Sababaha syndrome Sella madhan. Cilad, daaweynta

ah ee madhan Sella syndrome ayaa sababaha iyo sharaxaad badan. Waxa ay tahay in la yidhaahdo madhan, waa ahmiyadda a ma noqon karaan godan. Sababo la xiriira hoos u muhiim ah in mugga of qanjidhada sida pituitary ee, meel mar qabsadeen waxa by, lagu tiriyo ee hoos khamriga iyo xuubka kale.

Waxaa soo baxday in images X-ray pituitary shiidaa aan la arki karin iyo muuqaal la heli karo oo kaliya cerebrospinal iyo qolof ah. Sidaa darteed, meel tani waxaa la yiraahdaa madhan. Sidaa darteed, waxaa la ogaan karo ee MRI khubarada gobolka ama CT scan ee madaxa. Markaas Takhaatiirta dareemeyaasha iyo neurosurgeons horumarinta daawada sida waafaqsan this tallaabo dheeraad ah ka go'an.

Meeday koore Turkiga?

Sella goobta dabiiciga ah waa indentation koore-qaabeeya ee qaab-dhismeedka lafta oo ka mid ah saldhig dhaladii nin. Waa qayb ka mid ah sanka ka sphenoid, kuwaas oo, qaybtii derbiga sare waa. Waxay leedahay size yar oo dherer ah (oo ku saabsan 10 mm) oo height (7-13 mm). Sella saabka, kaas oo ku yaala Zhucheng ee, waxaa la yiraahdaa fossa pituitary ee. By meel subarachnoid kala by diaphragm a - qolof adag ee maskaxda. Iyada oo god yar ee diaphragm ku fidisaa si yeedhay jirid pituitary, taas oo uu leeyahay xiriir la hypothalamus ah.

Research aagga this

Back ee bartamihii qarnigii labaatanaad, waxa ogaaday in dunida fikirka ah "madhan Sella syndrome." Waa maxay taasi ka dhigan tahay waa inay awoodaan inay u tilmaantid pathologist Bush Maraykanka ee 50s hore. Intii lagu guda jiray cilmi-dheer dheer uu u suurtagashay in la ogaado maqan yahay ama uu horumar of aperture aad u kala bar dhintay. Waxbarashada qaliin ku dhawaad 800 oo dhintay, waxa loo soo gabagabeeyay ayaa laga yaabaa in aan dhammaan xaalado kasta oo prostate dilaa xaaladaha bahal u noqday arrin weyn. Bush ayaa sheegay in fossa pituitary ee si weyn u beddeli qanjirka pituitary ee, ayaa helay qaab aan caddayn oo u ekaa daaha khafiif ah unugyada.

cilmi-Ruush Savostianov 1995 modified soocidda la soo jeediyay by syndromes Bush kala duwan ee nooca diaphragm ka, Muga intrasellyarnyh taangiyada sameeyay dhexeeya cerebellum iyo oblongata medulla ah. At gabagabadii cilmiyaysan isla hadlay oo ku saabsan soo socda: 8 ka mid ah 10kii haween ka badan afartan sannadood, dhalmada ka badan hal mar la aasaasay cudurada iyo calaamadaha bilaabaan si ay u muujiyaan ilaa Sella madhan syndrome. Intaa waxaa dheer, saddex-meelood laba in ka badan ee bukaannada qaba dumar ah nolosha cayilka ee kala duwan. Muddo dhawr sano, saynisyahano ay awoodaan in ay xiri cudurada la calaamado clinical, jaraan syndrome Sella madhan hoose iyo kuwa sare.

noocyada cudurka

Sababo la xiriira kala qeybinta macquulka ah ee uu cudurku galay foomamka hoose iyo sare, waxaa suurtagal ah qofka bukaanka ah si loo ogaado fursad u daaweynta ugu haboon. In dhaqanka, taas oo ahmiyad weyn iyo saadaasha cudurka.

Primary syndrome madhan Sella syndrome, calaamadaha taas oo lagu muujiyey by cadaadis intracranial kordhay, shiidaa saameyn ah kuma laha gobolka qanjirka pituitary ee. Inkasta oo ay yar tahay "silcaya" qanjirka, soo bandhigaan iin gaar ah ee diaphragm ka. Ka dibna waxa pituitary baddalayso ka muuqataa ay mugga, anagoo nusqaamin furid, ka dib markii taas oo meesha bannaan ee degan Sella kaa dhaga xuubka iyo dheecaanka (CSF).

calaamadaha dareemayaasha ka badan waxaa loogu dhawaaqaa ee cudurada sare. Tan iyo markii ay "gudbin" birta ugu horeysay ee uu helo marar aad u badan waxay u baahan tahay daaweyn deg deg ah qalliin, daaweynta shucaaca, iyo isticmaalka hannaanka ka mid ah daroogada si looga hortago dhiig bax. Taas waxaa raacda in ugu khatarsan waa a syndrome sare Sella madhan syndrome. Sababaha asalka ah ee cudurka waxaa lagu daboolay in noocyo kala duwan oo arrimo u baahan in baaritaan faahfaahsan.

The duruufo badan tahay cudurka

First of dhan halis waa in ka mid ah dadka qaba taariikh qoys ah ee dhibaatada this a. By inta badan waalidka dhalay carruurta la geeyo diaphragm ah weli qaan gaadhin, taas oo dib dhacsan, qolof incompleteness. Asal ahaan maskaxda More dhalmada uurjiifka ee utero la abuuri laga yaabaa in la joogitaanka cilladaha hoos arrimo kasin deegaanka. Xubnihii ugu khatar ah ee shucaaca ah loo arkaa, jawi ammaan ahayn, cuntada modified, stress soo maray by hooyada mustaqbalka, tayada liidata ee biyaha la cabbo, iyo in ka badan.

Cawaaqib xumada cadaadis intracranial kordhay

dhibaatooyin khatar ah oo ah cudurada qaar ka mid ah waxay leeyihiin saameyn muhiim ah muuqaalka kore ee factor this. Kordhi cadaadis intracranial sabab u noqon kara:

• dhaawacyo xarrunta dhakada, burbur, maskaxda,
• hypertension iyo cudurada kale ee wadnaha,
• burooyinka kansarka,
• Dabcan allifey ee uurka, dhalmada adag, ilmo iska soo ridid,
• thrombosis,
• cudurka disc side dhabarta afka ilmo-galeenka (cudurka faragalin socodka dhiigga caadiga ah ee saabka cranial);
• cudurada kala duwan ee waxyeela habdhiska neerfaha dhexe (encephalitis, meningitis, qandhada dhiigbaxa, iwm).

Secondaries syndrome "Sella madhan" si weyn u saameeya heerka pituitary ee, korodhka cadaadiska gudaha saabka cranial ah. Waxa uu marka hore u kordhay, la xirrira burada, ka dibna si weyn u dhimay ee mugga ay sabab u tahay galleeyda, atrophy suuska unugyada Kaganacsiga neurosurgical iyo hawlgallada oncological.

Calaamadaha caadiga ah ee maskaxda

Asal ahaan, ka hor maris ah ee baadhitaan gaar ah, dad badan oo wax fikrad ah oo ku saabsan ereyga "Sella madhan syndrome." Waa maxay nooca cudurada iyo waxa khatar ah, dad badan oo buka Yaqaannaan isagoo kaliya on gacanta natiijada imaging. Inta badan iyaga oo aan haysan wax cabasho ah, oo ay dareemaan caafimaad. Si kastaba ha ahaatee, taasi ma tilmaamayso in dhammaan cabashooyinka iyo ma noqon karaan. Inta badan calaamadaha dareemayaasha muujiyey in ay soo socda:

• madax xanuun joogta ah, oo mararka qaar si joogto ah (iyaga oo aan haysan meel gaar ah oo ay leeyihiin xoojinta ka duwan);
• wareer;
• adkayn, socod aan la hubin (nin dhinac ilaa dhinac tuuro);
• xusuus beelid iyo ka-fiirsashada, muuqaalka jeediya;
• daal aan dabiici ahayn, hoos u dhac in heerka awoodda iyo dulqaadashada shaqeeya;
• psycho-niyadeed xanuunada.

xanuunada indhaha

Inta badan identify looga shakisan yahay cudurka u maamulaan si Dhakhaatiirta Indhaha. bukaanka kuwanu waxay ka iman cabashooyinka ku saabsan sii daraysa ee xubnaha aragga. Inta badan waxaa jira isbedelka soo socda:

• xanuun dhaqdhaqaaqa bu'da isha;
• waraabinta joogto ah;
• barar conjunctiva ah;
• saarmay caad,
• widhwidha dhalaalaya indhaha.

Inta lagu jiro khubaro baadhitaan faahfaahsan oo lagu ogaan karaa qaar ka mid ah daliilka bahal ah dabeecad u, taas oo ka mid ah barar iyo hyperemia ee dareemaha iftiinka, dhalanrog duurka ku of view, dhacdo ee indhuhu ku daalaan. cillad noocan oo kale ah ee habka muuqaalka aadanaha waxaa laga yaabaa in la joogo ay sabab u tahay sare cadaadis intracranial. In uu maqan yahay carruur waqtiga oo ka mid ah tallaabooyinka ku daweyn loo baahdo sii hypersecretion of dheecaan intraocular waxay keeni kartaa in gulukooma.

Isbedelada nidaamka hormoonada jidhka ee

Sida hore u soo sheegnay, intooda badan dumarka qaba ka dib markii uu 35 sano. Eebbe cudurka waa si toos ah ay ku xidhan tahay wajiga of sii daridda iyo dembidhaafka. On qayb ka mid ah habka hormoonada jidhka waa xanuunada ugu badan ee sababa syndromes autonomic:

• dyspnea qoto dheer xitaa nasan, neefta oo ku qabata;
• qarqaryo, qandho,
• xanuun iyo xanuun jidhka;
• adkaysi qandho fasalka jidhka;
• suuxid soo noqnoqda,
• tachycardia, xanuunka wadnaha,
• niyad of kursi.

Shaqeynaya failure hormoon pituitary ee dhaqanka caafimaad joogta ah qaldo muujin ka timid buro prostate kansarka. Intaa waxaa dheer, isku darka ee microadenomas iyo "Sella madhan" - wax aan caadi ahayn. Sababo la helo tirada looga baahan yahay ee ku hawshooday oo dhex jirid ee hormoonnada pituitary iyo in la yareeyo qanjirka hypothalamus xakameeyo laga yaabaa hadal ah cudurada galmada gaar ah ma aha oo kaliya dumarka dhexdiisa laakiin sidoo kale ka mid ah bukaanka oo lab ah (hoos u libido iyo awoodba, amenorrhea, hypothyroidism, iwm). Xaaladaha daran, waxaa jira halis of dheecaan of cerebrospinal iyada oo marinka sanka.

Baadhista xanuunada

Si loo ogaado cudurka waa in tixraac habka ugu kalsoonaan karo. Si aad u taariikhda, oo amiir u diidanayn in ogaanshaha cudurrada maskaxda ah ee maskaxda waxa loo arki karaa MRI ah. Natiijooyinka Qabto raajito loogu bixiyaan lacagta ugu badan ee warbixin ku saabsan xaaladda bukaanka. Waxaa muhiim ah in ay tixgeliyaan eegidda nabadgelyada buuxda ee noocan ah ee sahanka.

Sawirka wuxuu muujinayaa MRI ee bukaan-socodka ah isagoo ah "Sella madhan" syndrome, waa la heli karaa for muuqaalaynta:

• joogitaanka cerebrospinal;
• pituitary lahayo ku appreciable (qaab qalooca eg moon a bilaha ama sickle) masaf bartamaha ku yaal;
• in Sella saabka ay laftu taangiga asymmetrically suprasellar;
• naaska masaf uga dheeraado oo noqday khafiif ah.

Habka lagu ogaanayo cadaadiska intracranial kordhay image waxaa go'aan looga gaari karo iyo tilmaamayaasha dadban kale (size kordhay iyo meelaha ventricular kooban khamriga).

Dhakhaatiirta door biday in ay habab dheeraad ah oo lagu ogaanayo, oo ay ku jiraan waxbarashada sheybaarka (sampling dhiig arooriyaha for go'aan ah dheelitirka ee hormoonnada soo saaray qanjirka pituitary ee plasma) iyo xaalad imtixaan fundus indhaha ah.

Features ee daaweynta

Yaabban haddii ay macquul tahay in lagu daaweeyo syndrome ee "Sella madhan", waxaa la fahamsan yahay in kaliya tallaabooyin daweynta dhamaystiran kaa caawin doona u xaliyaan dhibaatada this. Ka dib oo dhan, iyada oo aan gargaarka ee Takhaatiirta dareemeyaasha, neurosurgeons, endocrinologists iyo Dhakhaatiirta Indhaha ma aan samayn karo.

syndrome Primary "Sella madhan", sida caadiga ah, ma u baahan tahay daaweyn gaar ah. Aan ku keeni karo dhibaato la taaban karo bukaan-socodka, cudurka qaab tani ma aha khatar ku ah nolosha. In kasta oo mararka qaar waxaa loo baahan yahay soo dhaweynta daawooyinka qaarkood iyo therapy hormone.

In the case of syndrome sare aan la daaweyn hormoon ma aan samayn karo. Tan iyo markii ay isbedel la taaban karo ku xiran yihiin qanjirka muhiim ah, hypothalamus iyo qanjirka pituitary ee, tani inta badan waa marxalad culus cudurka waa la daaweyn karaa hab buuxsan, kaliya. Tusaale ahaan, halka Tuujiya dareemaha iftiinka iyo isgoyska dhula muruqa neefsiga ee godka ku caawin kartaa oo kaliya hawlgalka ku lug qofkale oo a. tusmo ee qalliinka ayaa sidoo kale soo dusaya sanka ah ee dareeraha ah lafdhabarka. hoose Thinned of Sella ogol dillaac cerebrospinal.

Saadaasha rayshada

Fursadaha soo kabashada arrin weyn, gaar ahaan haddii darnaanta daliilka kiliinikada iyo aqoonsaday hooseeyo hoose syndrome Sella madhan syndrome. hypopituitarism vozniknuvshey Daaweynta isticmaalaya hormone replacement therapy la joojiyo xaaladaha ugu natiijo wanaagsan. Inta badan, si kastaba ha ahaatee, la saadaaliyo koorsada cudurka ku xiran yahay ee aan caadi ahayn pituitary socda iyo maskaxda.