gland yonakele ngale ndlela, ingathinta izinhlelo ezahlukene emzimbeni, njengobuchopho, uhlelo lokuzala, imisipha, isikhumba, amandla, ngisho ne-psyche. Le Sheehan Syndrome ibizwa nangokuthi 'i-postpartum hypopituitarism' noma 'i-postpartum pituitary necrosis'.

Kwenzekani emzimbeni one-Sheehan syndrome?

Uma i-pituitary gland yonakele, ilahlekelwa ikhono layo lokukhiqiza ama-hormone amaningana abalulekile umzimba owadingayo. Nakhu asho ukuthini:

• I-hormone ye-Adrenocorticotrophic (ACTH): Lokhu kukhuthaza ukukhiqizwa kwe -cortisol, i-hormone yokucindezeleka eyinhloko emzimbeni. I-Cortisol iyi-hormone elawula umfutho wegazi, amazinga kashukela egazini, futhi esiza umzimba ukuthi ubhekane nokucindezeleka.
• I-hormone evuselela i-thyroid (TSH): Lokhu kuvuselela i-thyroid gland . I-thyroid ilawula i-metabolism, amandla, kanye nesistimu yezinzwa.
• I-hormone yokukhula (GH): Isiza ukugcina ukuqina kwamathambo, imisipha, kanye nokusatshalaliswa kwamafutha.
• I-Follicle-stimulating hormone (FSH): Ikhuthaza ukukhiqizwa kwe-estrogen emaqanda, futhi ibangele ukuthi iqanda livuthwe njalo ngenyanga.
• I-hormone ye-luteinizing (LH):Kuyasiza ngokukhishwa kweqanda, okuwukukhishwa kweqanda emaqanda.
• I-Prolactin (i-PRL): Ikhuthaza ukukhiqizwa kobisi ngesikhathi sokukhulelwa futhi ivumela ingane ukuthi incelise.

Ngakho-ke cishe ungaqonda ukuthi uma noma yiliphi lala ma-hormone lingekho, umsebenzi ofanele emzimbeni ngeke usebenze kahle.

Sivame kangakanani lesi simo?

Ngezindlela zokwelapha zesimanje, i-Sheehan Syndrome iyisimo esingavamile kakhulu . Sivela cishe ezinganeni ezi-5 kwezingu-100,000 ezizalwayo. Kodwa-ke, singase sivame kakhulu ezindaweni lapho kungekho khona ukunakekelwa kwezokwelapha okuphuthumayo ukuvimbela ukopha ngokweqile ngesikhathi sokubeletha.

Ziyini izimpawu zalokhu?

Izimpawu ze-Sheehan syndrome ngezinye izikhathi zingabonakala ngokushesha , okungukuthi, ngokushesha nje ngemva kokuzalwa komntwana. Kodwa-ke, ngezinye izikhathi lezi zimpawu zingavela kancane kancane, ezinyangeni noma ngisho neminyaka . Izimpawu eziyinhloko ezingabonakala yilezi:

• Ubunzima bokuncelisa noma ukungangeni ubisi ngemva kokuzalwa komntwana.
• Ukuyeka ngokuphelele ukuya esikhathini kwanyanga zonke ( i-amenorrhea ) noma ukungahambi kahle.
• Izindonga zesitho sangasese sowesifazane ziba zincane futhi zome ( ukuncipha kwesitho sangasese sowesifazane ), okungenza ucansi lube buhlungu.
• Ukushwabana kwamabele nokulahlekelwa izinwele emakhwapheni nasezindaweni zangasese.
• Ukukhathala okukhulu , amandla aphansi, kanye nobunzima bokugxilisa ingqondo.
• Ukuncipha kwesifiso sobulili.
• Umfutho wegazi ophansi.
• Isikhumba esomile.

Okubalulekile, ngezinye izikhathi ungase ungabi nazimpawu ezinkulu bese ngokuzumayo ubhekana nokucindezeleka okukhulu empilweni yakho - isibonelo, ukuhlinzwa, ukutheleleka okukhulu, noma ingozi - ​​futhi umzimba wakho ungase ungabi ne-cortisol eyanele yokubhekana nakho, okuholela ezimpawini. Lokhu kubizwa ngokuthi i-adrenal crisis . Lesi yisimo esisongela ukuphila esidinga ukunakekelwa kwezokwelapha okusheshayo.

Kungani kwenzeka i-Sheehan syndrome?

Isizathu esiyinhloko salokhu ukopha ngokweqile ngesikhathi sokubeletha . Njengoba ngishilo ekuqaleni, indlala ye-pituitary iyakhula ngesikhathi sokukhulelwa, ngezinye izikhathi iphindwe kabili ngobukhulu. Lokhu kwenza kube lula ukuthi ilahlekelwe umoya-mpilo, ikakhulukazi uma kukhona ukopha okuningi noma ukwehla okungazelelwe komfutho wegazi. Uma kunokuntuleka komoya-mpilo, amaseli endlala ye-pituitary ayalimala. Ngenxa yalokho, indlala ye-pituitary ayikwazi ukukhiqiza ama-hormone anele ukulawula imisebenzi ehlukahlukene emzimbeni. Lokhu kuntuleka kwama-hormone kungabangela ukuthi uhlelo lokuzala kanye nohlelo lwezinzwa lusebenze kabi noma luyeke ngokuphelele.

Ingabe lokhu kuyinto evela ezizukulwaneni ngezizukulwane?

Cha. I-Sheehan syndrome ayisona isimo osithola kubazali bakho.

Kudingeka ukulahleka kwegazi okungakanani ukuze kubekwe lesi simo engcupheni?

Ngokuvamile, ingozi yokuthola i-Sheehan's syndrome iyanda kuphela uma ulahlekelwa igazi elisongela ukuphila, ukwehla okukhulu komfutho wegazi, kanye nokushaqeka. Kodwa-ke, ngenxa yokuthi ithimba lakho lezokwelapha lilungele lezi zimo eziphuthumayo, le ngozi manje isiphansi kakhulu.

Yiziphi izinto ezibangela ingozi?

Manje sesiyazi ukuthi i-Sheehan syndrome yenzeka kuphela uma kukhona ukopha ngokweqile ngesikhathi sokubeletha futhi umfutho wegazi wehla kakhulu. Ngakho-ke, izimo ezandisa ingozi yokopha ngokweqile ngesikhathi sokubeletha nazo zandisa ingozi ye-Sheehan syndrome. Lezi zimo zifaka:

• Ukubeletha izingane ezingaphezu kweyodwa (njengamawele, amawele amathathu).
• Ukubeletha umntwana omkhulu kunokuvamile.
• Ukuphazamiseka kwe-placenta .
• I-placenta previa (i-placenta ephansi ).
• Umfutho wegazi ophezulu ngesikhathi sokukhulelwa ( i-preeclampsia ).
• Ukulethwa kwezinsimbi zomculo (isb. i-forceps noma i-vacuum extraction ).

Yiziphi izinkinga ze-Sheehan syndrome?

Uma i-Sheehan syndrome ibangela inkinga ye-adrenal kamuva ekuphileni, ingaba yingozi empilweni. Ngaphezu kwalokho, ezinye izinkinga zalesi simo zingafaka:

• Umfutho wegazi ophansi.
• Ukulahlekelwa isisindo somzimba noma isisindo semisipha.
• Ukuya esikhathini okungajwayelekile noma ubunzima bokukhulelwa futhi.

Kodwa ungakhathazeki, udokotela wakho angakusiza ukuthi uphathe noma uvimbele lezi zinkinga ngokwelashwa okufanele.

Ukubona kanjani lokhu?

Uma unezimpawu ze-Sheehan's syndrome, udokotela wakho angase asebenzise okulandelayo ukuze axilonge lesi simo:

• Umlando wezokwelapha: Udokotela wakho uzobuza nganoma yikuphi ukopha okukhulu kwangaphambilini noma ezinye izinkinga oke waba nazo ngesikhathi sokukhulelwa kwakho. Kuzodingeka futhi ukhulume nganoma yiziphi izimpawu oke waba nazo ngemva kokubeletha (isibonelo, ubunzima bokuncelisa, noma ukungafiki esikhathini). Cacisa ngezimpawu zakho zamanje, ukuthi sezinesikhathi esingakanani zikhona, nokuthi wenzani ukuze zibe ngcono noma zibe zimbi kakhulu.
• Ukuhlolwa kwegazi: Kuthathwa isampula yegazi lakho bese kuhlolwa amazinga ama-hormone ahlobene nokusebenza kwe-pituitary gland.
• Ukuhlolwa kwezithombe: Ukuskena kwe-MRI (Magnetic Resonance Imaging) kungasusa ezinye izimbangela zezimpawu zakho (isibonelo, isimila se-pituitary). Uma imiphumela ye-MRI ingacacile, ukuskena kwe-CT (Computed Tomography scan) nakho kungenziwa.

Yiziphi izivivinyo zegazi ezisetshenziswa ukuxilonga?

Udokotela angase ahlole amazinga akho ama-hormone ngqo, noma angabheka nokuthi i-pituitary gland yakho isabela kanjani esikhuthazweni esithile.

• Ukuhlolwa Kwezinga Lama-hormone: Amazinga ama-hormone afana ne-ACTH, FSH, LH, TSH, T4, estradiol (uhlobo lwe-estrogen), i-IGF-1, kanye ne-cortisol angahlolwa.
• Ukuhlolwa kokukhuthaza: Udokotela wakho angakunika umuthi noma umjovo wokuvuselela amahomoni athile akhiqizwa yi-pituitary gland futhi ahlole ukuthi i-pituitary gland isabela kanjani kuyo.

Iphathwa kanjani?

Ukuze welaphe lesi simo, kuzodingeka uthathe ama-hormone impilo yakho yonke . Lokhu kusho ukuthi umzimba wakho uzokunikeza ama-hormone ongasawakhiqizi. Lokhu kubizwa nangokuthi ukwelashwa kokufaka esikhundleni sama-hormone . Izinhlobo zama-hormone owadingayo, ukuthi angakanani, nokuthi uwathatha kanjani kuzohluka kuye ngokuthi uxilongiwe yini kanye nezimpawu zakho. La ma-hormone angafaka:

• Ama-hormone ocansi: I-estrogen ne-progesterone kungasetshenziswa ukulawula ukuya kwakho nyanga zonke futhi kusize ngezimpawu zokunqamuka kokuya esikhathini ngaphambi kwesikhathi. Ama-hormone afana ne-LH ne-FSH asiza ngokukhishwa kwamaqanda, okungakusiza futhi ukuthi ukhulelwe futhi.
• Ama-Corticosteroids: Ungathatha i-hydrocortisone noma i-prednisone ukwelapha ukuntuleka kwe-ACTH. Umthamo wakho wala ma-hormone ungadinga ukulungiswa uma ungaphansi kokucindezeleka okukhulu (njengokuhlinzwa) ngoba umzimba wakho udinga ukukhiqiza i-cortisol eyengeziwe.
• Ama-hormone e-thyroid: I-Levothyroxine (isb., i-Synthroid®, i-Levoxyl®) ingasetshenziswa ngenxa yokuntuleka kwe-TSH. Umthamo walo muthi uzolungiswa ngokusekelwe emazingeni akho e-thyroid.
• Ama-hormone okukhula: Ukuthatha ama-hormone okukhula kungasiza ekugcineni imisipha kanye nokuqina kwamathambo.

Ezimweni eziningi, uzokwelashwa ngudokotela we-endocrinologist , udokotela ogxile kuma-hormone. Uzokwenza nokuhlolwa njalo ukuqinisekisa ukuthi amazinga akho ama-hormone asezingeni elifanele.

Ingabe i-Sheehan's syndrome ingavinjelwa?

Cha, akukho ongakwenza ukuvimbela i-Sheehan Syndrome. Ithimba lakho lezokwelapha lingalawula kuphela ukopha kanye nomfutho wegazi ngesikhathi sokubeletha kanye nokubeletha. Kodwa khumbula, i-Sheehan Syndrome iyisimo esingavamile kakhulu . Ukuba nethimba lezokwelapha elinekhono elingavimbela izinkinga ezifana nokopha ngokweqile ngesikhathi sokubeletha kanye nokubeletha kunciphisa kakhulu ingozi yakho yokuthola lesi simo.

Kwenzekani uma ngine-Sheehan syndrome?

Uma umuntu ene-Sheehan syndrome ethola ukwelashwa okufanele, angalindela ukululama okuhle kakhulu.Iningi labantu alibi nezinkinga ezinkulu. Ngokuqapha okuseduze yithimba lezokwelapha, abanye abantu bakhulelwa ngempumelelo ngemva kokuxilongwa. Kufanele ubonane nodokotela wakho we-endocrinologist njalo ukuqinisekisa ukuthi uthola imithi efanele yokulungisa noma yikuphi ukungalingani kwama-hormone. Ukuhlolwa kwegazi njalo ukuhlola amazinga akho ama-hormone nakho kuyingxenye yalokhu kunakekelwa okulandelayo.

Ingakanani iminyaka yokuphila yomuntu one-hypopituitarism?

Uma une-Sheehan syndrome, isikhathi sakho sokuphila ngeke sishintshe. Nakuba uzodinga ukwelashwa impilo yakho yonke, ungalindela isikhathi sokuphila esijwayelekile.

Kufanele ngimbone nini udokotela?

Uma unezimpawu ze-Sheehan syndrome, ikakhulukazi uma uke wopha kakhulu ngesikhathi sokubeletha , bona udokotela ngokushesha. Udokotela wakho angenza izivivinyo ukuze anqume ukuthi unalesi simo.

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma unezimpawu zenkinga ye-adrenal , kufanele uye ekamelweni eliphuthumayo ngokushesha. Lokhu kungaba yingozi empilweni uma kungelashwa. Lezi zimpawu zifaka:

• Ukuzizwa unesizungu, sengathi usuzolahlekelwa ingqondo.
• Ubuhlungu obukhulu esiswini, esifubeni esingezansi, noma emhlane.
• Imfiva.
• Umzimba ongenampilo.
• Isicanucanu nokuhlanza.
• Ukudideka noma ukulahlekelwa ukwazi.

Uma udokotela wakho ecabanga ukuthi usengozini, angase akucele ukuthi ugqoke isongo lesaziso sezokwelapha ukuze uthole ukwelashwa okusheshayo uma kwenzeka isimo esiphuthumayo.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungabuza udokotela wakho imibuzo efana nale:

• I-Sheehan syndrome iwuthinta kanjani umzimba wami?
• Ukwelashwa kuzozithuthukisa kanjani izimpawu zami?
• Ungakwazi yini ukukhulelwa une-Sheehan syndrome?
• Kukangaki ngidinga ukuhlolwa kwegazi?
• Yimiphi imithi noma izindlela zokwelapha ozincomayo?

Ukulimala kwe-pituitary gland kungathinta izinqubo eziningi zomzimba ezincike emazingeni anempilo ama-hormone. Ukwelashwa kokushintsha ama-hormone kungasiza ekubhekaneni neminye yemiphumela yokuntuleka kwama-hormone. Khuluma nodokotela wakho ngokuthi i-Sheehan syndrome izothinta kanjani indlela yakho yokuphila kanye nenhlalakahle iyonke. Futhi, xoxa ngokuthi udokotela wakho uzohlola kangaki amazinga akho ama-hormone ukuqinisekisa ukuthi uthola imithi efanele yempilo yakho.

Okokugcina, izinto okufanele uzikhumbule

I-Sheehan Syndrome yisimo esingavamile esibangelwa ukulimala kwe-pituitary gland ngenxa yokopha ngokweqile ngesikhathi sokubeletha. Lokhu kungaholela ekusweleni kwama-hormone ahlukahlukene, kanye nezimpawu ezifana nobunzima bokuncelisa, ukuyeka ukuya esikhathini, kanye nokukhathala okukhulu.

Into engcono kakhulu ukuthi lesi simo singaphathwa ngempumelelo ngokwelashwa ngama-hormone impilo yonke futhi impilo ejwayelekile ingafinyelelwa.

Uma unalezi zimpawu, ikakhulukazi uma ube nezinkinga ngesikhathi sokubeletha, kubaluleke kakhulu ukufuna iseluleko sezokwelapha. Uma kutholakale kusenesikhathi, ungaqala ukwelashwa futhi uhlale uphilile.

---

Isifo sikaSheehan , indlala ye-pituitary, ukubeletha, ukopha, ama-hormone, impilo yabesifazane, ukunakekelwa kwangemva kokubeletha