Pituitary lossis pituitary apoplexy yog ib yam kab mob tsis tshua muaj tab sis hnyav. Nws yog kev kho mob xwm txheej ceev uas yuav tsum tau muaj kev tswj kom tsim nyog.

Lus txhais

Pituitary apoplexy yog lub plawv nres lossis hemorrhage uas tshwm sim nyob rau hauv pituitary adenoma (ib tug benign, non-cancerous endocrine qog uas tsim los ntawm pituitary caj pas nyob rau hauv lub hlwb). Hauv ntau tshaj li ib nrab ntawm cov neeg mob, apoplexy nthuav tawm cov adenoma uas tsis muaj cov tsos mob tshwm sim.

Ua rau 

Qhov ua rau pituitary apoplexy tsis nkag siab tag nrho. Pituitary adenomas yog cov qog uas los ntshav los yog tuag tau yooj yim. Lub necrosis tuaj yeem yog vim qhov tsis txaus ntawm vascularization. 

diagnostic

Kev kuaj pom thaum muaj xwm txheej ceev (CT lossis MRI) ua rau nws muaj peev xwm ua qhov kev kuaj mob los ntawm kev qhia txog adenoma hauv tus txheej txheem ntawm necrosis lossis hemorrhage. Kev kuaj ntshav ceev kuj raug coj mus kuaj. 

Cov neeg txhawj xeeb 

Pituitary apoplexy tuaj yeem tshwm sim txhua lub hnub nyoog tab sis feem ntau tshwm sim hauv koj 3s. Cov txiv neej muaj kev cuam tshuam me ntsis ntau dua li poj niam. Pituitary apoplexy cuam tshuam rau 2% ntawm cov neeg uas muaj pituitary adenoma. Hauv ntau dua 3/XNUMX ntawm cov neeg mob, cov neeg mob tsis paub txog qhov muaj nyob ntawm lawv cov adenoma ua ntej qhov mob hnyav. 

Risk yam tseem ceeb 

Cov neeg uas muaj pituitary adenoma feem ntau muaj cov tsos mob tshwm sim los yog precipitating yam: noj qee yam tshuaj, tshuaj ntsuam xyuas, kev pheej hmoo siab pathologies (mob ntshav qab zib mellitus, kuaj mob angiographic, coagulation disorders, anti-coagulation, pituitary stimulation test, xov tooj cua, cev xeeb tub, kho nrog bromocriptine, isorbide. , chlorpromazine ...)

Txawm li cas los xij, feem ntau ntawm cov mob stroke tshwm sim yam tsis muaj qhov cuam tshuam los nag.

Pituitary lossis pituitary apoplexy yog kev sib xyaw ua ke ntawm ntau cov tsos mob, uas tuaj yeem tshwm sim ntau teev lossis hnub. 

mob taub hau 

Mob taub hau hnyav yog thawj cov tsos mob. Ntshav taub hau muaj nyob rau hauv ntau tshaj peb lub hlis twg ntawm cov neeg mob. Lawv tuaj yeem cuam tshuam nrog xeev siab, ntuav, ua npaws, cuam tshuam ntawm kev nco qab, yog li ua tiav meningeal syndrome. 

Pom kev tsis sib haum xeeb 

Hauv ntau tshaj li ib nrab ntawm cov neeg mob pituitary apoplexy, qhov muag pom kev cuam tshuam nrog mob taub hau. Cov no yog cov kev hloov kho qhov muag pom lossis poob ntawm qhov pom kev pom. Qhov ntau tshaj plaws yog bitemporal hemianopia (poob ntawm lub ntsej muag sab nraud ntawm sab nraud ntawm qhov muag pom). Oculomotor paralysis kuj tshwm sim. 

Cov cim qhia endocrine 

Pituitary apoplexy feem ntau nrog mob pituitary insufficiency (hypopituitarism) uas tsis tas yuav ua tiav.

Kev tswj ntawm pituitary apoplexy yog ntau yam kev qhuab qhia: ophthalmologists, neuroradiologists, neurosurgeons thiab endocrinologists. 

Kev kho mob ntawm apoplexy feem ntau yog kho mob. Kev hloov tshuaj hormones yog siv los kho qhov tsis txaus ntawm endocrinological: corticosteroid therapy, thyroid hormone therapy. Ib qho hydro-electrolytic resuscitation. 

Lub apoplexy tuaj yeem yog qhov kev kho mob neurosurgical. Qhov no yog lub hom phiaj kom decompress cov qauv hauv zos thiab tshwj xeeb yog txoj hauv kev kho qhov muag. 

Kev kho corticosteroid yog qhov ua tau zoo, txawm tias aoplexy tau kho neurosurgically lossis saib xyuas yam tsis muaj kev phais (tshwj xeeb tshaj yog nyob rau hauv cov neeg uas tsis pom qhov muag lossis pom kev tsis pom kev thiab tsis muaj kev puas tsuaj ntawm kev nco qab). 

Thaum qhov kev cuam tshuam sai sai, tag nrho cov kev rov zoo tuaj yeem ua tau, thaum qhov kev kho mob qeeb yuav muaj qhov muag tsis pom kev mus tas li lossis hemianopia. 

Nyob rau hauv lub hlis tom qab lub apoplexy ib tug rov ntsuam xyuas ntawm lub pituitary muaj nuj nqi yog nqa tawm, nyob rau hauv thiaj li yuav saib seb puas muaj pituitary tsis txaus.

Nws tsis tuaj yeem tiv thaiv pituitary apoplexies tiag tiag. Txawm li cas los xij, koj yuav tsum tsis txhob hnov ​​​​qab txog cov tsos mob uas yuav yog cov pituitary adenoma, tshwj xeeb yog kev cuam tshuam ntawm qhov muag (adenomas tuaj yeem ua rau cov hlab ntsha ntawm lub qhov muag). 

Kev phais tshem tawm ntawm adenoma tiv thaiv lwm ntu ntawm pituitary apoplexy. (1)

(1) Arafah BM, Taylor HC, Salazar R., Saadi H., Selman WR Apoplexy ntawm pituitary adenoma tom qab kuaj dynamic nrog gonadotropin-tso cov tshuaj hormones Am J Med Xyoo 1989; 87:103-105 : kuv