Pituitary apoplexy

Pituitary apoplexy ke boemo bo sa tloaelehang, empa bo tebile ba tšoelesa ea pituitary.

Pituitary ke tšoelesa e nyane botlaaseng ba boko. Pituitary e hlahisa lihormone tse ngata tse laolang lits'ebetso tsa bohlokoa tsa 'mele.

Pituitary apoplexy e ka bakoa ke ho tsoa mali ka har'a pituitary kapa ka ho koaloa ha mali ho ea pituitary. Apoplexy e bolela ho tsoa mali ka har'a setho kapa tahlehelo ea phallo ea mali ho setho.

Pituitary apoplexy hangata e bakoa ke ho tsoa mali kahare ho hlahala e se nang kankere (benign) ea pituitary. Lihlahala tsena li atile haholo 'me hangata ha li fumanoe. Pituitary e senyeha ha hlahala e hola ka tšohanyetso. E ka tsoa mali kahare kapa ea thibela phepelo ea mali ho pituitary. Ha hlahala e le kholoanyane, kotsi e kholo ea mokokotlo oa "pituitary apoplexy" e tla ba kholo.

Ha phallo ea mali e tsoa ho mosali nakong ea pelehi kapa hang ka mor'a ho pepa, e bitsoa Sheehan syndrome. Ena ke boemo bo sa tloaelehang haholo.

Lisosa tse kotsi bakeng sa pituitary apoplexy ho batho bao e seng baimana ntle le hlahala li kenyelletsa:

• Mathata a ho tsoa mali
• Lefu la tsoekere
• Kotsi ea hlooho
• Mahlaseli a ho ea ho tšoelesa ea pituitary
• Ts'ebeliso ea mochini o hemang

Pituitary apoplexy maemong ana ha e fumanehe hangata.

Pituitary apoplexy hangata e na le matšoao a nakoana (a hlobaetsang), a ka bang kotsi bophelong. Matšoao a kenyelletsa:

• Hlooho e bohloko (e mpe ka ho fetesisa bophelong ba hau)
• Ho holofala ha mesifa ea mahlo, ho baka pono e habeli (ophthalmoplegia) kapa mathata a ho bula leihlo
• Ho lahleheloa ke pono ea ponahalo kapa tahlehelo ea pono ka leihlong le leng kapa ka bobeli
• Khatello ea mali e tlase, ho nyekeloa ke pelo, ho lahleheloa ke takatso ea lijo, le ho hlatsa ho tsoa ho se lekane ha adrenal
• Botho bo fetoha ka lebaka la ho fokotseha ka tšohanyetso e 'ngoe ea methapo bokong (mothapo o ka pele oa bokong)

Hangata, ho se sebetse ha pituitary ho ka hlaha butle haholo. Ka mohlala, ho Sheehan syndrome, letšoao la pele e ka ba ho hloleha ho hlahisa lebese le bakoang ke ho haelloa ke hormone ea prolactin.

Ha nako e ntse e ea, mathata a li-hormone tse ling tsa pituitary a ka hlaha, a baka matšoao a maemo a latelang:

• Ho haella ha hormone ea kholo
• Ho haella ha adrenal (haeba e se e le sieo kapa e sa alafshoa)
• Hypogonadism (litšoelesa tsa 'mele tsa thobalano li hlahisa lihormone tse nyane kapa ha li na tsona)
• Hypothyroidism (tšoelesa ea qoqotho ha e etse hormone ea qoqotho e lekaneng)

Maemong a sa tloaelehang, ha karolo e ka morao (e ka morao) ea pituitary e ameha, matšoao a ka kenyelletsa:

• Ho hloleha ha popelo ho etsa konteraka ea ho beleha ngoana (ho basali)
• Ho sitoa ho hlahisa lebese la matsoele (ho basali)
• Ho rota khafetsa le lenyora le matla (lefu la tsoekere insipidus)

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse ka matšoao a hau.

Liteko tse ka laeloang li kenyelletsa:

• Litlhahlobo tsa mahlo
• MRI kapa CT scan

Ho tla etsoa liteko tsa mali ho lekola maemo a:

• ACTH (adrenocorticotropic hormone)
• Cortisol
• FSH (hormone e susumetsang follicle)
• Hormone ea kholo
• LH (hormone ea luteinizing)
• Prolactin
• TSH (hormone e susumetsang qoqotho)
• Khōlo e tšoanang le insulin-1 (IGF-1)
• Sodium
• Osmolarity maling le morong

Acople apoplexy e ka hloka ho buuoa ho fokotsa khatello ho pituitary le ho ntlafatsa matšoao a pono. Linyeoe tse matla li hloka ho buuoa ka tšohanyetso. Haeba pono e sa amehe, hangata ho buuoa ha ho hlokahale.

Ho ka hlokahala kalafo ea hanghang ka lihormone tsa li-adrenal (glucocorticoids). Hangata lihomone tsena li fanoa ka methapo (ea IV). Lihomone tse ling li ka qetella li nkeloe sebaka, ho kenyelletsa:

• Hormone ea kholo
• Lihormone tsa thobalano (estrogen / testosterone)
• Hormone ea qoqotho
• Vasopressin (ADH)

Pituitary apoplexy e matla e ka beha bophelo kotsing. Ponahalo e ntle ho batho ba nang le khaello ea "pituitary" ea nako e telele (e sa foleng) e fumanoang le ho phekoloa.

Mathata a pituitary apoplexy e sa sebetsanoeng a ka kenyelletsa:

• Mathata a adrenal (boemo bo hlahang ha ho se na cortisol e lekaneng, hormone e hlahisoang ke litšoelesa tsa adrenal)
• Ho lahleheloa ke pono

Haeba li-hormone tse ling tse sieo li sa nkeloe sebaka, matšoao a hypothyroidism le hypogonadism a ka hlaha, ho kenyelletsa le thari.

Bitsa mofani oa hau haeba u na le matšoao a ho se sebetse ho sa foleng ha pituitary.

E-ea kamoreng ea maemo a tšohanyetso kapa u letsetse nomoro ea ts'ohanyetso ea lehae (joalo ka 911) haeba u na le matšoao a lefu la pituitary apoplexy, ho kenyelletsa:

• Bofokoli ba mesifa ea mahlo kapa tahlehelo ea pono
• Ka tšohanyetso, hlooho e bohloko haholo
• Khatello ea mali e tlase (e ka bakang ho akheha)
• Ho nyekeloa
• Ho hlatsa

Haeba u hlahisa matšoao ana 'me u se u fumanoe u na le hlahala ea pituitary, batla thuso ea bongaka hang-hang.

Infarction ea pituitary; Hlahala ea pituitary apoplexy

• Litšoelesa tsa endocrine

Hannoush ZC, Weiss RE. Pituitary apoplexy. E ngotsoe: Feingold KR, Anawalt B, Boyce A, et al, eds. Endotext [Inthanete]. Boroa Dartmouth, MA: MDText.com. 2000-. www.ncbi.nlm.nih.gov/books/NBK279125. E ntlafalitsoe ka la 22 Mmesa, 2018. E fihlile ka la 20 Motšeanong, 2019.

Melmed S, Kleinberg D. Matšoafo a pituitary le lihlahala. Ka: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, bahlophisi. Buka ea Williams ea Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: khaolo ea 9.