Qhov tshwm sim ntawm tus mob ntawm qhov khoob Turkish eeb muaj ntau yam ua rau thiab piav qhia. Qhov tseeb yog tias, raug hu ua npliag, nws yog qhov tseem ceeb tsis tuaj yeem hollow. Vim qhov txo qis hauv qhov ntim ntawm cov qog xws li qog pituitary, qhov chaw ib zaug nyob ntawm nws dhau los ntawm cov kua cerebrospinal thiab lwm yam meninges.
Yog li nws hloov tawm tias lub caj pas pituitary yog qhov pom tsis pom ntawm x-rays, thiab tsuas yog cov kua cerebrospinal thiab daim nyias nyias tuaj yeem pom. Yog li ntawd, xws li qhov chaw yog hu ua khoob. Yog li, tus mob no tau kuaj pom los ntawm cov kws kho mob tshwj xeeb hauv MRI lossis CT ntawm lub taub hau. Tom qab ntawd cov kws kho mob neuropathologist thiab kws kho mob neurosurgeons txhim kho kev kho mob thiab, raws li nws, txiav txim siab ua ntxiv.
Lub eeb nyob qhov twg?
Qhov chaw nyob ntawm lub eeb Turkish yog lub eeb-zoo li kev nyuaj siab nyob rau hauv cov pob txha qauv ntawm lub hauv paus ntawm tib neeg pob txha taub hau. Nws yog ib feem ntawm sphenoid sinus, uas yog ntu ntawm phab ntsa sab saud. Nws muaj qhov me me me me ob qhov ntev (li 10 hli) thiab qhov siab (7-13 hli). CavityTurkish eeb, nyob rau hauv uas lub caj pas pituitary nyob, yog hu ua pituitary fossa. Nws raug cais tawm ntawm qhov chaw subarachnoid los ntawm diaphragm, lub plhaub tawv ntawm lub hlwb. Los ntawm ib lub qhov me me hauv lub diaphragm dhau lub npe hu ua pituitary stalk, uas muaj kev sib txuas nrog lub hypothalamus.
Tshawb nrhiav hauv daim teb no
Txawm tias nyob rau hauv nruab nrab ntawm lub xyoo pua nees nkaum, lub tswvyim ntawm "dawb Turkish eeb" tau paub rau tag nrho lub ntiaj teb. Qhov no txhais tau li cas, nws muaj peev xwm txiav txim siab qhov tseeb ntawm American pathologist Bush nyob rau hauv thaum ntxov 50s. Thaum lub sij hawm ntev kev kawm ntev, nws tau tswj xyuas qhov tsis tuaj los yog kev txhim kho ntawm tib lub diaphragm hauv ib nrab ntawm cov neeg tuag. Kawm txog cov khoom siv ntawm lub cev tuag ntawm yuav luag 800 tus neeg tuag, nws tuaj yeem xaus lus tias tsis yog txhua tus neeg tuag, cov kab mob pathological ntawm lub caj pas los ua qhov tseem ceeb. Bush pom tias lub caj pas pituitary nyob rau hauv pituitary fossa tau hloov pauv loj heev, tau txais cov duab tsis meej thiab zoo li cov ntaub so ntswg nyias.
Tus kws tshawb fawb Lavxias Savostyanov hauv xyoo 1995 tau hloov kho cov kev faib tawm ntawm cov tsos mob uas tau hais los ntawm Bush, txawv ntawm hom diaphragm, qhov ntim ntawm intrasellar cisterns tsim ntawm lub cerebellum thiab medulla oblongata. Nyob rau tib lub sijhawm, kev tshawb fawb tshawb fawb tau qhia txog cov hauv qab no: hauv 8 ntawm 10 tus poj niam hnub nyoog plaub caug xyoo uas tau yug ntau dua ib zaug, pathology raug tsim, thiab cov tsos mob ntawm tus mob ntawm lub plab khoob Turkish pib tshwm. Tsis tas li ntawd, ntau tshaj li ob feem peb ntawm cov poj niam muaj mob raug kev txom nyem los ntawm kev rog ntawm kev sib txawv ntawm lawv lub neej. Twb dhau lawmTau ntau xyoo, cov kws tshawb fawb tau tuaj yeem txuas cov kab mob pathology nrog cov kev kho mob tshwm sim, qhia txog qhov tseem ceeb thiab theem nrab ntawm tus mob ntawm lub eeb Turkish khoob.
kab mob daim ntawv
Vim tias muaj peev xwm faib tus kab mob mus rau hauv thawj thiab theem nrab, nws muaj peev xwm rau tus neeg mob los txiav txim qhov kev xaiv kho mob uas tsim nyog tshaj plaws. Hauv kev xyaum, qhov no tseem ceeb heev hauv kev kwv yees tus kab mob.
Primary Syndrome ntawm qhov khoob Turkish eeb, cov tsos mob uas tshwm sim los ntawm kev nce hauv intracranial siab, xyaum tsis cuam tshuam rau lub xeev ntawm lub caj pas pituitary. Txawm hais tias tsawg kawg "kev txom nyem" ntawm lub caj pas, muaj qee yam tsis xws luag hauv lub diaphragm. Nyob rau hauv lub neej yav tom ntej, cov nyhuv deforming ntawm lub caj pas pituitary yog tshwm sim nyob rau hauv nws ntim, txo nws, tom qab uas qhov chaw ntawm lub Turkish eeb yog nyob rau hauv lub meninges thiab kua (xiav) txo qis.
Cov tsos mob ntawm lub paj hlwb hauv cov kab mob thib ob tau tshaj tawm. Txij li thaum lub caj pas nws tus kheej yog thawj zaug raug ntaus, nws feem ntau yuav tsum tau kho mob tam sim ntawd, kho hluav taws xob, thiab siv ntau yam tshuaj los tiv thaiv hemorrhage. Nws ua raws li qhov thib ob syndrome ntawm qhov khoob Turkish eeb yog suav tias yog qhov txaus ntshai tshaj plaws. Qhov ua rau lub hauv paus chiv keeb ntawm tus kab mob yog nyob rau hauv ntau yam uas yuav tsum tau kom meej meej txiav txim siab.
Zoo tshwm sim ntawm qhov pib ntawm tus kab mob
Ua ntej ntawm tag nrho, pawg pheej hmoo yuav tsum suav nrog cov neeg uas muaj keeb kwm yav dhau los rau qhov tshwm sim ntawm qhov teeb meem no. Los ntawm cov niam txiv lom, cov me nyuam feem ntau tsis paub qab haudiaphragm, uas yog ib qho underdeveloped, tsis tiav plhaub.
Yeej, txawm tias thaum lub sijhawm cev xeeb tub, lub paj hlwb hauv plab tuaj yeem tsim muaj qhov tsis xws luag raws li qhov tsis zoo ntawm ib puag ncig. Cov ntsiab lus txaus ntshai tshaj plaws yog suav tias yog hluav taws xob, kev nyab xeeb ib puag ncig, hloov khoom noj, kev ntxhov siab los ntawm leej niam lub siab xav, dej tsis zoo thiab ntau ntxiv.
Qhov tshwm sim ntawm nce intracranial siab
Cov teeb meem txaus ntshai ntawm qee cov kab mob muaj kev cuam tshuam loj rau qhov tshwm sim ntawm qhov xwm txheej no. Nce intracranial siab tuaj yeem yog vim:
- tawm kev raug mob pob txha taub hau, bruises, concussions;
- mob ntshav siab thiab lwm yam kab mob plawv;
- oncological neoplasms;
- cev xeeb tub, yug me nyuam nyuaj, rho menyuam;
- thrombosis;
- osteochondrosis ntawm lub ncauj tsev menyuam nqaj qaum (tus kab mob no tiv thaiv cov ntshav ntws mus rau hauv cov kab noj hniav hauv cranial);
- ntau yam kab mob cuam tshuam rau lub hauv nruab nrab lub paj hlwb (encephalitis, meningitis, hemorrhagic fever, thiab lwm yam).
Qhov xwm txheej thib ob ntawm tus mob ntawm "lub eeb turkish khoob" cuam tshuam rau qhov loj ntawm lub caj pas pituitary vim muaj zog ntxiv hauv cov kab noj hniav cranial.
Nws thawj zaug pom tau nce, tsim cov qog, thiab tom qab ntawd txo qis hauv ntim vim necrosis, cov ntaub so ntswg tawg,atrophy, ua tiav cov haujlwm neurosurgical thiab oncological.
Cov tsos mob ntawm lub hlwb
Qhov tseem ceeb, ua ntej kev kuaj xyuas tshwj xeeb, ntau tus neeg tsis paub txog lo lus "lub eeb Turkish khoob". Dab tsi ntawm pathology nws yog thiab dab tsi yog qhov txaus ntshai, ntau tus neeg mob yuav pom tsuas yog muaj cov txiaj ntsig ntawm tomography hauv lawv txhais tes. Feem ntau lawv tsis muaj kev tsis txaus siab, thiab lawv muaj kev noj qab nyob zoo. Txawm li cas los xij, qhov no tsis txhais tau tias tsis tuaj yeem muaj kev tsis txaus siab txhua. Feem ntau, cov tsos mob ntawm neurological tshwm sim lawv tus kheej raws li hauv qab no:
- mob taub hau, qee zaum tas li (lawv tsis muaj qhov chaw tshwj xeeb thiab muaj qhov sib txawv);
- kiv taub hau;
- tsis khov, tsis khov kho taug kev (tus neeg raug pov ntawm ib sab);
- txo qis hauv kev nco thiab kev xav, zoo li tsis nco qab;
- qaug zog tsis zoo, poob qis hauv kev ua haujlwm thiab kev ua siab ntev;
- psycho-emotional disorders.
Kev mob qhov muag tsis pom kev
Cov kws kho qhov muag pom kev feem ntau tswj xyuas qhov tsis txaus ntseeg ntawm tus kab mob. Cov neeg mob tuaj rau lawv nrog kev tsis txaus siab ntawm kev tsis zoo nyob rau hauv lub xeev ntawm lub cev ntawm lub zeem muag. Cov kev hloov pauv hauv qab no feem ntau pom:
- mob thaum txav lub qhov muag;
- tawm kua muag;
- conjunctival edema;
- fogging;
- ci ntsa iab hauv qhov muag.
Thaum lub sijhawm kuaj xyuas kom ntxaws, cov kws tshaj lij tuaj yeem kuaj pom qee yam kab mob tshwm sim,uas muaj xws li o thiab hyperemia ntawm lub paj hlwb, distortion ntawm qhov pom kev, qhov tshwm sim ntawm asthenopia. Xws li kev ua haujlwm tsis zoo ntawm tib neeg kev pom qhov system tuaj yeem tshwm sim vim muaj kev kub siab intracranial. Thaum tsis tau txais kev pom zoo raws sij hawm ntawm cov kev ntsuas tsim nyog, ntxiv hypersecretion ntawm intraocular kua tuaj yeem ua rau muaj glaucoma.
Hloov pauv hauv endocrine system
Raws li tau hais dhau los, feem ntau ntawm cov neeg mob yog cov poj niam hnub nyoog 35 xyoos. Cov kev tshwm sim ntawm tus kab mob ncaj qha nyob ntawm seb lub sij hawm ntawm exacerbation thiab tiav remission. Ntawm ib feem ntawm cov kab mob endocrine, cov kab mob tshwm sim los ntawm cov kab mob vegetative syndromes feem ntau:
- dav dyspnea txawm thaum so, ua pa ua pa;
- mob thiab mob lub cev;
- persistent subfebrile lub cev kub;
- frequent fainting;
- tachycardia, mob plawv;
- quav quav.
Hormonal malfunction ntawm lub qog pituitary nyob rau hauv kev kho mob tau rov ua yuam kev rau ib tug tshwm sim ntawm ib tug oncological qog ntawm lub caj pas. Tsis tas li ntawd, kev sib xyaw ua ke ntawm microadenoma thiab "dawb Turkish eeb" tsis yog qhov tsis tshua muaj. Vim yog qhov nyuaj ntawm kev noj cov tshuaj hormones los ntawm pituitary stalk thiab txo qis ntawm kev tswj ntawm hypothalamus hla lub caj pas, qee qhov kev sib deev tuaj yeem tshwm sim tsis yog rau cov poj niam, tab sis kuj rau cov txiv neej cov neeg mob (tso libido thiab potency, amenorrhea., hypothyroidism, thiab lwm yam). Hauv cov xwm txheej hnyav, muaj peev xwm tawm tauCSF dhau ntawm qhov ntswg.
Diagnosis
Yuav kom kuaj tau tus kab mob, nws tsim nyog tig mus rau txoj kev ntseeg siab tshaj plaws. Txog rau tam sim no, MRI tuaj yeem suav hais tias yog tus thawj coj tsis muaj teeb meem hauv kev kuaj mob hlwb ntawm lub hlwb. Cov txiaj ntsig ntawm kev ua tomography muab cov ntaub ntawv ntau tshaj plaws txog tus neeg mob tus mob. Tib lub sijhawm, nws yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv tus account qhov tseem ceeb ua tiav kev nyab xeeb ntawm hom kev xeem no.
Ntawm daim duab MRI ntawm tus neeg mob uas muaj qhov khoob Turkish eeb syndrome, muaj rau kev pom:
- muaj cov kua dej cerebrospinal;
- ceeb toom deformity ntawm lub caj pas pituitary (kho duab zoo li lub crescent los yog mob), centrally nyob infundibulum;
- a suprasellar cistern protrudes asymmetrically nyob rau hauv kab noj hniav ntawm Turkish eeb;
- lub funnel ntawm caj pas tau ntev thiab ua nyias.
Txoj kev txiav txim siab intracranial nce siab hauv daim duab kuj tseem tuaj yeem txiav txim siab lwm yam kev ntsuas tsis ncaj (qhov nce ntawm qhov loj ntawm lub ventricles thiab qhov chaw uas muaj cov kua dej cerebrospinal).
Cov kws kho mob kuj tseem siv cov kev kuaj mob ntxiv, suav nrog kev tshawb fawb hauv chaw kuaj mob (kev kuaj ntshav venous los txiav txim siab qhov sib npaug ntawm cov tshuaj hormones uas tsim los ntawm lub caj pas pituitary hauv cov ntshav plasma) thiab tshuaj xyuas qhov muag ntawm qhov mob ntawm pob nyiaj.
Txoj kev kho mob
Nug cov lus nug ntawm seb puas tuaj yeem kho tus mob "tsis muaj Turkish eeb", nws yuav tsum nkag siab tias tsuas yog kev ntsuas kev kho mob yuav pab daws qhov teeb meem no. Tom qab tag nrho, ib tus tsis tuaj yeem ua yam tsis muaj kev pab los ntawm neurologists, neurosurgeons, endocrinologists thiab ophthalmologists.
Primary khoob sella syndrome feem ntau tsis tas yuav kho tshwj xeeb. Yog tsis xa cov teeb meem tshwm sim rau tus neeg mob, tus kab mob hauv daim ntawv no tsis ua rau muaj kev hem thawj rau lub neej. Txawm hais tias qee zaum yuav tsum tau noj tshuaj thiab ua qee yam tshuaj hormones.
Yog tias kuaj pom tus mob thib ob, kev kho hormonal yog qhov tseem ceeb. Txij li cov qog nqaij hlav tseem ceeb, lub qog hypothalamus thiab pituitary caj pas raug hloov pauv, feem ntau qhov mob hnyav dua no tuaj yeem kho tau los ntawm txoj kev ua haujlwm. Piv txwv li, thaum squeezing lub optic paj hlwb thiab sagging kev sib tshuam nyob rau hauv lub diaphragmatic qhib, tsuas yog kev phais nrog kev koom tes ntawm ib tug neurosurgeon yuav pab tau. Cov lus qhia rau kev phais yog qhov tso tawm ntawm cov kua cerebrospinal los ntawm qhov ntswg. Lub thinned hauv qab ntawm Turkish eeb tso cai rau CSF nkag mus.
Kev ntsuas kom rov zoo
Qhov kev pheej hmoo ntawm kev rov zoo yog qhov siab heev, tshwj xeeb tshaj yog tias qhov mob hnyav ntawm kev kho mob tsis tshua muaj thiab kuaj pom thawj tus mob sella. Kev kho mob ntawm hypopituitarism tshwm sim nrog kev hloov tshuaj hormones xaus rau feem ntau nrog cov txiaj ntsig zoo. Txawm li cas los xij, feem ntau qhov kev kwv yees ntawm chav kawm ntawm tus kab mob yog nyob ntawm cov kab mob sib txuas ntawm lub caj pas pituitary thiab lub hlwb.
