Ihe Kpatara syndrome efu sella. Nchoputa, ọgwụgwọ

Ntoputa nke efu sella syndrome nwere ọtụtụ na-akpata na nkọwa. Ihe bụ na a na-akpọ efu, ọ bụ a priori nwere ike ịbụ oghere. N'ihi na ịrịba Mbelata na olu nke ndị dị otú ahụ glands ka pituitary, ohere ugboro ji site na ya, na-aga n'okpuru mmanya na ndị ọzọ na meninges.

Ọ na-enyo na X-ray oyiyi fọrọ nke nta-adịghị ahụ anya pituitary na anya inweta naanị cerebrospinal ọmụmụ na shei. Ya mere, nke a ohere a na-akpọ efu. Ya mere, ọ na-ahụrụ site na steeti ọkachamara MRI ma ọ bụ CT Doppler nke isi. Mgbe ahụ neurologists na neurosurgeons emepe ọgwụgwọ Usoro dị na nke a kpebisiri n'ihu ihe.

Ebee bụ Turkish sadulu?

Natural ebe sella bụ sadulu ekara indentation na ọkpụkpụ Ọdịdị nke ahụ okpokoro isi isi mmadụ. Ọ bụ akụkụ nke sphenoid imi, ya bụ, n'elu mgbidi òkè. Ọ nwere a dịtụ obere size n'ogologo (banyere 10 mm) na ịdị elu (7-13 mm). Oghere sella, nke ụlọ ndị pituitary gland, a na-akpọ pituitary fossa. Site subarachnoid ohere na-iche site na a diaphragm - a siri ike shei nke ụbụrụ. Site a obere oghere na diaphragm gbatịrị ka a na-akpọ pituitary stalk, nke nwere a njikọ na hypothalamus.

Research na mpaghara ebe a

Back na ufọt ufọt iri abụọ na narị afọ, ọ bịara mara na ụwa echiche nke "efu sella syndrome." Ihe nke a pụtara bụ ike ịmata kpọmkwem American pathologist Bush ná mmalite 50s. N'oge ogologo ogologo nnyocha o jisiri ịchọpụta enweghị ma ọ bụ underdevelopment nke ukwuu aperture ọkara nwụrụ anwụ. Im otopsii fọrọ nke nta 800 nwụrụ anwụ, ọ nwere ike kwubiri na ọ bụghị ihe niile ikpe nke na-egbu egbu prostate enweghị nchịkwa ọnọdụ aghọwo a isi. Bush kwuru na na pituitary fossa budata gbanwere ndị pituitary gland, ka enwetara a na-edochaghị anya na udi ma na-ele anya dị a mkpa oyi akwa nke anụ ahụ.

Russian nchọpụta Savostianov na 1995 gbanwetụrụ na nhazi ọkwa chọrọ site Bush ọrịamkpokọta dị iche iche na diaphragm ụdị, mpịakọta intrasellyarnyh tankị kpụrụ n'etiti cerebellum na medulla oblongata. N'otu na nkà mmụta sayensị ubiere-ekwu banyere ndị na-esonụ: 8 nke 10 inyom karịrị afọ iri anọ, na-amụ ihe karịrị otu ugboro kpụrụ daa ọrịa na mgbaàmà-amalite na-egosi elu efu sella syndrome. Ke adianade do, ihe karịrị ụzọ abụọ n'ụzọ atọ nke nwanyi ọrịa na-ata ahụhụ na ibu oké ibu ndụ nke dị iche iche degrees. N'ime afọ ole na ole, ndị ọkà mmụta sayensị na-enwe ike ejikọta daa ọrịa na-adakarị mgbaàmà, na-anọrọ isi na sekọndrị syndrome efu sella.

forms nke ọrịa

N'ihi a kwere omume nkewa nke ọrịa n'ime isi na abụọ iche-iche, ọ bụ mee ka onye ọrịa na-ekpebi ndị kasị mma ọgwụgwọ nhọrọ. Na omume, nke a bụ nke dị oké mkpa na na amụma nke ọrịa.

Primary efu sella syndrome syndrome, mgbaàmà nke na-egosipụta site na ụba intracranial mgbali, ọ nweghị mmetụta na ala nke pituitary gland. N'agbanyeghị ntakiri "na-ata ahụhụ" gland, chee a ụfọdụ nkwarụ na diaphragm. Ekemende ezighị pituitary gosipụtara na ya olu, mbenata ya, mgbe nke ohere nwere sella drooping meninges na ọmụmụ (CSF).

Akwara ozi mgbaàmà ọzọ akpọ na abụọ ọrịa. Ebe ọ bụ na "gafere" mbụ ígwè na-akawanye nnọọ mgbe ọ na-achọ ozugbo ịwa ahụ ọgwụgwọ, radieshon ọrịa, na ojiji nke a plurality ọgwụ gbochie ọbara ọgbụgba. Oputara na kasị dị ize ndụ bụ a syndrome sekọndrị efu sella syndrome. Ihe mere na mbido nke ọrịa na-kpuchie ke a dịgasị iche iche nke ihe na mkpa ntụle zuru ezu.

The yiri ọnọdụ nke ọrịa

Mbụ niile na n'ihe ize ndụ ga-agụnye ndị mmadụ na a akụkọ ezinụlọ nke ntoputa nke nsogbu a. Site mụrụ mgbe ụmụaka na-aga ihe ọmụmụ akabeghị aka diaphragm, nke bụ underdeveloped, incompleteness shei. Ọwọrọ More prenatal nwa ebu n'afọ na ụbụrụ na utero nwere ike kpụrụ na ọnụnọ nke ntụpọ n'okpuru oghom gburugburu ebe obibi ihe. The kasị dị ize ndụ na ihe nke ụzarị ọkụ na-atụle, nwedịrị ike ịta na gburugburu ebe obibi, gbanwetụrụ oriri, nchegbu nwetara site n'ọdịnihu nne, ndị ogbenye mma nke mmiri ọṅụṅụ, na ndị ọzọ.

The esi nke na ụba intracranial mgbali

Ize Ndụ nsogbu nke ọrịa ụfọdụ nwere ịrịba mmetụta na ọdịdị nke a na-akpata. Dịkwuo intracranial mgbali nwere ike ịbụ n'ihi:

• ported okpokoro isi unan, bruises, concussions;
• ọbara mgbali na ndị ọzọ na ọrịa obi;
• cancer etuto ahụ;
• ọjọọ N'ezie nke afọ ime, mgbagwoju anya na-amụ nwa, ime na;
• thrombosis;
• degenerative diski ọrịa nke cervical spain (ọrịa emetụtakarị nkịtị ọbara eruba na cranial oghere);
• dị iche iche na-efe efe na-emetụta ndị Central ụjọ usoro (ụbụrụ, meningitis, hemorrhagic fever, wdg).

Secondaries syndrome "efu sella" budata emetụta larịị nke pituitary, a mgbali abawanye n'ime cranial oghere. Ọ mbụ budata ụba, akpụ akpụ, na mgbe ahụ budata belata na olu n'ihi na necrosis, anụ ahụ ire ere atrophy ported neurosurgical na oncological arụmọrụ.

Common mgbaàmà nke ụbụrụ

Ihu ọma, tupu Itie a pụrụ iche e mere na, ọtụtụ ndị na-enweghị echiche banyere okwu ahụ bụ "efu sella syndrome." Olee ụdị daa ọrịa na ihe na-ize ndụ, ọtụtụ ndị ọrịa mara na naanị na aka pụta Onyonyo. Ọtụtụ mgbe ha na-enweghị ihe ọ bụla mkpesa, na ha na-eche zuru oke mma. Otú ọ dị, nke a adịghị egosi na ihe niile mkpesa na ike ịbụ. Ọtụtụ mgbe akwara ozi mgbaàmà gosi na ndị na-esonụ:

• Ugboro isi ọwụwa, mgbe ụfọdụ, mgbe nile (na ha enweghị a kpọmkwem ebe na-enwe a dị iche iche osisi ike);
• dizziness;
• precariousness, na-ejighị n'aka na-eje ije (nwoke ẹsịn site n'otu akụkụ gaa n'akụkụ);
• ọnwụ nke ebe nchekwa na ịta, ọdịdị nke na-adọpụ uche;
• ekwekọghị n'okike ike ọgwụgwụ, iju ke larịị nke na-arụ ọrụ ike na ntachi obi;
• -emetụta akparamàgwà mmadụ obi ọrịa.

ophthalmic ọrịa

Ọtụtụ mgbe mata enyo enyo ọrịa jikwaa ophthalmologists. Ndị ọrịa a na-abịa na-eme mkpesa banyere arịa ọrịa nke akụkụ nke ọhụụ. Ọtụtụ mgbe e nwere ndị na-esonụ mgbanwe:

• mgbu n'oge ije nke nwa anya;
• mgbe nile atọ;
• ozizi nke conjunctiva;
• bịara ikiri;
• na-egbuke egbuke mgbukepụ n'anya.

N'oge zuru ezu nnyocha e mere ndị ọkachamara nwere ike ịchọpụta na ụfọdụ ji mara enweghị nchịkwa ngosipụta, nke na-agụnye edema na hyperemia nke optic akwara, na distortion nke ubi nke echiche, omume nke eyestrain. Dị otú ahụ dysfunction nke mmadụ visual usoro nwere ike ịbụ ugbu ruru elu intracranial nsogbu. Na-anọghị nke adọ doro nke ndị dị mkpa ọgwụgwọ jikoro n'ihu hypersecretion nke intraocular ọmụmụ pụrụ iduga glaucoma.

Mgbanwe ndị na-endocrine usoro

Dị ka e kwuru na mbụ, ọtụtụ ndị inyom na-ata ahụhụ mgbe isua 35. Ngosipụta nke ọrịa bụ kpọmkwem dabere na-adọ nke exacerbation na ngbaghara. Na akụkụ nke endocrine usoro bụ kasị ọrịa mere site autonomic ọrịamkpokọta:

• miri dyspnea ọbụna ezumike, iku ume ọkụ ọkụ;
• akpata oyi, fever;
• mgbu na aru aches;
• eguzogide ọgwụ ọkwa fever ahu;
• Ugboro-ada mbà;
• tachycardia, gbasara obi mgbu;
• nkụda mmụọ nke a oche.

Arụ ọrụ pituitary mmiri ọgwụ ọdịda ọgwụ omume ugboro ugboro emeghe maka a ngosipụta nke cancer prostate akpụ. Ke adianade do, Nchikota microadenomas na "efu sella" - bụghị ihe ọhụrụ. N'ihi na nnata nke chọrọ nọmba nke nējisi site stalk nke pituitary homonụ na belata hypothalamus gland nwere ike ịchịkwa okwu ụfọdụ mmekọahụ ọrịa bụghị nanị n'etiti ndị inyom ma n'etiti ndị ikom ọrịa (ebelata libido na potency, amenorrhea, hypothyroidism, wdg). Na oké ikpe, e nwere ihe ize ndụ nke orùrù nke cerebrospinal ọmụmụ site gọzie gị Itie.

nchọpụta nsogbu

Iji chọpụta ọrịa ga-ezo aka na ihe ndị kasị pụrụ ịdabere na usoro. Ka ụbọchị, agbagha ndú na nchoputa nke akwara ozi ọrịa nke ụbụrụ nwere ike na-ahuta ka ihe MRI. Results ekenịmde tomography enye kasị ukwuu ego nke ihe ọmụma banyere ọrịa na-arịa. Ọ dị mkpa ka n'ime akaụntụ n'ọkwá nke zuru nchekwa nke ụdị nnyocha e mere.

The foto na-egosi na MRI na a ọrịa nwere "efu sella" syndrome, dị maka anya:

• ọnụnọ nke cerebrospinal ọmụmụ;
• pituitary appreciable deformation (curved udi yiri a mpekere onwa ọnwa ma ọ bụ mma owuwe ihe ubi) centrally odude foneelu;
• na sella oghere sikwa asymmetrically suprasellar tank;
• foneelu ara ukwu lengthened na ghọrọ thinner.

Method maka ịchọpụta na intracranial mgbali elu na image nwere ike kpebisie na ndị ọzọ na-apụtachaghị ìhè na-egosi (abawanye size na ventricular oghere nwere mmanya).

Dọkịta na-amalite ọzọ na-achọpụta ọrịa ụzọ, gụnyere adakarị laabu ọmụmụ (venous ọbara ụfọdụ maka mkpebi siri ike nke itule nke homonụ-emepụta site na pituitary gland na plasma) na ocular fundus ule ọnọdụ.

Akụkụ nke ọgwụgwọ

-Eche ma ọ bụ omume na-agwọ ndị ọrịa nke "efu sella", ọ ga-aghọta na ọ bụ nanị a mbara ọgwụgwọ jikoro ga-enyere dozie nsogbu a. Mgbe niile, na-enweghị enyemaka nke neurologists, neurosurgeons, endocrinologists na ophthalmologists apụghị ime.

Primary syndrome "efu sella", dị ka a na-achị, ọ dịghị mkpa pụrụ iche ọgwụgwọ. Enweghị na-eme ọrịa tangible nsogbu, ọrịa n'ụdị a abụghị a egwu egwu ka ndụ. Ọ bụ ezie na mgbe ụfọdụ, e nwere mkpa maka n'ikuku nke ụfọdụ ọgwụ na hormone ọgwụ.

N'ihe banyere nke abụọ syndrome enweghị mmiri ọgwụ ọgwụgwọ nwere ike ime. Ebe ọ bụ na ịrịba mgbanwe bụ isiokwu dị mkpa gland, na hypothalamus na pituitary gland, nke a bụ mgbe a arọ ogbo nke ọrịa nwere ike gwọrọ naanị operable usoro. Ka ihe atụ, mgbe apịpụta optic akwara na diaphragmatic sagging nrutu na onu nwere ike na-enyere ndị ọrụ metụtara a neurosurgeon. The ngosi maka ịwa ahụ a na-eri eri si na imi nke cerebrospinal ọmụmụ. Thinned ala nke sella enye ohere cerebrospinal ọmụmụ ehi ehi.

Amụma mgbake

Ohere mgbake nnọọ ukwuu, karịsịa ma ọ bụrụ na ịdị njọ nke-adakarị ngosipụta na kwuru na ala isi syndrome efu sella syndrome. Ọgwụgwọ vozniknuvshey hypopituitarism iji hormone nnọchi ọgwụ na-kwụsị ọtụtụ mgbe a mma pụta. Ọtụtụ mgbe, Otú ọ dị, ịkọ N'ezie nke ọrịa bụ dabere na ịdọkapụta pituitary abnormalities na ụbụrụ.