Pheochromocytoma - abin da yake da shi? Pheochromocytoma: cututtuka, ganewar asali, magani, photos

The sosai gaskiyar abin da ya faru na marurai a cikin jikin mutum, ko benign? Shi ne riga isa dalilin damuwa. Kuma don amsa ga wannan wata harka dole ne sosai m, in ba haka ba fuskantar hadarin rikitarwa ƙaruwa muhimmanci. A saboda wannan dalili, shi ya sa hankali domin koyon tushen alamun bayyanar marurai, musamman idan muna magana ne game da wani m tsari a matsayin pheochromocytoma. Mun kamata ba la'akari da sakamakon hangen zaman kan matsalar da jama'a magunguna da sauran madadin hanyoyin. A ziyarar da likita ne mafi dogara bayani.

Pheochromocytoma - abin da yake da shi?

Wannan lokaci ya kamata a fahimci matsayin da ƙari ne m, ko benign yanayi, hada da chromaffin Kwayoyin, wanda nuna catecholamines. Yana iya nuna duka biyu biogenic amines kuma peptides da suka hada da norepinephrine da dopamine.

A mafi yawan lokuta (90%) na irin wannan ƙari tasowa a cikin adrenal medulla, da yawa kasa ta bayyanar gyarawa a aortic jiki, da kafafuwa, na ciki ko thoracic kogo. Ana zargin wani pheochromocytoma a kai ko wuyansa yankin za a iya dangana ga category na ban.

A 10% na dukkan lokuta, irin wannan ƙari ne a m extraadrenal sarrafawa. Kamar wancan akwai samar da dopamine. Amma ga aiwatar da metastasis a irin wannan matsala, da ƙari Kwayoyin fada, yawanci a cikin huhu, hanta, kasusuwa, tsokoki, da kuma yankin Lymph nodes.

A dalilan da fitowan da kuma ci gaban

Mutane da yawa sun ji game da wannan cuta a matsayin pheochromocytoma. Abin da shi ne, da rashin alheri, ba kowa da kowa ya sani. Yana da muhimmanci a fahimci dalilin da ya sa irin wannan matsalar ya auku a cikin jikin mutum. Kuma a sa'an nan da zarar ya kamata a lura da cewa a sarari m amsar game da hanyar tukuna. Amma a sakamakon nazarin da aka sanya wasu karshe game da kwayoyin halitta na pheochromocytoma.

Mafi sau da yawa cutar ta auku a cikin mutane masu shekaru 25 zuwa shekaru 50. Amma, da ci gaban irin wannan ƙari ne gyarawa a tsakiyar-shekaru mata. Idan muka magana game da yara, da irin wannan ganewar asali ne mafi girma a cikin maza. Amma a general, pheochromocytoma ƙari - a gwada rare sabon abu.

Kamar wancan ne game da 10% na jimlar yawan irin matsalolin da dangantaka da iyalinmu form. Wannan yana nufin cewa irin wannan ƙari da aka ba a akalla daya daga cikin iyaye na haƙuri.

Ci gaba da bincika musabbabin wannan irin cuta, shi ne ya kamata a lura da cewa zai iya zama daya daga cikin aka gyara na ciwo na mahara endocrine neoplasia (irin 2A da 2B). Pheochromocytoma gyarawa a 1% da marasa lafiya bincikar lafiya tare da diastolic jini.

symptomatology

A cikin nazarin irin siffofin maruran kamar yadda pheochromocytoma, cututtuka, bincike da kuma magance su key bayanai tubalan, wanda damar a yi la'akari da batun daga kusurwoyi mabambanta. Amma ya kamata a fara da manifestations da cutar. Symptomatology ne quite bambancin da kuma sau da yawa kama a kasa hatsari kiwon lafiya matsaloli.

Ya kamata ka fara da cewa akwai daya alama cewa shi ne barga a irin wannan cuta a matsayin pheochromocytoma. Hauhawar jini - wadannan su ne wasu daga cikin manifestations na ƙari a tambaya. Yana iya faru a cikin wani barga, kuma krizovoe form. Lokacin da ƙari tasowa a catecholamine hawan jinni rikicin, jini yana ƙaruwa quite sharply. Amma a mezhkrizovy lokaci BP iya zama consistently high ko zama a cikin al'ada kewayo. Rubuce lokuta idan pheochromocytoma tafi tare da m high matsa lamba, amma ba tare da crises.

Don ƙarin bayani game da bugun jini

Shi ya sa hankali domin kula da cewa da irin wannan matsala kamar yadda pheochromocytoma rikicin (hauhawar jini) ne sau da yawa tare da gastrointestinal, zuciya da jijiyoyin jini, na rayuwa da kuma neuro-tabin hankali cuta. Da yake magana game da ci gaban irin wannan jiha, ya kamata a lura da cewa shi ne halin da wadannan cututtuka: ciwon kai, tremor, juyayi, restlessness, kodadde fata, amai, cramps da sweating. Akwai iya zama wani take hakkin kari, tachycardia da zuciya zafi.

Lokacin kamu da pheochromocytoma, da hawan jinni rikicin iya tsokana amai, tashin zuciya da kuma bushe baki. Amma wadannan canje-canje a cikin haƙuri na jihar kiwon lafiya da aka ba ko da yaushe iyakance. Tare da irin siffofin maruran sau da yawa canza jihar na jini. Muna magana ne game da irin wannan rikitarwa kamar yadda lymphocytosis, hyperglycemia, leukocytosis, kuma eosinophilia.

Crease iya wuce daga 'yan mintoci zuwa awa daya ko fiye. Don wannan jiha halayyar ne ta m kashewa. Karu a jini kuma ya auku hanzari, sabõda haka, ko akwai hadarin hypotension. Kamar yadda tsokane bayyanar cututtuka irin abubuwan iya yin motsa jiki, dauke da fitar zurfin palpation na ciki, yin amfani da barasa da kwayoyi, hypothermia ko zafi fiye da kima, kaifi ƙungiyoyi, wani tunanin disturbances da kuma wasu dalilai.

musamman hare-hare

Seizures ayan da wani daban-daban mita. Su za a iya ji 10 zuwa 15 sau a rana, ko kuma sau daya a wata. Idan farko na tsanani rikicin a pheochromocytoma, to, shi ke sa hankali don magana game da real hadarin bugun jini, zubar da jini a cikin akan tantanin ido, koda gazawar, tsokar zuciya infarction, dissecting aneurysm na lakã, na huhu edema, da sauransu. A mafi tsanani wahala daga wannan yanayin ne catecholamine buga bayyana kanta da wanda ba a iya lura da shi ba hemodynamics. Muna magana ne game da canza hypo- da hauhawar jini, da ciwon tare da la'akari a cikin yanayi da kuma ba za a iya gyara.

Saboda haka, pheochromocytoma - abin da yake da shi? Ganin ta bayyananen, ya kamata a biya da hankali ga mata masu ciki, domin suna da irin wannan ƙari iya dodo as eclampsia, pre-eclampsia da toxaemia. A sakamakon irin wannan bayyanar cututtuka na iya zama illa haihuwa sakamakon.

Zai yiwu da kuma barga siffar da ƙari, a cikin abin da jini ne consistently high. A wannan jiha, sau da yawa rubuta canje-canje a cikin kodan, da fundus, da kuma myocardium. Shi ne kuma zai yiwu kwatsam canje-canje a cikin yanayi, da ciwon kai, gajiya da irritability. Daya daga cikin 10 da marasa lafiya da ciwon sukari ci gaba.

Akwai sauran cututtuka da ake sau da yawa dangantaka pheochromocytoma. Shi ne game da Raynaud ta ciwo, gallstone cuta, ciwo Cushing, neurofibromatosis, da sauransu. A cikin taron cewa tasowa a m ƙari, jin zafi a ciki, akwai metastasis to m gabobin, kuma m nauyi asara.

Specific asibiti manifestations

Akwai wasu siffofin da cutar, wanda zai iya haifar da wasu rikitarwa. Shi ne game da wadannan matakai:

• Yara kamu da pheochromocytoma a mafi yawan lokuta tasowa hauhawar jini. A kwata na marasa lafiya a wani wuri shekaru ne mai ƙayyadadden ajali polydipsia, polyuria, kuma seizures. Wani wahala da za su iya haifar da pheochromocytoma a yara - wani slowdown a girma. Haka kuma, shi ya kasance a wani wuri shekaru da ganewar asali sa kanta ji karfi nauyi asara, sweating, tashin zuciya da kuma amai, na gani disturbances, kuma vasomotor disturbances.
• Mata tare da pheochromocytoma iya samun tabarbarewar kiwon lafiya saboda da tides. Mata masu ciki zai iya zama wani kwaikwayo na eclampsia da pre-eclampsia.
• A lokuta inda ƙari ne dake kusa da bango na mafitsara, urination iya dangantawa da seizures. Akwai kuma wani hadarin m hematuria, ta ƙara jini, da ciwon kai, tashin zuciya da kuma palpitations.

hanyoyin da ganewar asali

Domin gane da yanayin haƙuri da ake zargin cuta kamar pheochromocytoma, jihar analysis jiki ya kamata a mayar da hankali musamman a kan wadannan cututtuka: paleness na fata fuska da ƙirãza, ta ƙara jini, tachycardia, orthostatic hypotension.

Kamar haka wajibi ne a yi hankali palpation na yunkurin a cikin hali na marurai a cikin wuyansa, ko ciki. A kasa line ne cewa irin ayyuka za su iya sa da ci gaban catecholamine rikicin.

Har ila yau, high quality-ganewar asali a cikin irin marurai kamata hada da ziyarar da ophthalmologist. Wannan yanayin za a iya dangana ga cewa kusan 40% na mutanen da fama da hauhawar jini, da hawan jinni retinopathy aka gano, da kuma sãɓãwar launukansa mai tsanani.

Akwai biochemical sharudda ga ganewar asali na pheochromocytoma, wani photo na wanda ƙyale mu mu fahimci muhimmancin da halin da ake ciki. Saboda haka muna magana ne game da ƙara matakan catecholamines a jini, fitsari, jini glucose da kuma chromogranin-A cikin jini magani. Wani lokaci yana iya zama dacewa data on karuwa a maida hankali parathyroid hormone, cortisol, alli, phosphorus, calcitonin, da kuma sauran abubuwa.

A karkashin wani yanayi na marasa lafiya ne da za'ayi bambanci ganewar asali da siffofin maruran. Muna magana ne game cututtuka irin psychosis, neurosis, hauhawar jini, hyperthyroidism, paroxysmal tachycardia, dalma da kuma tafka magudi a CNS.

A kayyade da irin ciwon daji da kuma digiri na ta ci gaba da za a iya amfani da MRI da CT, kazalika da nazari na haƙuri ta cardiac aiki. Idan pheochromocytoma aka bincikar lafiya, cututtuka, bincike da kuma magance - ne al'amurran da cewa su ne musamman dacewa kamar a marurai na daban-daban irin aka dace ganewa na matsaloli da kuma m magani suna da key zuwa wani tabbatacce sakamako na aikin da mãsu haƙuri.

Yadda za mu bi

Akwai hanyoyi daban-daban na tasiri a ƙari a matsayin m, kuma ba wata barazana. A mafi yawan lokuta, tiyata zai zama mafi m yanke shawara, idan aka gano pheochromocytoma. Cire zai zama musamman dacewa a yanayin saukan wani ƙari a cikin adrenal gland shine yake.

Amma akwai iya zama ware saboda da yanayin talauci da zuciya, jini da kuma cutar hawan jini. Saka hannu likita a lokacin da irin wannan yanayin ne sosai a ke so ko unacceptable. Sai dai itace mafi kan tasiri da irin wannan ciwon daji kamar yadda pheochromocytoma. Jiyya an rage wa miyagun ƙwayoyi far, yawanci daukan 'yan kwanaki.

A amfani da daban-daban kwayoyi zuwa ƙari neutralization ya nuna cewa da haƙuri zai zama a cikin gado, da kuma dauki rabin zaune matsayi. Don kawo wata al'ada jini likita iya rubũta alpha-blockers. More musamman, yana da kwayoyi kamar "Tropafen" da "phenoxybenzamine." Idan haƙuri yana gyarawa hawan jinni rikicin, Topical gwamnati zai zama "phentolamine" "sodium nitroprusside" da kuma sauran irin wannan kwayoyi. Abin da yake da muhimmanci shi ne gaskiya cewa a lokacin da pre-jiyya wajibi ne a ajiye haƙuri daga dehydration.

Amfani da tiyata

Idan pheochromocytoma aka gano, da magani ta yin amfani da wukar yin aikin tiyata da aka zaba game da abin da musamman tsari ne ƙari. Mafi na kowa ake hada, transbryushinny, extraperitoneal da transthoracic hanyoyin.

A cikin taron cewa ainihi ƙari da aka gano bayan da jarrabawa, da hangen nesa tare da m magani zai zama da amfani. Hakika, da akwai iya zama dakwai, komowan cutar, amma sun bayyana kansu kawai a 13-15% na lokuta.

Amma lokacin da akwai mahara marurai, halin da ake ciki shi ne muhimmanci mafi rikitarwa. A mafi m bayani ne a cire duk siffofin maruran, amma matsalar ta'allaka ne da cewa yiwuwar samun nasara sakamako ne quite low. Yana da wannan dalili da cewa a yanayin saukan mahara pheochromocytomas tiyata ne da za'ayi a dama, saukarwa. A wasu yanayi, kawai ƙari an cire partially.

Amma ga fasali na aiki, a cikin shakka daga da aiwatar za su shafi na musamman laparotomy damar. Yana bayyana wannan m high-hadarin extraadrenal ƙari sarrafawa. Shi ne ma daraja da sanin cewa iko da hemodynamic (jini da kuma tsakiyar venous matsa lamba) da aka gudanar a ko'ina cikin baki.

A mafi yawan lokuta bayan pheochromocytoma aka cire, jini rage-rage. Idan irin wannan dauki da kwayoyin ba ba, to, a can ne kowane dalili na shakkun gaskiyar samuwar ectopic ƙari nama.

Idan pheochromocytoma da aka samu a cikin mata masu juna biyu, da farko yi da karfafawa na jini, sa'an nan ya yi cesarean sashe, ko zubar da ciki, da kuma kawai sai cire ƙari kanta.

A hali na diagnosing wani m pheochromocytoma, a da rarraba metastases sami jiyyar cutar sankara ( "Dacarbazine" "Vincristine", "Cyclophosphamide").

A general, idan ƙari da aka gano a wani wuri mataki, kuma da mãsu haƙuri ne lafiya shirye domin magani, da chances shawo kan wannan matsala ne quite high.

Abin da dalilai za a iya bayyana a matsayin triggers

Tare da ci gaban marurai a cikin jiki ne ko da yaushe hadarin sa wani hari. Saboda haka muhimmanci ya zama sane da, wanda na iya haifar da ƙarin tsanani na jihar. Yana da wani tambaya game da jima'i, jikin hali canje-canje, hyperventilation, ƙagauta a lokacin hanji ƙungiyoyi, jiki kaya, shafi tunanin mutum zumudi da kuma matsa lamba ga yankin inda sarrafa ƙari. Idan ka kamu da aka pheochromocytoma, ba su samu shiga tare da barasa, musamman ruwan inabi, da giya, kazalika da ci cuku.

Akwai sun kuma an rubuce lokuta lokacin da hare-haren suka fara bayan samun nicotine, tricyclic antidepressants, phenothiazine Kalam kuma beta-blockers.

sakamakon

Kamar wancan ne muke da taken "Pheochromocytoma" da aka bayyana. Mene ne shi, za mu dubi mafi daki-daki. Ya zauna a sa a bayyane ƙarshe: matsalar ne ma tsanani mu bi da shi da sauƙi ba. A farko alamun cewa kama da bayyanar cututtuka na pheochromocytoma, shi wajibi ne don tuntubar likita, zama kamu da fara magani.