Pituitary apoplexy

Pituitary apoplexy ishoma, asi yakakomba mamiriro epituitary gland.

Iyo pituitary idiki gland iri pasi peuropi. Iyo pituitary inogadzira mazhinji emahormone ayo anodzora akakosha maitiro emuviri.

Pituitary apoplexy inogona kukonzerwa nekubuda ropa mupituitary kana neropa rakavharika kuyerera kune iyo pituitary. Apoplexy zvinoreva kubuda ropa kupinda nhengo kana kurasikirwa kweropa kuyerera kunhengo.

Pituitary apoplexy inowanzo kukonzerwa nekubuda ropa mukati mecancer (benign) bundu repituitary. Aya mamota akajairika uye kazhinji haawanikwe. Iyo pituitary inokanganisika apo bundu rinokura kamwe kamwe. Iyo inogona kubuda ropa mune iyo pituitary kana inovhara ropa kuendesa kune iyo pituitary. Iyo yakakura bundu, inowedzera njodzi kune ramangwana pituitary apoplexy.

Kana kubuda kwepituitary kunoitika mumukadzi panguva kana mushure mekusununguka, inonzi Sheehan syndrome. Ichi chiitiko chisingawanzoitika.

Njodzi dzinokanganisa pituitary apoplexy muvasina-pamuviri vanhu vasina bundu dzinosanganisira:

• Dambudziko rekubuda ropa
• Chirwere cheshuga
• Kukuvara kwemusoro
• Radiation kune iyo pituitary gland
• Kushandiswa kwemuchina wekufema

Pituitary apoplexy mune aya mamiriro hazviwanzo.

Pituitary apoplexy kazhinji ine nguva pfupi yezviratidzo (acute), inogona kutyisidzira hupenyu. Zviratidzo zvinowanzo sanganisira:

• Yakanyanya misoro (yakaipisisa yehupenyu hwako)
• Kuoma mitezo yemasuru eziso, zvichikonzera kuona kaviri (ophthalmoplegia) kana matambudziko ekuvhura eyelid
• Kurasikirwa kwekuratidzira kwekunze kana kurasikirwa kwemaonero ese mune rimwe kana ese maziso
• Yakaderera BP, kusvotwa, kurasikirwa nechido, uye kurutsa kubva kune yakaoma adrenal kusakwana
• Hunhu hunoshanduka nekuda kwekuderera kamwe kamwe kweimwe yetsinga muuropi (anterior cerebral arteri)

Zvishoma pane zvakajairika, kusagadzikana kwepituitary kunogona kuoneka zvishoma nezvishoma. MuSheehan syndrome, semuenzaniso, chiratidzo chekutanga chinogona kunge chiri kutadza kuburitsa mukaka unokonzerwa nekushaikwa kwehomoni prolactin.

Nekufamba kwenguva, matambudziko ane mamwe pituitary mahormoni anogona kukura, zvichikonzera zviratidzo zveanotevera mamiriro:

• Kukura kushomeka kwehomoni
• Adrenal kusakwana (kana isati yatovapo kana kurapwa)
• Hypogonadism (glands yemuviri mabonde inoburitsa mashoma kana asina mahormone)
• Hypothyroidism (thyroid shwanu haigadzi yakakwana utachiona kemikari)

Muzviitiko zvisingawanzoitika, kana iyo yepashure (kumashure chikamu) chepituitary ichibatanidzwa, zviratidzo zvinogona kusanganisira:

• Kukundikana kwechibereko chibvumirano chekuzvara mwana (mune vakadzi)
• Kukundikana kuburitsa mukaka wemukaka (muvakadzi)
• Kakawanda kuita weti uye nyota yakasimba (chirwere cheshuga insipidus)

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezve zviratidzo zvako.

Miedzo inogona kurairwa inosanganisira:

• Kuongorora kwemaziso
• MRI kana CT scan

Kuongororwa kweropa kuchaitwa kuti utarise huwandu hwe:

• ACTH (adrenocorticotropic kemikari)
• Cortisol
• FSH (follicle-inosimudzira mahormone)
• Kukura kemikari
• LH (luteinizing kemikari)
• Prolactin
• TSH (thyroid-inokurudzira hormone)
• Insulini-senge kukura chinhu-1 (IGF-1)
• Sodium
• Osmolarity muropa uye weti

Acute apoplexy ingangoda kuvhiyiwa kuti ibvise kumanikidza kwepituitary uye kugadzirisa zviratidzo zvekuona. Mhosva dzakakomba dzinoda kuvhiyiwa nechimbichimbi. Kana chiratidzo chisina kukanganiswa, kuvhiya kazhinji hakudi.

Pakarepo kurapwa neadrenal kutsiva mahormone (glucocorticoids) anogona kudikanwa. Aya mahormoni anowanzo kupihwa kuburikidza netsinga (ne IV). Mamwe mahormone anogona kupedzisira atsiviwa, kusanganisira:

• Kukura kemikari
• Zvepabonde mahormone (estrogen / testosterone)
• Uturu hwehomoni
• Vasopressin (ADH)

Acute pituitary apoplexy inogona kutyisidzira hupenyu. Maonero acho akanaka kune vanhu vane kwenguva refu (chisingaperi) kushomeka kwepituitary inoonekwa uye kurapwa.

Matambudziko easina kurapwa pituitary apoplexy anogona kusanganisira:

• Adrenal dambudziko (mamiriro anoitika kana pasina kukwana cortisol, kemikari inogadzirwa neadrenal glands)
• Chiratidzo kurasikirwa

Kana mamwe mahormone akashaikwa akasatsiviwa, zviratidzo zvehypothyroidism uye hypogonadism zvinogona kukura, kusanganisira kushaya mbereko.

Fonera mupi wako kana iwe uine chero zviratidzo zvekusingaperi pituitary kusakwana.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (se911) kana uine zviratidzo zveacute pituitary apoplexy, inosanganisira:

• Ziso mhasuru kushaya simba kana kuona kurasikirwa
• Pakarepo, musoro wakakomba
• Kuderera kweropa (izvo zvinogona kukonzera kupera simba)
• Nausea
• Kusvipa

Kana iwe ukaita izvi zviratidzo uye iwe watoonekwa kuti une pituitary bundu, tsvaga rubatsiro rwechiremba ipapo ipapo.

Pituitary infarction; Pituitary bundu apoplexy

• Endocrine masero

Hannoush ZC, Weiss RE. Pituitary apoplexy. Muna: Feingold KR, Anawalt B, Boyce A, et al, eds. Endotext [Indaneti]. Maodzanyemba Dartmouth, MA: MDText.com. 2000-. www.yori.nlm.nih.gov/books/NBK279125. Yakagadziridzwa Kubvumbi 22, 2018. Yakasvika May 20, 2019.

Melmed S, Kleinberg D. Masango epituitary uye mamota. Mune: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Chinyorwa cheEndocrinology. 13 ed. Philadelphia, PA: Elsevier; 2016: chits. 9.