Primary hyperparathyroidism: ua rau, tsos mob, kuaj mob thiab kho

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Primary hyperparathyroidism: ua rau, tsos mob, kuaj mob thiab kho
Primary hyperparathyroidism: ua rau, tsos mob, kuaj mob thiab kho

Video: Primary hyperparathyroidism: ua rau, tsos mob, kuaj mob thiab kho

Video: Primary hyperparathyroidism: ua rau, tsos mob, kuaj mob thiab kho
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Primary hyperparathyroidism yog ib yam kab mob endocrine hnyav uas tshwm sim los ntawm kev tso zis ntau ntxiv ntawm cov qog parathyroid. Pathology feem ntau cuam tshuam rau cov pob txha apparatus thiab ob lub raum. Dab tsi yog vim li cas rau qhov kev ua txhaum cai no? Thiab yuav ua li cas thiaj paub txog qhov pib ntawm tus kab mob? Peb yuav teb cov lus nug no hauv kab lus.

Kev piav qhia ntawm pathology

Nyob rau tom qab ntawm cov thyroid caj pas yog ob khub ntawm cov qog parathyroid. Lawv tsim cov tshuaj parathyroid hormone (PTH). Cov tshuaj no yog lub luag haujlwm rau cov metabolism hauv calcium thiab phosphorus. PTH muaj cov teebmeem hauv qab no rau lub cev:

  1. Txhawb kev tso tawm calcium los ntawm cov pob txha thiab nce nws cov concentration hauv cov ntshav.
  2. Txhim kho qhov tso tawm ntawm phosphorus hauv cov zis.

Yog tias cov tshuaj hormone PTH raug tsim tawm hauv qhov ntau ntxiv, ces cov kws kho mob hu tus mob no hyperparathyroidism. Qhov kev ua txhaum cai no yuav yog vim muaj ntau yam. Yog hais tias muaj ntau ntau ntawm cov tshuaj hormones parathyroid tshwm sim los ntawm kev hloov pauv hauv cov qog parathyroid (cov qog lossishyperplasia), ces cov kws txawj hais txog thawj hyperparathyroidism. Yog tias qhov teeb meem endocrine no tshwm sim los ntawm cov kab mob ntawm lwm yam kabmob (feem ntau lub raum), ces nws yog qhov thib ob.

Txhim kho cov tshuaj hormones parathyroid muaj qhov cuam tshuam tsis zoo rau tag nrho lub cev, thiab tag nrho ntawm cov pob txha thiab ob lub raum. Kev tso zis ntau ntxiv ntawm PTH ua rau tshem tawm cov calcium ntawm cov pob txha thiab nce hauv nws cov concentration hauv cov ntshav (hypercalcemia). Qhov no ua rau muaj kev cuam tshuam hauv qab no:

  • tsim ntawm fibrous hloov hauv cov pob txha;
  • skeletal deformities;
  • calcium deposits nyob rau hauv lub raum thiab nyob rau hauv cov phab ntsa ntawm cov hlab ntsha;
  • qeeb qeeb kis ntawm cov hlab ntsha impulses;
  • mob ntshav siab;
  • nce tso kua txiv plab;
  • pom rwj hauv plab hnyuv.

Ntxiv rau, tus neeg mob qhov tso tawm ntawm phosphorus los ntawm ob lub raum nce ntau. Qhov no ua rau pom pob zeb nyob rau hauv lub cev excretory.

Primary hyperparathyroidism muaj ntau dua rau cov poj niam dua li cov txiv neej. Feem ntau, cov tsos mob ntawm tus kab mob tshwm sim thaum cev xeeb tub. Cov kab mob no tseem hu ua parathyroid osteodystrophy lossis Engel-Recklinghausen kab mob. Cov kab mob endocrine no feem ntau tshwm sim. Nws yog qhov thib peb uas tshwm sim tom qab ntshav qab zib thiab thyroid tsis ua haujlwm.

Yog vim li cas

Qhov ua rau thawj hyperparathyroidism yog cov kev hloov pauv hauv qab no hauv cov qog parathyroid:

  • adenoma;
  • hyperplasia;
  • malignanto.

Nyob rau hauv 90% ntawm cov neeg mob, hyperparathyroidism tshwm sim vim tsim cov adenoma ntawm ib los yog ntau dua parathyroid qog. Cov qog nqaij hlav zoo no feem ntau kuaj pom hauv cov neeg laus, tshwj xeeb tshaj yog cov poj niam tom qab yug me nyuam.

Adenoma ntawm cov qog parathyroid
Adenoma ntawm cov qog parathyroid

Ntau zaus tsawg, qhov ua rau hyperparathyroidism yog kev loj hlob ntawm cov nqaij mos (hyperplasia) ntawm cov qog. Qhov no pathology feem ntau yog tshwm sim thiab tshwm sim hauv cov neeg mob hluas. Hyperplasia feem ntau nrog rau kev ua haujlwm tsis zoo ntawm lwm cov kabmob endocrine.

Cov qog nqaij hlav parathyroid yog qhov tsawg heev, tsuas yog 1-2% ntawm cov neeg mob. Cov qog nqaij hlav qog nqaij hlav tom qab raug hluav taws xob ntawm lub caj dab lossis lub taub hau.

Nws yog ib qho tseem ceeb kom nco ntsoov tias kwv yees li 15-20% ntawm cov neeg muaj cov qog parathyroid ntxiv nyob rau hauv mediastinum. Qhov no yog ib tug variant ntawm tus qauv. Txawm li cas los xij, cov kab mob ntxiv tuaj yeem hloov pauv pathological. Muaj qee kis thaum cov qog hauv caj dab noj qab haus huv tag nrho, tab sis tus neeg mob muaj qhov nce siab PTH hormone. Qhov no yuav qhia tau tias muaj qog nqaij hlav lossis hyperplasia hauv cov kabmob ntxiv, uas ua rau kev kuaj mob nyuaj.

Ntau yam ntawm pathology

Raws li twb tau hais lawm, kev tsim cov tshuaj parathyroid ntau ntxiv cuam tshuam rau kev ua haujlwm ntawm ntau yam kabmob. Nyob ntawm qhov chaw ntawm qhov txhab thiab cov tsos mob, cov kws kho mob paub qhov txawv cov qauv hauv qab no ntawm thawj hyperparathyroidism:

  1. pob txha. Nrog rau hom kab mob no, kev puas tsuaj loj rau lub cev musculoskeletal tau sau tseg.cuab yeej. Cov pob txha ua heev nkig thiab deformed. Cov neeg mob raug mob ntau zaus. Cov pob txha tshwm sim txawm tias tsis muaj pob txha thiab loj hlob ua ke ntev heev.
  2. Visceral. Nrog rau daim ntawv no ntawm pathology, feem ntau cov kab mob hauv nruab nrog cev raug cuam tshuam. Raws li qhov tshwm sim ntawm hypercalcemia, cov neeg mob tsim cov pob zeb hauv lub raum thiab lub gallbladder, thiab muaj cov tsos mob ntawm atherosclerosis. Tsis tas li ntawd, ulcers tshwm nyob rau hauv lub plab hnyuv ib ntsuj av, tsis pom kev deteriorates, thiab lub neuropsychic sphere raug kev txom nyem. Pathological hloov nyob rau hauv cov pob txha cov ntaub so ntswg yog me me.
  3. Nco. Cov neeg mob ib txhij muaj kev puas tsuaj rau cov pob txha thiab cov kab mob hauv nruab nrog cev vim hypercalcemia.

ICD: kev faib tawm ntawm pathology

Primary hyperparathyroidism raws li ICD-10 yog suav tias yog kev ua txhaum ntawm kev ua haujlwm ntawm cov qog parathyroid. Cov kab mob no yog tsim los ntawm code E21. Cov pab pawg ntawm pathologies no suav nrog tag nrho cov kab mob endocrine, nrog rau kev nce hauv cov tshuaj hormones parathyroid secretion. Tag nrho ICD-10 code rau thawj hyperparathyroidism yog E21.0.

Cov tsos mob pib

Thaum ntxov, tus kab mob tuaj yeem tshwm sim yam tsis muaj tsos mob hnyav. Thaum pib ntawm pathology, PTH secretion yog me ntsis nce. Raws li qhov tshwm sim, kev ua txhaum ntawm kev ua haujlwm ntawm cov qog parathyroid tau kuaj pom lig, thaum tus neeg mob twb muaj qhov mob hnyav ntawm cov pob txha thiab cov kab mob hauv nruab nrog cev. Kev kuaj mob ntawm tus kab mob thaum ntxov yog ua tau nrog kev pab los ntawm kev kuaj ntshav rau cov tshuaj hormones.

Thawj cov tsos mob ntawm tus kab mob endocrine tshwm sim nrog kev nce ntxiv hauv kev tso tawm ntawm parathyroid hormone. Cov tsos mob thiab kev kho mob ntawm thawjhyperparathyroidism nyob rau hauv cov poj niam thiab cov txiv neej nyob ntawm daim ntawv ntawm tus kab mob. Txawm li cas los xij, nws muaj peev xwm txheeb xyuas cov cim thawj zaug ntawm pathology:

  1. qaug zog thiab tsis muaj zog. Kev nce ntxiv ntawm calcium ua rau cov leeg tsis muaj zog. Cov neeg mob nkees sai, nyuaj taug kev mus ntev. Nws feem ntau nyuaj rau cov neeg mob kom sawv ntawm lub rooj zaum yam tsis muaj kev txhawb nqa lossis nkag mus hauv lub qhov rooj ntawm kev thauj mus los rau pej xeem.
  2. mob musculoskeletal. Qhov no yog thawj lub cim ntawm leaching ntawm calcium los ntawm cov ntaub so ntswg. Qhov mob tshwm sim tshaj plaws yog nyob rau hauv ko taw. Yam ntxwv "duck" gait. Vim qhov mob mob, cov neeg mob taug kev, taug kev ntawm ib ko taw mus rau lwm qhov.
  3. tso zis ntau zaus thiab nqhis dej. Hauv cov neeg mob uas muaj thawj hyperparathyroidism, calcium excretion nyob rau hauv cov zis yog nce. Qhov no ua rau kev puas tsuaj rau lub raum tubules. Cov ntaub so ntswg ntawm lub cev excretory poob lawv rhiab heev rau pituitary hormone - vasopressin, uas tswj cov diuresis.
  4. Kev kho hniav ntawm cov hniav. Qhov tshwm sim thaum ntxov ntawm pathology yog txuam nrog calcium deficiency. Feem ntau thawj qhov kev mob tshwm sim yog xoob thiab poob ntawm cov hniav, nrog rau cov kab mob sai sai.
  5. Slimming, tawv nqaij hloov xim. Qhov hnyav ntawm cov neeg mob hauv thawj lub hlis ntawm tus kab mob tuaj yeem txo qis los ntawm 10-15 kg. Kev nce diuresis ua rau lub cev qhuav dej hnyav, uas ua rau poob phaus. Cov neeg mob daim tawv nqaij qhuav dhau thiab greyish los yog av.
  6. Neuropsychiatric mob. Hypercalcemia ua rau lub hlwb puas lawm. Cov neeg mob uas muaj mob taub hau ntau zaus, lub siab hloov pauv,nce kev ntxhov siab thiab kev nyuaj siab.
Kev nyuaj siab yog thawj qhov cim ntawm hyperparathyroidism
Kev nyuaj siab yog thawj qhov cim ntawm hyperparathyroidism

Cov neeg mob tsis tas yuav koom nrog cov tsos mob zoo li no nrog cov kab mob endocrine. Yog li ntawd, kev mus ntsib kws kho mob feem ntau qeeb.

Nyob rau theem siab ntawm pathology, lub tsev kho mob ntawm thawj hyperparathyroidism yog tus cwj pwm los ntawm qhov pom ntawm cov pob txha, cov hlab ntsha thiab cov kab mob hauv nruab nrog cev. Kev nce hauv qhov tso tawm ntawm cov tshuaj hormones parathyroid ua rau muaj qhov tsis zoo ntawm tus neeg mob. Tom ntej no, peb yuav xav txog qhov nthuav dav ntawm pathological tshwm sim ntawm ntau yam kabmob thiab lub cev.

pob txha

Primary hyperparathyroidism yog tus cwj pwm los ntawm kev hloov pauv hauv cov pob txha. Cov cim qhia hauv qab no ntawm kev puas tsuaj rau lub cev musculoskeletal tau sau tseg:

  1. Txo cov pob txha ceev. Cov leaching ntawm calcium thiab phosphorus ua rau tsis tshua muaj thiab fragility ntawm cov pob txha (osteoporosis). Fibrosis thiab cysts tsim nyob rau hauv cov pob txha.
  2. Deformations ntawm lub cev pob txha. Cov pob txha ua mos thiab khoov yooj yim. Muaj qhov curvature ntawm pelvis, txha nraub qaum, thiab thaum mob hnyav, thiab ceg ceg. Lub hauv siab ua tswb.
  3. Pain Syndrome. Cov neeg mob raug kev txom nyem los ntawm qhov mob ntawm lub nraub qaum thiab ceg. Feem ntau muaj kev tawm tsam uas zoo li tshwm sim ntawm gout. Qhov no yog vim ob leeg pob txha deformities thiab deposition ntawm calcium thiab phosphorus ntsev nyob rau hauv cov pob qij txha.
  4. Nquag tawg. Cov neeg mob raug mob tsis yog tsuas yog ntog thiab bruises, tab sis txawm tias nrog kev txav tsis zoo. Qee zaum kev puas tsuaj tshwm sim tshwm sim thaum tus neeg mob tau so tag. NtawmHauv hyperparathyroidism, traumatization tsis yog ib txwm nrog kev mob hnyav. Muaj qee zaus cov neeg mob tsis pom kev puas tsuaj. Hauv qhov no, kev kho mob qeeb heev, vim cov pob txha tsis loj hlob ua ke zoo.
  5. siab txo. Vim cov pob txha deformities, qhov siab ntawm cov neeg mob yuav raug txo los ntawm 10 - 15 cm.
Mob pob txha hauv thawj hyperparathyroidism
Mob pob txha hauv thawj hyperparathyroidism

Ntau pob txha tuaj yeem ua rau tus neeg mob tsis taus. Hauv cov xwm txheej zoo, tus neeg mob poob peev xwm txav mus los ntawm nws tus kheej thiab ua haujlwm rau nws tus kheej.

Lub cev ntawm kev tso tawm

Nrog ntau ntxiv ntawm cov tshuaj hormone PTH, lub raum ua lub hom phiaj thib ob tom qab lub cev pob txha. Kev tso tawm ntau ntxiv ntawm calcium hauv cov zis ua rau muaj kev puas tsuaj rau cov tubules. Thaum ntxov, qhov no manifests nws tus kheej nyob rau hauv nquag tso zis thiab nqhis dej. Thaum lub sij hawm, pob zeb tsim nyob rau hauv lub cev, uas yog nrog los ntawm bouts ntawm lub raum colic.

Qhov pom muaj zog ntawm lub raum kev puas tsuaj, qhov tsis zoo ntawm qhov kev mob tshwm sim ntau dua. Hauv qhov xwm txheej hnyav, cov neeg mob tsim o thiab lub raum tsis ua haujlwm, uas yog qhov hloov tsis tau.

Lub raum puas vim hypercalcemia
Lub raum puas vim hypercalcemia

Vessels

Cov calcium ntau dhau tso rau hauv cov hlab ntsha ntawm phab ntsa. Qhov no ua rau muaj kev tsis zoo ntawm cov ntshav ncig thiab khoom noj khoom haus ntawm ntau yam kabmob. Cov neeg mob uas muaj cov tsos mob zoo ib yam nrog cov kab mob plawv:

  • mob taub hau;
  • arrhythmia;
  • ntshav siab;
  • angina tawm tsam.

Calcium deposits tautsim nyob rau hauv myocardium, uas feem ntau ua rau lub plawv nres.

Nervous system

Qhov siab dua cov calcium hauv cov ntshav plasma, qhov ua rau muaj kev cuam tshuam ntau ntawm lub paj hlwb thiab lub hlwb. Cov neeg mob yws yws ntawm cov tsos mob hauv qab no:

  • pab siab;
  • sluggishness;
  • mob taub hau;
  • dreary mood;
  • xov xwm;
  • drowsy;
  • txo qis hauv kev nco thiab lub peev xwm hlwb.

Thaum mob hnyav, cov neeg mob tsim muaj kev puas siab puas ntsws nrog kev nco qab, kev xav tsis thoob thiab hnov qab.

plab hnyuv plab

Raws li twb tau hais lawm, cov tshuaj hormone PTH cuam tshuam rau kev tso kua dej hauv plab. Ntau tus neeg mob hyperparathyroidism muaj hyperacidity. Qhov no yog nrog los ntawm cov tsos mob hauv qab no:

  • mob plab ntawm ntau qhov chaw;
  • nauseous;
  • siab roj ntau lawm;
  • nrawm cem quav.

Tawm tsam keeb kwm yav dhau los ntawm kev nce acidity, cov txheej txheem ulcerative tsim. Feem ntau lawv nyob hauv duodenum, tsis tshua muaj nyob hauv plab thiab txoj hlab pas. Cov kab mob nrog rau qhov mob thiab los ntshav.

Calcium ntsev kuj tuaj yeem tso rau hauv lub gallbladder. Qhov no ua rau mob ntawm lub cev (cholecystitis), thiab tom qab ntawd mus rau cholelithiasis. Muaj qhov mob ntawm txoj cai hypochondrium thiab xeev siab.

Calcifications feem ntau tso rau hauv pancreas. Qhov no ua rau pancreatitis. Cov neeg mob yws yws ntawm qhov mob plab hnyav ntawm girdle cim. Nrog parathyroid pancreatitiskeeb kwm hauv cov ntshav, qhov concentration ntawm calcium feem ntau yog txo qis.

Eyes

Calcium deposits tau sau tseg nyob rau hauv cov hlab ntsha ntawm lub cev ntawm lub zeem muag, thiab nyob rau hauv lub cornea. Thaum ntxov, cov neeg mob pom qhov muag liab. Cov neeg mob raug kev txom nyem los ntawm conjunctivitis.

Tom qab ntawd, band keratopathy txhim kho. Qhov no yog ib yam kab mob uas calcium ntsev nyob rau hauv nruab nrab ntawm lub cornea. Nws nrog rau qhov mob ntawm qhov muag thiab qhov muag tsis pom kev.

Hypercalcemic crisis

Hypercalcemic ntsoog yog qhov tshwm sim loj heev ntawm thawj hyperparathyroidism. Nws yog dab tsi? Qhov no yog qhov ua rau muaj kev phom sij rau lub neej, nrog rau qhov ntse thiab nrawm nrawm ntawm cov calcium hauv cov ntshav. Feem ntau nws tshwm sim nyob rau theem tom qab ntawm tus kab mob thaum tsis muaj kev kho mob txaus. Txawm li cas los xij, muaj cov xwm txheej thaum muaj teeb meem hypercalcemic tshwm sim thaum ntxov. Qhov teeb meem tuaj yeem tshwm sim sai sai ntawm keeb kwm ntawm kev noj qab haus huv.

Cov hauv qab no tuaj yeem ua rau muaj kev kub ntxhov:

  • kab mob sib kis;
  • xeeb tub;
  • poisoning;
  • pob txha loj;
  • dehydration;
  • noj zaub mov nplua nuj calcium;
  • noj diuretics thiab antacids.

Hypercalcemic ntsoog ib txwm tshwm sim hnyav. Tus neeg mob tus mob yog sai heev. Qhov xwm txheej txaus ntshai no nrog rau cov tsos mob hauv qab no:

  • mob plab tsis txaus (raws li nrog peritonitis);
  • ua npaws (nce txog +39 - +40 degrees);
  • txuas ntxivntuav;
  • cem quav;
  • pob txha;
  • psychomotor agitation;
  • coma (thaum mob hnyav).

Qhov teeb meem no ua rau tuag taus li ntawm ib nrab ntawm cov xwm txheej. Mob hypercalcemia ua rau cov ntshav txhaws hauv cov hlab ntsha. Cov neeg mob tuag los ntawm lub plawv nres lossis tuag tes tuag taw ntawm qhov chaw ua pa.

Yuav ua li cas yog tias muaj teeb meem ntawm thawj hyperparathyroidism? Cov txheej txheem kho mob qhia tau hais tias cov neeg mob uas muaj teeb meem hypercalcemic yuav raug mus pw hauv tsev kho mob xwm txheej ceev. Nws tsis yooj yim sua kom muab kev pab hauv tsev ntawm koj tus kheej, yog li koj yuav tsum hu rau pab neeg kho mob tam sim ntawd. Cov neeg mob zoo li no tau qhia rau kev phais sai ntawm cov qog parathyroid. Yog tias phais tsis tau, cov neeg mob tau txais calcium antagonists.

Diagnosis

Cov kab mob no tau kho los ntawm tus kws endocrinologist. Yog xav tau kev phais, tus kws phais yuav muaj kev sab laj.

Hypercalcemia thiab osteoporosis kuj yog tus yam ntxwv ntawm lwm yam pathologies. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tau txiav txim siab qhov txawv ntawm thawj hyperparathyroidism nrog cov kab mob hauv qab no:

  • pob txha hlav;
  • ntau dhau hauv lub cev ntawm vitamin D;
  • hypercalcemia vim yog lwm yam kab mob endocrine lossis diuretics.

Cov neeg mob tau muab tshuaj kuaj ntshav rau cov tshuaj hormone parathyroid. Nce PTH concentration qhia tias muaj hyperparathyroidism.

Kev kuaj ntshav rau parathyroid hormone
Kev kuaj ntshav rau parathyroid hormone

Tom qab ntawd koj yuav tsum paub qhov txawvthawj daim ntawv ntawm pathology los ntawm theem nrab. Rau lub hom phiaj no, kev kuaj ntshav thiab zis yog muab rau cov ntsiab lus ntawm calcium thiab phosphorus. Nyob rau hauv thawj daim ntawv ntawm tus kab mob, cov concentration ntawm calcium yog nce nyob rau hauv ob qho tib si plasma thiab tso zis. Nyob rau tib lub sijhawm, qib ntawm phosphates hauv cov ntshav txo qis, thiab hauv cov zis nws nce ntxiv. Yog tias hyperparathyroidism yog theem nrab, ces cov ntsiab lus calcium hauv cov ntshav tseem nyob hauv qhov qub.

Tom qab kuaj pom qhov nce siab ntawm PTH thiab hypercalcemia, kev kuaj pom thawj zaug ntawm hyperparathyroidism tau ua. Qhov no pab tsim cov etiology ntawm tus kab mob. Cov neeg mob tau muab tshuaj ultrasound, MRI lossis CT ntawm cov qog parathyroid. Cov kev ntsuam xyuas no ua rau nws tuaj yeem kuaj pom muaj cov qog thiab hyperplasia ntawm lub cev.

Qee zaum hauv cov neeg mob, kev tshuaj ntsuam xyuas tsis pom cov kev hloov pauv hauv cov qog parathyroid. Tab sis tib lub sijhawm, cov neeg mob muaj tag nrho cov tsos mob ntawm thawj hyperparathyroidism. Cov txheej txheem kho mob qhia tau hais tias nyob rau hauv cov xwm txheej zoo li no yuav tsum tau ua MRI ntawm mediastinum. Cov qog parathyroid ntxiv tuaj yeem nyob hauv thaj chaw no, uas feem ntau adenomas tsim.

Surgery

Cov kab mob no tsis raug rau kev kho tshuaj. Tam sim no, tsis muaj cov tshuaj muaj txiaj ntsig zoo los txo qis cov tshuaj hormones parathyroid. Tsis tas li ntawd, adenomas thiab hyperplasia ntawm cov qog parathyroid feem ntau ua tiav. Yog li ntawd, txoj hauv kev zoo tshaj plaws los kho thawj hyperthyroidism yog kev phais.

Qhia rau kev phais yog cov tsos mob hnyav ntawm tus kab mob:

  • hnyavosteoporosis;
  • plasma calcium concentration ntau dua 3 mmol / l;
  • raum tsis haum;
  • pob zeb tsim nyob rau hauv cov zis;
  • Calcium tshem tawm hauv cov zis ntau dua 10 mmol / hnub.

Yog tias hyperparathyroidism provoked los ntawm adenoma lossis qog nqaij hlav, tus kws kho mob yuav tshem tawm cov neoplasm. Nrog hyperplasia, tus kws phais tau tshem tawm tag nrho peb lub caj pas parathyroid thiab ib feem ntawm plaub. Qhov kev ua haujlwm no yog hu ua subtotal parathyroidectomy. Tam sim no, kev phais mob ntawm cov qog parathyroid feem ntau ua los ntawm txoj kev endoscopic.

Kev ua haujlwm ntawm cov qog parathyroid
Kev ua haujlwm ntawm cov qog parathyroid

Tom qab ua haujlwm, qhov tshwm sim ntawm thawj hyperparathyroidism maj mam ploj mus. Cov lus pom zoo ntawm tus kws kho mob thaum lub sijhawm rov qab los tom qab kev cuam tshuam yuav tsum tau ua tib zoo ua raws. Tsis pub dhau 1.5-2 lub hlis tom qab tshem tawm cov qog lossis parathyroidectomy, ib tus yuav tsum tsis txhob siv lub cev hnyav thiab kev ua kis las. Hauv cov neeg mob ua haujlwm, kev rov qab los ntawm tus kab mob tau pom hauv 5-7% ntawm cov neeg mob.

saib xyuas tus neeg mob

Nyob rau hauv cov ntaub ntawv me me ntawm tus kab mob thiab tsis muaj qhov qhia tau rau kev phais, kev tshuaj xyuas dynamic tau sau tseg. Txhua tus neeg uas kuaj pom tias muaj tus mob hyperparathyroidism thawj zaug yuav raug sau npe kho mob. Cov npe ntawm cov neeg mob yog khaws cia nyob rau hauv lub endocrinological dispensary. Cov neeg mob yuav tsum tau mus ntsib kws kho mob tsis tu ncua thiab kuaj cov hauv qab no:

  • ntshav thiab zis kuaj rau calcium thiab phosphorus;
  • ntsuas ntshav siab;
  • Ultrasound ntawm lub raum;
  • ntsuas ntshavCov tshuaj hormones parathyroid;
  • MRI lossis ultrasound ntawm cov qog parathyroid.
Kev kuaj ultrasound ntawm cov qog parathyroid
Kev kuaj ultrasound ntawm cov qog parathyroid

Cov kws kho mob tau sau cov zaub mov tshwj xeeb rau cov neeg mob. Cov khoom noj uas muaj calcium, feem ntau yog cov mis nyuj thiab cov khoom siv mis nyuj, tsis suav nrog cov khoom noj. Tus neeg mob yuav tsum haus tsawg kawg 2 litres dej ib hnub twg. Qhov no yuav pab txo qis calcium concentration hauv cov ntshav thiab zam lub cev qhuav dej.

Kev noj zaub mov yog ib feem tseem ceeb ntawm kev kho mob ntawm thawj hyperparathyroidism. Cov lus pom zoo ntawm tus kws kho mob hais txog cov cai ntawm kev noj haus yuav tsum ua raws li nruj me ntsis. Noj cov zaub mov uas muaj calcium ntau tuaj yeem ua rau muaj teeb meem hypercalcemic.

Cov neeg mob yog categorically contraindicated nyob rau hauv noj diuretics thiab plawv glycosides. Cov tshuaj no tuaj yeem ua rau mob hnyav dua. Yog hais tias hyperparathyroidism tshwm sim nyob rau hauv ib tug poj niam tiv thaiv keeb kwm ntawm menopause, tom qab kev sab laj nrog ib tug gynecologist, estrogen hloov kho yuav raug sau.

Huab cua

Nrog kev kho mob raws sij hawm ntawm thawj hyperparathyroidism, qhov kev cia siab ntawm tus kab mob yog qhov zoo. Tom qab kev phais ntawm cov qog parathyroid, tus neeg mob txoj kev noj qab haus huv maj mam rov zoo li qub. Pathological tshwm sim los ntawm cov hlab ntsha, lub paj hlwb thiab cov kab mob ntawm lub plab hnyuv siab raum ploj nyob rau hauv 1 lub hlis tom qab tshem tawm cov qog los yog parathyroidectomy. Cov pob txha pob txha tau rov qab ua tiav hauv 1-2 xyoos tom qab ua haujlwm.

Kev kuaj mob hnyav zuj zus nrog rau lub raum puas. Cov kev hloov no yog irreversible. Cov cim qhia ntawm lub raum tsis ua haujlwm tshwm sim tom qab kev phais.

Ua tauxaus lus tias hyperparathyroidism yog ib yam kab mob loj thiab txaus ntshai uas cuam tshuam kev ua haujlwm ntawm ntau lub cev thiab lub cev. Nws tseem ceeb heev kom tsis txhob nco thawj cov cim qhia ntawm pathology thiab pib kho raws sijhawm.

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