Indawo yokuhlala

I-pituitary apoplexy yinto enqabileyo, kodwa imeko enzima ye-pituitary gland.

I-pituitary yindlala encinci emazantsi engqondo. Indawo yebhinqa ivelisa iihomoni ezininzi ezilawula iinkqubo zomzimba ezibalulekileyo.

Indawo ekuthiwa yi-pituitary apoplexy inokubangelwa kukopha kungene kwityhefu okanye ngokuhamba kwegazi okuvalelweyo. Apoplexy kuthetha ukopha kwilungu okanye ukulahleka kokuhamba kwegazi kwilungu.

I-pituitary apoplexy ihlala ibangelwa kukopha ngaphakathi kwithumba elingafakwanga ngumhlaza (benign). Ezi tumors zixhaphake kakhulu kwaye zihlala zingafumaneki. Indawo yonakele xa ithumba lisanda ngesiquphe. Isopha kwigazi okanye ivimbe ukunikezelwa kwegazi kwindawo ekuhlalwa kuyo. Okukhona lisiba likhulu eli thumba, kokukhona iphakamisa umngcipheko we-pituitary apoplexy.

Xa ukuphuma kwegazi kusenzeka kumfazi ngexesha okanye kanye emva kokubeleka, kubizwa ngokuba yi-Sheehan syndrome. Le yimeko enqabileyo kakhulu.

Imiba yomngcipheko we-pituitary apoplexy kubantu abangakhulelwanga ngaphandle kwesisu kubandakanya:

• Iingxaki zokopha
• Seswekile
• Ukwenzakala entloko
• Imitha yelungu lengqula
• Ukusetyenziswa komatshini wokuphefumla

I-pituitary apoplexy kwezi meko inqabile kakhulu.

I-pituitary apoplexy ihlala inexesha elifutshane leempawu (ezibukhali), ezinokubusongela ubomi. Iimpawu zihlala zibandakanya:

• Intloko ebuhlungu (eyona mbi ebomini bakho)
• Ukukhubazeka kwemisipha yamehlo, kubangela umbono ophindwe kabini (ophthalmoplegia) okanye iingxaki zokuvula ijwabu leso
• Ukuphulukana nombono womda okanye ukulahleka kwawo wonke umbono kwiliso elinye okanye omabini
• Uxinzelelo lwegazi oluphantsi, isicaphucaphu, ukulahleka kwesidlo, kunye nokugabha kwi-adrenal insufficiency
• Utshintsho lomntu ngenxa yokunciphisa ngesiquphe yenye yeethambo kwingqondo (umthambo wangaphakathi wobuchopho)

Ngaphantsi kwesiqhelo, ukungasebenzi kakuhle kwepituitary kunokuvela kancinci kancinci. Kwi-Sheehan syndrome, umzekelo, uphawu lokuqala kunokuba kukusilela ukuvelisa ubisi olubangelwa kukunqongophala kwehomoni prolactin.

Ixesha elingaphezulu, iingxaki ezinokuvela kwezinye iihomoni zepituitary, zibangele iimpawu zezi meko zilandelayo:

• Ukusilela kwehomoni yokukhula
• Ukungabikho kwe-adrenal (ukuba ayikabikho okanye iphathwe)
• Hypogonadism (amadlala esini omzimba avelisa incinci okanye ayinawo amahomoni)
• IHypothyroidism (idlala lengqula alenzi ngokwaneleyo idlala lengqula)

Kwiimeko ezinqabileyo, xa kubekwa umva (ngasemva) kwepituitary, iimpawu zinokubandakanya:

• Ukusilela kwesibeleko kwisivumelwano sokuzala umntwana (kwabasetyhini)
• Ukusilela ukuvelisa ubisi lwebele (kwabasetyhini)
• Ukuchama rhoqo kunye nokunxanwa kakhulu (isifo seswekile insipidus)

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho.

Uvavanyo olunoku-odolwa lubandakanya:

• Iimviwo zamehlo
• I-MRI okanye i-CT scan

Kuya kwenziwa uvavanyo lwegazi ukujonga amanqanaba:

• I-ACTH (iadrenocorticotropic hormone)
• ICortisol
• I-FSH (i-hormone evuselelayo)
• Ukukhula kwehomoni
• I-LH (luteinizing hormone)
• IProlactin
• I-TSH (ihomoni ekhuthaza idlala lengqula)
• Ukukhula okufana ne-insulin-1 (IGF-1)
• Isodium
• I-Osmolarity egazini nasemchameni

I-acople apoplexy inokufuna utyando ukukhulula uxinzelelo kwi-pituitary kunye nokuphucula iimpawu zombono. Iimeko ezinzima zifuna ukuhlinzwa ngokukhawuleza. Ukuba umbono awuchaphazeleki, utyando kaninzi aluyomfuneko.

Unyango kwangoko nge-adrenal replacement hormone (i-glucocorticoids) inokufuneka. Ezi hormone zihlala zinikezelwa ngomthambo (nge-IV). Ezinye iihormoni zinokutshintsha endaweni yazo, kubandakanya:

• Ukukhula kwehomoni
• Iihormone zesondo (estrogen / testosterone)
• Idlala lengqula
• IVasopressin (ADH)

Indawo ekuthiwa yipituitary apoplexy inokubusongela ubomi. Imbonakalo ilungile kubantu abanesiphene sexesha elide (esingapheliyo) sokuchongwa kwamayeza okuchongwa nokunyangwa.

Iingxaki ze-pituitary apoplexy enganyangekiyo inokubandakanya:

• Ingxaki ye-adrenal (imeko eyenzeka xa kungekho cortisol eyaneleyo, ihomoni eveliswa ngamadlala adrenal)
• Ukulahleka kombono

Ukuba ezinye iihormoni ezingekhoyo azithathelwanga ndawo, iimpawu ze-hypothyroidism kunye ne-hypogonadism zinokukhula, kubandakanya ukungachumi.

Fowunela umnikezeli wakho ukuba unazo naziphi na iimpawu zentswelo engapheliyo.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba unempawu ze-pituitary apoplexy, kubandakanya:

• Ubuthathaka bemisipha yamehlo okanye ukulahleka kombono
• Ngokukhawuleza, intloko ebuhlungu
• Uxinzelelo lwegazi oluphantsi (olunokubangela ukuba utyhafe)
• Isicaphucaphu
• Ukuhlanza

Ukuba uziphuhlisa ezi mpawu kwaye sele ufumanekile ukuba unethumba lengqula, funa uncedo lwezonyango kwangoko.

Ububeletha obusebusweni; Ithumba lelungu lobufazi

• Amadlala endocrine

IHannoush ZC, i-Weiss RE. Indawo yokuhlala. Ku: Feingold KR, Anawalt B, Boyce A, et al, ii-eds. Ukuphelisa [intanethi]. EMazantsi eDartmouth, MA: MDText.com. 2000-. www.ncbi.nlm.nih.gov/books/NBK279125. Ukuhlaziywa ngo-Epreli 22, 2018. Kufikeleleke ngoMeyi 20, 2019.

I-Melmed S, i-Kleinberg D. Ubunzima bePituitary kunye nezihlunu. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier; 2016: isahluko 9.