Cov qog adrenal yog ib qho ntawm cov kabmob tseem ceeb tshaj plaws. Cov no yog cov qog endocrine uas tsim cov tshuaj hormones ntau. Nws yog cov tshuaj hormones uas ua rau nws muaj peev xwm tswj hwm ntau cov txheej txheem metabolic: electrolyte thiab dej sib npaug, poj niam lub peev xwm xeeb menyuam, thiab ntsuas ntshav siab. Adenoma yog ib qho mob qog nqaij hlav uas tshwm sim feem ntau hauv cov qog nqaij hlav ntawm cov qog adrenal. Txoj kev loj hlob ntawm adenoma muaj qhov xwm txheej maj mam, thiab nrog kev kho tsis raws sijhawm, nws tuaj yeem degenerate mus rau hauv cov qog nqaij hlav txaus ntshai. Ob leeg poj niam tuaj yeem tsim tus mob no, tab sis adrenal adenomas muaj ntau dua rau cov poj niam.
Yog vim li cas
Qhov laj thawj tseeb uas ua rau muaj qhov tshwm sim ntawm adenoma hauv tib neeg, cov kws tshawb fawb tseem tsis tau paub meej. Lub luag haujlwm txhawb nqa feem ntau yuav ua si los ntawm lub caj pas pituitary, uas yog lub luag haujlwm rau kev tso tawm thiab tsim cov tshuaj hormone adrenocorticotropic. Cov tshuaj no muab lub zog rau lub cortex kom nce cov tshuaj hormones, tshwj xeeb tshaj yog tias muaj lwm yam zoo rau qhov no.
Muaj kev xav tias cov hauv qab no cuam tshuam rau kev loj hlob ntawm adrenal adenoma hauv tib neeg:
- kev ua neej nyob;
- phom sijcwj pwm;
- muaj rog;
- nce qib roj cholesterol;
- metabolic ntshawv siab;
- lub plawv tsis ua haujlwm;
- tsis txaus siab ntawm vascular system;
- hnub nyoog tshaj 30;
- hormonal imbalance;
- mob stroke lossis plawv nres;
- raug mob rau hauv lub cev.
Cov poj niam feem ntau raug kuaj pom tus kab mob no, uas yog tshwm sim los ntawm cov neeg tawm tsam xws li:
- cev xeeb tub;
- polycystic zes qe menyuam;
- siv tsis tau tshuaj tiv thaiv kab mob lossis tshuaj hormonal.
Qhov ua rau adrenal adenoma hauv tib neeg tseem tsis tau nkag siab. Tab sis tsab xov xwm qhia txog feem ntau yam uas tuaj yeem ua rau muaj kev loj hlob ntawm cov qog nqaij hlav hauv cov qog adrenal. Qhov tseem ceeb yog tsis txhob pib tus kab mob thiab tiv thaiv cov qog los ntawm kev loj hlob mus rau ib tug malignant.
Cov tsos mob dav dav
Cov qog adrenal yog ib qho tseem ceeb heev ntawm cov kab mob endocrine rau tib neeg kev noj qab haus huv, uas yog, raws li, saum lub raum. Adrenal adenoma feem ntau yog qog nqaij hlav uas, yog tias kho tsis tau sijhawm thiab kho tsis raug, tuaj yeem ua rau mob tsis zoo.
Thaum thawj theem ntawm adrenal adenoma, tsis muaj cov tsos mob tshwm sim. Cov qog adrenal tsim cov tshuaj hormones sib txawv, thiab thaum cov qog tshwm sim, lawv tuaj yeem ua rau cov tshuaj hormonal tsis ua haujlwm. Nyob rau hauv daim ntawv siab, tus neeg mob yuavCov xwm txheej txaus ntshai tshwm sim: piv txwv li, Cushing's syndrome (nce cov tshuaj hormone cortisol) thiab Kohn's syndrome (ntau tshaj aldosterone).
Cov tsos mob ntawm adenoma yog qhov hnyav tsis tsim nyog, uas tuaj yeem tshwm sim nrog cov tshuaj hormonal, thiab nce ntshav siab.
Cov tsos mob ntawm poj niam
Cov tsos mob ntawm adrenal adenoma hauv cov poj niam yog qhov uas lawv tuaj yeem pom cov plaub hau loj ntawm lub cev lossis lub ntsej muag, lub suab ntxhib, thiab kev coj khaub ncaws yuav cuam tshuam. Cov kev ua tsis tiav no tuaj yeem tshwm sim rau qee lub sijhawm txawm tias tom qab ua haujlwm, yog li nws yog qhov tsim nyog los sab laj tus kws kho mob endocrinologist thaum lawv tshwm sim. Ntxiv nrog rau keeb kwm hormonal, tus poj niam adenoma kuj tuaj yeem tshwm sim nws tus kheej nrog lwm cov tsos mob: ua tsis taus pa thaum lub cev ua haujlwm, cov leeg tsis muaj zog thiab qaug zog.
Symptoms in men
Thaum corticosteroma feem ntau yog ua txhaum ntawm lipid metabolism, uas feem ntau ua rau pom kev rog, cov leeg nqaij atrophy yuav tshwm sim. Nrog aldosterone, lub cev cov poov tshuaj poob qis, ua rau cov kua dej khaws cia thiab nce ntshav siab.
Yog tias adrenal adenoma me me, tom qab tshem tawm cov neoplasm, tag nrho cov tsos mob ntawm tus kab mob ploj mus. Tab sis nws yog ib qho nyuaj heev los twv seb qhov tshwm sim ntawm qhov muaj cov qog malignant! Txhawm rau zam qhov teeb meem no, nws yog ib qho tsim nyog yuav tsum tau ntsuas kev tiv thaiv thiab mus ntsib cov kws kho mob nqaim kom raws sijhawm.
Kev faib tawm
Neoplasms nyob rau hauv cortical txheej ntawm cov qog adrenal hu ua adenomas. Tus kab mob no tshwm sim los ntawm qhov tsis muaj cov tsos mob thaum ntxov thiab thaum pib ntawm txoj kev loj hlob tuaj yeem kuaj pom thaum lub sijhawm kuaj mob niaj hnub. Lub adenoma ntawm txoj cai adrenal caj pas, zoo li sab laug, zoo li kev loj hlob compacted nyob rau hauv ib ntsiav tshuaj.
Cov qog nqaij hlav raug cais raws li qhov muaj lossis tsis muaj kev ua haujlwm hormonal. Kev tsim cov tshuaj hormones muaj kev cuam tshuam tsis zoo rau txhua lub cev. Nrog rau kev loj hlob ntawm cov nodule, hormonal tsis txaus yuav nce, ua rau muaj kev hloov pauv ntawm cov txiv neej thiab poj niam, pob txha fragility, uas tuaj yeem ua rau kev loj hlob ntawm Cushing's thiab Kohn's syndromes. Kev nce hauv qhov loj dua 4 cm yog qhov qhia ceev rau kev phais. Kev ua haujlwm tuaj yeem yog lub plab zom mov classic lossis ua los ntawm cov txheej txheem laparoscopic minimally invasive. Hauv cov xwm txheej tshwj xeeb, hluav taws xob lossis tshuaj khomob yog siv los txo cov ntaub so ntswg loj hlob. Kev xaiv ntawm txoj kev yog ua los ntawm tus kws kho mob raws li qhov xaus ntawm cov duab, hom thiab qhov loj ntawm cov qog. Tom qab ua tiav kev phais, ib lub sij hawm ntawm kev kho mob pib. Nws muaj nyob rau hauv cov tshuaj hormone hloov kho uas tsim nyog rau kev rov ua haujlwm ntawm cov qog adrenal.
Diagnosis
Adenoma ntawm lub qog adrenal hauv tus neeg mob tau kuaj pom los ntawm lub sijhawm thaum qee qhov kev kuaj mob niaj hnub. Tom qab kuaj pom cov qog, cov kws kho mob ntsib lub hom phiaj ua haujlwm: txhawm rau txiav txim siab tus qauv ntawm adenoma, txheeb xyuas qhov xwm txheej ntawm nws txoj kev loj hlob (benign,malignant). Kev tshawb fawb tau ua tiav txhawm rau txheeb xyuas hom qog:
- Computed tomography.
- Magnetic resonance imaging.
- Kev kuaj ntshav ntawm adrenal adenoma.
- Txhim tus nqi cortisol hauv cov zis.
- Nqa cov qauv me me thiab loj dexamethasone.
- Koj kuj xav tau kev kuaj ntshav rau renin, chromogranin, aldosterone, ACTH, kuaj pom muaj ions hauv cov ntshav, calcitonins.
xam tomography yuav tsum tau ua tsuas yog ntawm ib tug zoo tomography. Qhov kev pom zoo sib txawv ntawm qhov tsis sib xws ntawm cov cuab yeej siv nrog qhov muaj nyob ntawm ntu 64, 128. Thaum lub sijhawm kuaj xyuas, qhov loj ntawm cov qog, qhov ntom ntawm qhov tsim tau kawm, thiab cov duab ntawm cov hlab ntsha ntawm cov hlab ntsha raug coj mus. Tom qab kev ntsuam xyuas, kev txiav txim siab yog txiav txim siab seb hom qog. Nrog tsawg ceev - benign, nrog siab ceev - malignant.
Biopsy tsuas yog ua thaum muaj qhov xav tau los txiav txim qhov kis ntawm cov kabmob uas nyob sib ze. Hauv lwm qhov xwm txheej, cov kws kho mob lawv tus kheej sim tsis kam muab tshuaj biopsy, vim qhov no yog ib txoj kev tshawb fawb uas raug mob heev.
Urine cortisol txiav txim siab vim nws lub ntsiab lus tuaj yeem txhais tsis raug los ntawm cov ntshav.
Kev kuaj Dexamethasone tso cai rau koj los txiav txim qhov tseeb ntawm cortisol zais los ntawm cov ntaub so ntswg nrog qog. Txhawm rau ua qhov kev ntsuam xyuas, ntshav raug coj los ntawm tus neeg mob rau kev tshuaj xyuas thaum sawv ntxov, tom qab ntawd lawv muab ib ntsiav tshuaj dexamethasone rau kev ua phem. Hnub tom qab, rov kuaj ntshav dua thiab ob qhov kev ntsuas tau muab piv. Thaum cov qib cortisol tom qab noj cov tshuaj tsis txo qis tsawg kawg ob zaug, ua qhov tsim nyogQhov kev txiav txim siab yog tias nws tso tawm los ntawm cov ntaub so ntswg uas muaj kab mob yog tswj tsis tau.
Tom qab kuaj mob, txheeb xyuas cov tsos mob thiab kho adrenal adenoma ntawm cov poj niam thiab txiv neej, kev kho mob tuaj yeem pib.
Kev kho mob
Tom qab kuaj pom tus kab mob no, nws yog ib qho tsim nyog yuav tsum pib kho adrenal adenoma ntawm cov poj niam thiab cov txiv neej kom sai li sai tau, vim tias cov qog nqaij hlav tuaj yeem loj hlob mus rau qhov tsis zoo. Nrog rau cov qog me me uas tsis ua haujlwm, tus neeg mob nyob hauv kev saib xyuas tas li ntawm oncologists uas saib xyuas kev loj hlob ntawm cov qog thiab, yog tias tsim nyog, kho cov kev kho mob. Tus neeg mob tau txais kev kho hormonal, uas tiv thaiv kev loj hlob ntawm cov qog, nws nkag mus rau hauv lub cev noj qab haus huv thiab txhim kho cov tshuaj hormonal tom qab, thiab ntau yam kev ntsuam xyuas thiab kev ntsuam xyuas (CT scan thiab ntshav kuaj cov tshuaj hormones). Yog tias thaum lub sijhawm soj ntsuam, adenoma tsis pib loj hlob thiab qhia txog kev ua haujlwm hormonal, kev kho mob tsis tsim nyog. Feem ntau, kev kho mob ntawm adrenal adenoma yuav tsum tau phais, uas cov qog tshem tawm.
Yam tshem tawm
Muaj ntau hom kev tshem tawm adenoma:
- Minimally invasive, nyob rau hauv peb qhov kev txiav me me, kev ua haujlwm yog ua los ntawm kev siv lub koob yees duab video nrog cov diodes built-in, uas muab rau tus kws phais neeg saib xyuas ntawm cov kabmob sab hauv. Tom qab ua haujlwm, tus neeg mob nyob hauv tsev kho mob rau 4-6 hnub, tom qab ntawd nws tuaj yeem tawm mus. Rehabilitation nrog hom kev phais mob no sai dua. Txoj kev no tshem tawm adenomaua tau, muab hais tias nws yog benign thiab me me.
- Cav. Thaum lub sijhawm ua haujlwm no, ib qho kev phais loj yog ua nyob rau hauv lub plab kab noj hniav kom pom zoo ntawm cov kabmob sab hauv. Nws yog tsuas yog siv rau ob sab hauv cheeb tsam ntawm cov qog.
- Ntau niaj hnub thiab nyab xeeb dua yog lumbar extraperitoneal hom nkag, uas cov twj paj nruag tau ntxig los ntawm daim tawv nqaij, thiab kev ua haujlwm tau ua yam tsis cuam tshuam rau lub plab kab noj hniav. Txhawm rau tshem tawm cov qog, peb punctures los yog incision 2-3 cm ntev yog ua. Qhov zoo tshaj plaws ntawm kev ua haujlwm no yog qhov tsawg kawg nkaus ntawm kev raug mob, kom tus neeg mob tuaj yeem tawm tom qab 2 hnub, thiab qhov pom tsis pom ntawm qhov caws pliav. los ntawm kev ua haujlwm.
- Kev ua haujlwm Robotic. Cov txheej txheem yog tib yam li laparoscopy. Lub qog adrenal yog sab laug thiab sab xis. Vim qhov muaj, nws yooj yim dua los kuaj xyuas thiab tshem tawm cov qog ntawm sab laug adrenal.
Tom qab kev phais, tus neeg mob yuav tsum tau kho cov tshuaj hormonal kom rov zoo, qee zaum, thaum muaj peev xwm rov loj hlob ntawm tes, mitotane-based chemotherapy yog siv. Kev kho siab beam yog muab rau ntawm theem peb ntawm adrenal adenoma. Yog hais tias lub adrenal adenoma yog benign nyob rau hauv cov xwm, ces lub caij nyoog ntawm ib tug tshiab tsim yog yuav luag xoom, tab sis yog hais tias nws muaj malignant inclusions, txoj kev vam meej ntawm kev kho mob yog kwv yees li 40%. Contraindications rau kev ua haujlwm yuav yog ntshav qab zib mellitus, kab mob ntawm lub raum thiab cov kab mob genitourinary.
kev kho neeg zoo
Kev kho mob ntawm adrenal adenoma nrog cov tshuaj pej xeem muaj kev kho mob tsuas yog nyob rau ob kis, xws li:
- Nyob rau hauv rov qab.
- Thaum thawj lossis theem ob ntawm kev txhim kho adenoma.
Txhawm rau kom ua haujlwm ntawm cov qog adrenal, kom txo qis thiab tswj cov qib tshuaj hormones, ntau yam tshuaj ntsuab npaj, siv cov infusions.
Decoctions rau kev kho mob ntawm adrenal adenoma, indications thiab contraindications yuav tham ntxiv.
Licorice cag pab txo qis qib ntawm cov tshuaj hormones hauv cov ntshav, txo qis kev pheej hmoo kis mob.
Kev ua noj ua haus. Siv ib tug tshiab licorice paus, yaug kom huv si thiab ncuav boiling dej tshaj nws. Qhuav, ces grind. Koj tuaj yeem yuav cov khoom npaj ua tiav ntawm cov hauv paus licorice ntawm lub tsev muag tshuaj, tab sis nws pom tau tias tsis zoo.
Ntxiv cov hauv paus licorice rau hauv dej npau npau, cia nws boil rau 3 feeb, thiab tom qab ntawd tshem tawm ntawm qhov cub. Ncuav rau hauv ib lub hub, qhwv thiab muab pov tseg rau 5-6 teev.
Yuav siv li cas. 100-200 milliliters 3 zaug ib hnub twg, ua ntej noj mov.
Contraindications:
- Tus kab mob mob hnyav.
- Hypertension.
- Intolerance to Cheebtsam ntawm licorice cag.
Ntawm lwm yam, thaum npaj ib lub decoction, koj tuaj yeem siv ntau yam khoom tsim nyog los txhim kho kev ua haujlwm ntawm cov qog adrenal. Piv txwv li, carrots, parsley, dandelion thiab lwm yam.
Decoction ntawm geranium nplooj txhim kho cov ntshav ncig, muaj cov nyhuv analgesic thiab diuretic.
Kev ua noj ua haus. Nojqhuav los yog tshiab geranium nplooj. Sib tov, ntsuas 50 grams. Ncuav geranium nplooj hauv 250 milliliters dej. Cia li 5-10 feeb.
Yuav siv li cas. 1 khob 10-15 feeb ua ntej noj mov.
Contraindications:
- Cov me nyuam hnub nyoog (txog 10 xyoo).
- kab mob hauv plab.
- ntshav siab;.
- ntshav txhaws.
Infusions ntawm cov tshuaj ntsuab siv los kho adrenal adenoma ntawm cov txiv neej thiab poj niam. Tsis zoo li cov pa decoctions, infusions siv sijhawm ntev los npaj, zoo dua, tab sis yuav tsum tau siv ceev faj. Cov nplooj Snowdrop pab normalize cov haujlwm ntawm cov qog adrenal, pab lub cev kho cov ntaub so ntswg thiab tiv thaiv kev loj hlob ntawm neoplasms.
Kev ua noj ua haus. Nws yog tsim nyog los noj 70-80 paj los yog snowdrop nplooj. Tus nqi yuav tsum yog xam nyob ntawm lub cev hnyav. Ncuav 70% cawv tov, hais nyob rau hauv ib qho chaw tsaus rau ib hlis.
Yuav siv li cas. Nws yog ib qho tsim nyog yuav tsum tau kawm, pib nrog 1 poob, thiab tom qab ntawd, hauv ib lub lis piam, nqa mus txog 20-30 tee 2 zaug hauv ib hnub, ua ntej noj mov. Tus naj npawb ntawm cov tee kuj nyob ntawm lub hnub nyoog thiab qhov hnyav ntawm tus neeg mob.
Kev Tiv Thaiv
Tsuas yog ua raws li kev tiv thaiv kev tiv thaiv tuaj yeem zam qhov tshwm sim ntawm cov kab mob xws li adrenal adenoma. Qhov no yog vim qhov tseeb tias cov tshuaj tseem tsis tau tsim cov phiaj xwm nqaim los tiv thaiv cov tsos mob ntawm neoplasms. Kev tiv thaiv:
- Ua tiav thiab tsis lees txais kev lees paub ntawmtxhua tus cwj pwm phem rau tag nrho koj lub neej.
- Saib xyuas lub cev qhov hnyav thiab tswj nws hauv qhov qub.
- Siv cov tshuaj uas kws kho mob pom zoo.
- Txhua yam tshuaj hormonal tshwj xeeb yog txwv.
- Kev kuaj xyuas thiab kho raws sijhawm, kom txog thaum rov ua tiav, ntawm txhua yam kab mob uas tuaj yeem tsim muaj adenoma.
- Mus ntsib cov kws tshaj lij kom ntau li ntau tau nrog kev kuaj xyuas kev tiv thaiv tag nrho, ultrasound, CT thiab MRI, dhau qhov kev sim thiab tshuaj ntsuam xyuas.
Tus kab mob yuav muaj kev pom zoo yog tias tus kab mob raug kuaj thiab kho sai li sai tau. Kev ua tiav tiav kev kho mob muab lub sijhawm kom tsis txhob rov qab los. Qhov phom sij tseem ceeb ntawm adrenal adenoma yog qhov kev pheej hmoo uas cov qog yuav raug hloov pauv thiab dhau los ua qhov tsim tsis zoo. Yog tias muaj mob hnyav tshwm sim, ces qhov kev kwv yees ua rau poob siab, qhov kev tuag nce mus txog 50%.
