U tuyen yen de nham benh khac!.

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U tuyen yen de nham benh khac!

La benh o so nao nhung cac trieu chung cua u tuyen yen lai rat giong mot so benh khac. Neu bac si khong co kinh nghiem se chan doan nham lan va nguoi benh se phai chay long vong..

U tuyen yen de nham benh khac! - Ban co dau.
U tuyen yen de nham benh khac! - Ban khong dau.
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U tuyen yen de nham benh khac!.

Tuyen yen la tuyen noi tiet co nhiem vu dieu khien moi chuc nang noi tiet trong co the con nguoi. Tuyen yen nam trong so nao nen u tuyen yen duoc xep vao loai u so nao. Khi bi u tuyen yen, benh nhan bi xao tron nhieu loai noi tiet to (hormon), vi the benh nhan co nhung bieu hien benh de nham lan voi benh cua mot so chuyen khoa khac. U tuyen yen chiem ti le 10-15% cac u noi so.

U tuyen yen ma tri... bao tu!

Ngay 21-5, chung toi  gap anh N.T.N. (27 tuoi, ngu huyen Nha Be, TP.HCM) tai Benh vien  (BV) Tai mui hong TP.HCM. Truoc do hai ngay, anh N. da duoc phau thuat cat bo u tuyen yen to den 3,2cm. Theo anh N., cach day khoang ba nam anh thay hay met moi, buon non, co khi non oi. Anh da di kham benh nhieu noi, bac si cho lam du thu xet nghiem va deu chan doan la dau bao tu. Anh da uong thuoc tri dau bao tu rat nhieu nhung cac trieu chung met moi, buon non... chi giam tam thoi. Dac biet, du tuoi con tre nhung mot nam tro lai day anh gan nhu mat han nhu cau sinh hoat vo chong ma khong biet  vi sao. Ngoai ra, ban tay, ban chan cung nhu xuong o guong mat (tran, ham) cua anh co bieu hien to ra. Nghi minh lao dong  chan tay, anh khong chu y nhung bat thuong nay va bac si cung khong noi gi moi khi anh di kham benh tong quat.

Giua thang 5-2009, trong mot lan den Trung tam  Chan doan y khoa (Medic) kham benh, mot bac si cua trung tam  nay tinh co gap anh va bao chac chan anh bi u tuyen yen. Bac si nay chi dinh cho chup cong huong tu (MRI) so nao. Ket qua khang dinh anh N. bi u tuyen yen nen bac si huong dan  anh den BV Tai mui hong TP.HCM phau thuat.

Trong khi do, mot benh nhan khac la anh N.T. (41 tuoi, Can Gio, TP.HCM) lai cho biet may nam nay anh thuong xuyen bi nhuc dau. Bac si o mot co so y te tu nhan cho chup X-quang roi chan doan anh bi viem xoang. Khi uong thuoc anh thay bot nhung ngung thuoc thi nhuc lai. Muc do nhuc dau ngay cang nhieu hon, nang hon. Gan day, dau anh nhuc nhu bua bo, nguoi luon xay xam, hai mat mo dan, oi mua. Nghi minh bi viem xoang nang anh den BV Tai mui hong TP kham benh. Tai BV, sau khi loai tru yeu to viem xoang, bac si nghi ngo anh bi u tuyen yen nen da cho chup CT scanner. Ket qua anh co u tuyen yen to 2,3cm. Sau mo noi soi cat u tuyen yen, cac trieu chung nhuc dau, mo mat, non oi... het han.

Trieu chung da dang

Bac si Tran Trong Uyen Minh - khoa mui xoang BV Tai mui hong TP.HCM - cho biet u tuyen yen la benh thuong gap o nguoi truong thanh, cung co khi gap o thieu nien, nguoi gia.

Co hai nhom u tuyen yen: u chuc nang va u khong chuc nang. U khong chuc nang khong tiet ra noi tiet to nen it gay roi loan noi tiet va thuong trieu chung khien benh nhan di kham benh la nhuc dau, mo mat. U chuc nang tiet ra noi tiet to nen gay roi loan chuc nang noi tiet. Khoi u se lam benh nhan bi giam hoac tang sinh noi tiet to cua co the, dan den benh nhan bi thieu hoac thua noi tiet to tang truong, noi tiet to sinh duc, noi tiet to tuyen giap, noi tiet to tuyen thuong than. Dac biet, neu bi suy toan bo tuyen yen, benh nhan co the roi vao soc, hon me va tu vong.

Phuong phap phau thuat moi

Theo bac si Uyen Minh, viec chan doan xac dinh u tuyen yen khong kho, bang phuong phap chan doan hinh anh  (chup MRI, CT scanner) ket hop voi trieu chung lam sang co the phan biet duoc u tuyen yen voi cac loai u khac nhu u so hau, u mang nao, u soi than kinh, u di can...

Benh nhan co the duoc dieu tri bang phuong phap noi khoa de dieu chinh noi tiet to tro lai binh thuong. Truong hop u ac tinh co the xa tri de tieu huy cac te bao bat thuong. Xa tri con thuong duoc dung sau phau thuat tuyen yen doi voi tat ca cac loai u con sot. Tuy nhien, da so truong hop benh nhan can phai duoc mo cat bo khoi u. Truoc day bac si phai khoan va mo hop so, sau do phai ven nao len moi co the thay khoi u de cat. Hien nay, mot so BV cua TP da thuc hien phau thuat vi phau cat u tuyen yen bang duong mo qua mui. Phuong phap nay co mot ti le nho benh nhan bi bien chung nang nhu: ro dich nao tuy, viem mang nao don thuan, chay mau hau phau, ton thuong dong mach canh, ton thuong than kinh thi giac, tham chi tu vong. Nhung bien chung nhe la te moi thoang qua, nghet mui, thung vach ngan...

Bac si Uyen Minh cho biet hon mot nam nay BV Tai mui hong TP da thuc hien mo lay u tuyen yen qua noi soi xoang buom duoi su huong dan  cua may dinh vi ba chieu. Day la phuong phap moi, tien bo va duoc xem la thich hop nhat tren the gioi  hien nay de phau thuat cac u tuyen yen lon tu 2cm tro len. Tuy nhien, voi cac u nho duoi 2cm neu co trieu chung nhuc dau, roi loan noi tiet hoac dot quy tuyen yen thi cung co chi dinh phau thuat. Voi phuong phap nay, hinh anh  chup CT scanner cua benh nhan se duoc dua vao may vi tinh, duoc su dung de dinh vi va huong dan  dung cu trong luc phau thuat. Khi mo, bac si nhin tren man hinh  may vi tinh se biet duoc dung cu mo dang o vi tri nao. Nho do dem lai hieu qua cao, it bien chung do tranh duoc cac vung nguy hiem, benh nhan de chiu hon, thoi gian  hoi phuc va nam vien ngan hon han so voi cac phuong phap khac.

Tuy nhien, de su dung phuong phap nay can co su phoi hop cua phau thuat vien ngoai than kinh cung nhu bac si noi tiet. Benh nhan phai tuan thu dieu tri va theo doi day du vi cac dieu chinh noi tiet thuong keo dai...

Nhung roi loan noi tiet ma u tuyen yen co the gay ra

 

Thieu noi tiet to tuyen thuong than

 

Thua noi tiet to tuyen thuong than

 

Thieu noi tiet to tang truong

 

Thua noi tiet to tang truong

 

Thua noi tiet to prolactin

 

Trieu chung

 

Sut can, thieu nang luong, yeu met, co khi phai di cap cuu

 

Benh Cushing: tang can, mat tron nhu mat trang, ran da, de bam tim, thay doi tam than, tang huyet ap, tieu duong, duc thuy tinh the, tang nhan ap

 

Nguoi lon tang nguy co bi benh tim mach, giam suc co, giam kha nang hoat dong, tang cholesterol; tre lon: giam chieu cao, giam ti le tang truong; tre nho: ha duong huyet

 

o tre em, thanh thieu nien se bi chung khong lo, con o nguoi da truong thanh, ban tay, chan to rong ra, cac ngon tay, chan day, mat tho, tran do, ham nho ra, thay doi giong noi,
ram long

 

Phu nu mat kinh, tiet sua (du khong co thai hoac cho con bu), kho thu tinh; dan ong giam ham muon,
bat luc...

 

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Updated: 17/06/2009 | Views: 184 | Comments: 0

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Hien tai chua co binh luan nao ve bai viet U tuyen yen de nham benh khac!!

Ban co y kien gi ve bai viet U tuyen yen de nham benh khac! nay? Hay goi suy nghi, binh luan, danh gia, loi khuyen ... cua ban ve bai viet U tuyen yen de nham benh khac! ban tai day.

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