Pheochromocytoma - he aha te mea te reira? Pheochromocytoma: tohumate, te tātaritanga, maimoatanga, whakaahua

Ko te meka rawa o te tupu o te pukupuku i roto i te tinana tangata, ara mārire? Ko reira kua rawaka take mo te āwangawanga. A ki te urupare ki te meka taua kia tino nohopuku, te kore kanohi te mōrea o piki pōauautanga tino. Hoki tenei take, hanga ana e ia tikanga ki te ako i te tohu taketake o te ahua o te pukupuku, rawa, ki te e korero tatou e pā ana ki te puka onge rite pheochromocytoma. E kore e whakaaro tatou i te pānga o te tirohanga i runga i te raruraru o rongoā iwi me ētahi atu tikanga kē. Ko te haerenga ki te tākuta, ko te otinga tino pono.

Pheochromocytoma - he aha te mea te reira?

kia mohio ki tenei wā rite te puku he natula mārere Koló ranei, tito o ngā pūtau chromaffin, e hua catecholamines. Ka taea e hua te reira i rua amines biogenic me peptides e ngā norepinephrine me dopamine.

I roto i te nuinga o te wā (90%) o tenei momo o te puku whanake i roto i te medulla adrenal, nui iti tona ahua whakaritea i roto i te tinana te pūtahi o, nga papatoiake, puku ranei kōhao rei. Ka taea te pēnei te putanga o te pheochromocytoma i roto i te upoko kaki ranei rohe ki te kāwai o okotahi.

I roto i te 10% o te wā katoa o tenei ahua o te puku ko te localization extraadrenal mārere. Ko te kupu i reira ko te hanga o te dopamine. Ko te tukanga o te metastasis i taua raruraru, hinga nga pūtau puku, te tikanga i roto i nga pūkahukahu, ate, wheua, uaua, me taikiri rohe.

Ko te take mo te putanga me te whanaketanga

E rave rahi Kua rongo e pā ana ki tenei mate rite pheochromocytoma. He aha te mea te reira, kāore, e mohio e kore katoa. He mea nui ki te matau te aha te raruraru taua puta i roto i te tinana tangata. A ka kotahi kia tuhia te reira e te mārama whakahoki whānui e pā ana ki te take o ano. Engari kia rite ki te hua o ngā akoranga kua hanga etahi whakatau e pā ana ki te āhua ira o pheochromocytoma.

Nuinga o ngā wā puta te mate i roto i te iwi 25 ki te 50 tau te pakeke. Fele, whakaritea te whanaketanga o tenei momo o te puku i roto i nga wahine waenganui-pakeke. Ki te kōrero tatou e pā ana ki tamariki, he nui i roto i te mau tamaroa i te tātaritanga taua. Otiia i roto i te whānui, pheochromocytoma puku - he āhuatanga āhua onge.

Ko te kupu e pā ana ki 10% o te katoa maha o taua raruraru pā ana ki te puka te utuafare,. Tenei te tikanga e ko tenei momo o te puku hakari i roto i te iti rawa tetahi o nga matua o te manawanui.

Tonu ki te titiro i te take o tenei ahua o te mate, ko reira ia tapao e taea e te reira tetahi o nga wae o te syndrome o neoplasia endocrine maha (momo 2A me 2B). Pheochromocytoma whakaritea i roto i te 1% o tūroro pāngia ki te pēhanga toto diastolic.

tohutanga

I roto i te ako o taua pukupuku rite pheochromocytoma, tohu, te tātaritanga me te maimoatanga he poraka ngā mōhiohio matua, e tukua ana ki te whakaaro i te tumu parau i koki rerekē. Engari kia tīmata ki te mau faaiteraa o te mate. Ko te tino kanorau tohutanga a maha titiro rite te raruraru hauora iti mōrearea.

kia tīmata koe ki te meka i reira he kotahi tohumate e he kainga i taua mate rite pheochromocytoma. Takawhita - ko etahi o nga mau faaiteraa o te puku i roto i te pātai enei. Ka taea e te tango i te reira i te wahi i roto i te puka pūmau me te krizovoe. A, no te whanake he puku i catecholamine raruraru hypertensive, piki pēhanga toto tino koi. Otiia i roto i te wā mezhkrizovy kia noho BP wā tiketike, kia i roto i te awhe noa ranei. Papa'ihia i take ka puta pheochromocytoma ki te pēhanga tiketike tamau, engari kahore mōrearea.

Mō ētahi atu pārongo e pā ana ki Stroke

Hanga ana te reira tikanga ki te whakarongo ki te meka e ki te raruraru pērā i pheochromocytoma raruraru (takawhita) Kei te maha haere tahi i te gastrointestinal, Cardiovascular, pūkoro me disorders neuro-hinengaro. A paraparau e pā ana ki te whanaketanga o te kāwanatanga taua, kia tuhia te reira e te āhuatanga reira e te tohu e whai ake nei: ānini, faaati, manukanuka, tahurihuri kau, kiri ha ma, ruaki, cramps me sweating. He pea he takahi o manawataki, tachycardia me te mamae ngakau.

A, no te pāngia ki te pheochromocytoma, raruraru hypertensive kia whakapataritari ruaki, whakapairuaki, me te mangai maroke. Otiia e kore e te enei huringa i roto i te āhua o te manawanui o te hauora iti tonu. Ki te taua te pukupuku maha huri āhua o te toto. Kei te korero tatou e pā ana ki taua pōauautanga rite lymphocytosis, Hyperglycemia, leukocytosis, me eosinophilia.

Pae taea ki te muri i te meneti torutoru ki te haora, neke atu rānei. Ki tenei āhuatanga kāwanatanga ko tona whakaweto ohorere. Whakaiti i roto i te pēhanga toto hoki puta tere, na e ara i reira te mōrea o te hypotension. Ka rite ki kia hanga tohumate whakapataritari ia taua āhuatanga mahi, e mau ana i roto i palpation hohonu o te puku, te whakamahi o te waipiro me te raau taero, hauhauaitu pukā ranei, nekehanga koi, raruraru aronganui, me te tahi atu āhuatanga.

rawa patua

Haurangi ahu ki te whai i te auau rerekē. Ka taea e ratou te ua 10 ki te 15 ngā wā i te ra ranei kotahi te marama. Ki te te tīmatanga o te raruraru nui i roto i te pheochromocytoma, ka hanga reira tikanga ki te kōrero e pā ana ki te mōrea tūturu o te patu, te toto i roto i te etine, täkihi, infarction myocardial, wāwāhi aneurysm o te haoraora, edema pūkahukahu, me etahi atu. Ko te pōauautanga tino nui o tenei huru ko faaite te ru catecholamine ano e haere noa hemodynamics. Kei te korero tatou e pā ana ki te rerekē haere hypo- me takawhita, he taimaha i te āhua, me te kore e taea te papaki.

Na, pheochromocytoma - he aha te mea te reira? Whakaaro ona mau faaiteraa, kia kia whakarongo utua ki nga wahine hapu, no te mea to ratou e taea e te puku taua whakaahua ke rite eclampsia, i mua-eclampsia me toxaemia. Ko te putanga o taua tohu kia meinga putanga whanau kino.

āhua ka taea, me te pūmau o te puku, i roto i te mea i ngā wā katoa tiketike te pēhanga toto. I roto i tenei ahua, maha tuhia huringa i roto i te whatukuhu, te fundus, me te myocardium. Ko reira ano hoki e taea huringa ohorere i roto i te tūāhua, ānini, rohirohi, me te kārangirangi. Ko tētahi o nga tūroro 10 i te whanaketanga huka.

He atu mate e maha e pā ana ki pheochromocytoma. Ko reira e pā ana ki syndrome o Raynaud, mate gallstone, syndrome Cushing, neurofibromatosis, me etahi atu. I roto i te kaupapa e whakawhanake te puku mārere, mamae i roto i te kopu, i reira he metastasis ki whēkau tawhiti, me te mate taimaha tere.

faaiteraa haumanu motuhake

He etahi āhuatanga o te mate, e taea arahi ki etahi pōauautanga. Ko reira e pā ana ki te tukanga e whai ake nei:

• Tamariki pāngia ki pheochromocytoma i roto i nuinga o te wā whakawhanake takawhita. He hauwhā o te tūroro i te wawe tau he polydipsia pūmau, polyuria, me haurangi. Ko tētahi atu pōauautanga e taea meinga pheochromocytoma i roto i te tamariki - he āta i roto i te tupu. Ano, ko reira i te tau wawe ki te tātaritanga hanga ite iho i te kaha mate taimaha, sweating, whakapairuaki, me te ruaki, raruraru ataata, me raruraru vasomotor.
• Women ki pheochromocytoma kia wheako ino o te hauora e tika ana ki te tai. kia waiho nga wahine hapu he peehia o eclampsia me mua eclampsia-.
• I roto i te wā i reira kei te puku te muri ki te taiepa o te tōngāmimi, kia pā ana urination ki hukihuki. He he ano hoki te mōrea o te hematuria mamae kore, te pēhanga toto nui haere, ānini, whakapairuaki me palpitations.

tikanga o te tātaritanga

I roto i te tikanga ki te tautuhi i te huru o te manawanui ki te mate whakapae pērā i pheochromocytoma, tātari kāwanatanga kia arotahi te tinana matua i runga i te tohu e whai ake nei: koma o te kiri o te mata, me u, te pēhanga toto nui haere, tachycardia, hypotension orthostatic.

Ko te kupu he mea e tika ana ki te hei palpation tupato o te nganatanga i te take o te pukupuku i te kaki, puku ranei. Ko te rārangi raro e taea taua mahi meinga te whanaketanga o te catecholamine raruraru.

Hoki, kia ngā-kounga tiketike tātaritanga i roto i taua pukupuku i te haerenga ki te ophthalmologist. Ka taea te hāngai ana tēnei huru ki te meka e tata 40% o te iwi e mate ana i te takawhita, kitea retinopathy hypertensive te, me te rerekē pakeke.

He paearu matüora mō te tātaritanga o pheochromocytoma, he whakaahua o e tukua ki a tatou mahino te kaumatua o te āhuatanga. Na e korero tatou e pā ana ki te nui haere ngā taumata o catecholamines i toto, mimi, kūhuka toto me te chromogranin-A i roto i te serum toto. I te tahi taime kia ai taua mea raraunga e hāngai ana i runga i te hua i roto i te kukū o te taiaki parathyroid, cortisol, konupūmā, ūkuikui, calcitonin, me ētahi atu āhuatanga.

I raro i etahi tikanga o tūroro kawea i roto i pārōnaki tātaritanga o te pukupuku. Kei te korero tatou e pā ana ki mate pērā i āhotea, neurosis, takawhita, hyperthyroidism, tachycardia paroxysmal, poisoning me kōtītiti i roto i te CNS.

I roto i te whakatau i te momo o te puku, me te tohu o tona whanaketanga taea te whakamahi MRI ko CT, me te te ako o te mahi cardiac o te manawanui. Ki te pāngia pheochromocytoma te, tohu, te tātaritanga me te maimoatanga - he te āhuatanga e he tino hāngai rite i roto i te pukupuku o ngā momo te rapunga wā o ngā raruraru, me te maimoatanga wawe e te kī ki te putanga pai o te mahi ki te manawanui.

Me pēhea te ki te hamani

He ngā tikanga o te mana i runga i te puku rite mārere, me te kore i te riri. I roto i te nuinga o te wā, ka hei pokanga te whakatau tino kouma, ki te i kitea ai pheochromocytoma. ka waiho rawa e hāngai ana i roto i te take o te puku i roto i te repe adrenal Tango.

Ko reira kia kia okotahi tika ki te huru rawakore o te ngakau, oko toto me te pēhanga toto tiketike. taote whai wāhitanga ka ko tino houhou ranei ara Kāore taua huru. Huri i te reira i roto i atu i runga i te pānga o te puku, pērā i pheochromocytoma. heke Treatment te ki therapy tarukino, te tikanga e te ra torutoru.

Ko te whakamahi o taero rerekē ki te puku neutralization titau e ka waiho te manawanui i roto i te moenga, a ka tango hawhe-noho tūranga. Hei kawe i te tākuta pēhanga toto noa kia whakahau Arepa-blockers. More āta, te reira raau taero pērā i "Tropafen" me "phenoxybenzamine." Ki te whakaritea te manawanui te raruraru hypertensive, e kia whakahaere wā "phentolamine" "nitroprusside Konutai" me ētahi atu raau taero rite. He aha te mea nui ko te meka e i roto i te maimoatanga-mua ko e tika ana ki te whakaora i te manawanui i te maroketanga.

Mā te pokanga

Ki te i kitea pheochromocytoma, whiriwhiria te maimoatanga te whakamahi i te scalpel te ki te whakaaro ki te mea tukanga ngā he puku. E ngā te tino noa, transbryushinny, extraperitoneal me tikanga transthoracic.

I roto i te kaupapa i kitea te puku tuakiri i muri i te whakamātautau, te waitohunga ki maimoatanga hāparapara ka painga. O te akoranga, i reira kia kia relapses, engari faaite mai ratou ratou anake i roto i te 13-15% o te wā.

Otira ka reira he pukupuku maha, he tino uaua ake te āhuatanga. Ko te otinga tino whaitake ko ki te tango pukupuku katoa, engari te raruraru e takoto i roto i te meka e te tūponotanga o te putanga angitu ko tino iti. Ko reira hoki tenei take i kawea i roto i te take o pheochromocytomas maha pokanga i roto i roto i te maha ngā wāhanga. I roto i te tahi mau āhuatanga, nekehia te puku anake te wāhanga.

Ko nga āhuatanga o te mahi, i roto i te akoranga o tona whakatinanatanga ka tono te uru anake laparotomy. faataa te reira i tenei huarahi nui-mōrea puku extraadrenal localization. He utu ano hoki te reira i te ite e, puritia te mana o te hemodynamic (pēhanga toto me te pēhanga venous pokapū) te puta noa te wawaotanga.

I roto i te nuinga o te wā i muri i nekehia atu pheochromocytoma, heke te pēhanga toto. Ki te kore te mea reira te tauhohenga taua o te rauropi, na reira he take katoa ki te whakapae i te meka o te hanganga o te kiko puku mōwaho.

Ki te kitea pheochromocytoma i roto i nga wahine hapu, te tuatahi i hanga te stabilization o te pēhanga toto, a ka whakamana te wāhanga cesarean, materoto ranei, a anake ka tango i te puku iho.

I roto i te take o Tātaritia he pheochromocytoma mārere, i nei te tohatoha o metastases riro hahau ( "Dacarbazine" "Vincristine", "Cyclophosphamide").

I roto i te whānui, ki te kitea te puku i i te wā wawe, a he pai rite hoki maimoatanga te manawanui, te tūponotanga ki te hinga tenei raruraru e tino nui.

He aha ngā āhuatanga ka taea te tautuhi rite pāngia e

Ki te whanaketanga o te pukupuku i roto i te tinana, ko nga wa katoa te mōrea o whakapataritari te whakaeke. Ko reira he mea nui ki te kia mōhio o, e kia arahi ki whakahōhā o te kāwanatanga. Ko te pātai e pā ana ki te takoto, te huringa tūranga tinana, hyperventilation, ruwha i roto i nekehanga whēkau, kawenga tinana, excitation hinengaro me te pēhanga ki te rohe i reira paetata puku. Ki te i pāngia koe ki te pheochromocytoma, e kore e whiwhi whai wāhi ki waipiro, ngā waina, me te pia, me te ki te kai tiihi.

Kua hoki ki reira i tuhia take ka timata nga whakaeke i muri i te fariiraa i nikotīni, pōuritanga tricyclic, pärönaki phenothiazine me beta-blockers.

hua

Ko te kupu i tatou whakakitea te kaupapa o "Pheochromocytoma" i. He aha te mea te reira, ka titiro matou ki te taipitopito te nuinga. tonu te reira ki te hanga i te mutunga kitea: te raruraru ko te nui rawa ki te hamani i te reira iti. I nga tohu tuatahi e rite nga tohu o pheochromocytoma, he mea e tika ana ki te kōrero i te tākuta, kia pāngia me timata maimoatanga.