Dab tsi yog galactorrhea, lub ntsiab ua thiab kho

Zoo Siab

• Cov tseem ceeb ua
• Cov tsos mob tshwm sim
• Yuav kuaj li cas
• Yuav kho tus mob li cas

Galactorrhea yog lub tso pa tsis tsim nyog ntawm cov kua muaj mis tawm ntawm lub mis, uas tshwm rau cov txiv neej lossis cov poj niam uas tsis xeeb tub lossis pub niam mis. Nws feem ntau yog cov tsos mob tshwm sim los ntawm kev nce hauv prolactin, yam tshuaj tsim nyob rau hauv lub hlwb uas ua haujlwm yog los tsim kev tsim cov mis nyuj los ntawm ob lub mis, ib qho xwm txheej hu ua hyperprolactinemia.

Lub hauv paus tseem ceeb rau kev nce hauv prolactin yog cev xeeb tub thiab pub niam mis, thiab muaj ntau yam ua rau nws tsis tsim nyog nce ntxiv, suav nrog lub qog ua kom lub hlwb, siv cov tshuaj noj, xws li qee cov neuroleptics thiab tshuaj tiv thaiv kab mob, ua kom lub mis lossis qee cov kabmob endocrine, xws li hypothyroidism thiab polycystic zes qe menyuam mob.

Yog li, txhawm rau kho hyperprolactinemia thiab galactorrhea, nws yog ib qho tsim nyog los daws nws qhov ua rau, txawm tias yog tshem tawm cov tshuaj los yog kho tus kab mob uas ua rau kev tsim cov mis los ntawm lub mis.

Cov tseem ceeb ua

Cov laj thawj tseem ceeb rau kev tsim cov kua mis los ntawm ob lub mis yog cev xeeb tub thiab pub niam mis, txawm li cas los xij, galactorrhea tshwm sim, feem ntau yog vim muaj xwm txheej xws li:

• Pituitary adenoma: nws yog cov qog benign ntawm lub caj pas pituitary, ua lub luag haujlwm tsim ntau cov tshuaj hormones, suav nrog prolactin. Lub ntsiab yog prolactinoma, uas feem ntau ua rau kev nce hauv cov ntshav prolactin ntau dua 200mcg / L;
• Lwm yam kev hloov ntawm cov qog pituitary: mob qog, hlav, mob, cuam tshuam lossis hlab ntsha hlwb tawg, piv txwv;
• Tsim kho lub hauv siab lossis lub hauv siab phab ntsa: tus yam ntxwv tseem ceeb ntawm kev ua kom loj hlob yog qhov nqus ntawm ob lub mis los ntawm tus menyuam, uas ua kom cov qog ntawm lub plab thiab ua kom ntau ntxiv ntawm kev ua haujlwm ntawm cerebral prolactin thiab, yog li ntawd, kev tsim cov mis;
• Cov kab mob uas ua rau cov tshuaj hormonal cuam tshuam: qee qhov tseem ceeb yog hypothyroidism, kab mob siab hauv lub siab, mob raum tsis ua haujlwm, Addison's disease thiab polycystic syndrome;
• Tus mob cancer mis: tuaj yeem ua rau galactorrhea rau hauv tib leeg, feem ntau nrog ntshav;
• Kev siv tshuaj: 
  • Cov Tshuaj Tiv Thaiv Kab Mob, xws li Risperidone, Chlorpromazine, Haloperidol lossis Metoclopramide;
  • Opiates, xws li Morphine, Tramadol lossis Codeine;
  • Lub plab zom mov plab, xws li Ranitidine lossis Cimetidine;
  • Cov tshuaj tiv thaiv kev puas tsuaj, xws li Amitriptyline, Amoxapine lossis Fluoxetine;
  • Qee cov tshuaj tiv thaiv kabmob, xws li Verapamil, Reserpina thiab Metildopa;
  • Siv cov tshuaj hormones, xws li estrogens, anti-androgens lossis HRT.

Kev pw tsaug zog thiab kev ntxhov siab yog lwm yam mob uas ua rau muaj ntau ntxiv hauv prolactin, txawm li cas los xij, lawv tsis tshua muaj kev hloov txaus los ua rau galactorrhea.

Cov tsos mob tshwm sim

Galactorrhea yog cov tsos mob tseem ceeb ntawm hyperprolactinemia, lossis ntau dhau ntawm prolactin hauv lub cev, thiab tej zaum yuav ua rau pob tshab, plhaw lossis ntshav muaj xim, thiab tshwm sim hauv ib lossis ob lub mis.

Txawm li cas los xij, lwm cov cim qhia thiab cov tsos mob yuav tshwm sim, vim tias qhov nce ntawm qhov no yuav ua rau kev hloov pauv ntawm cov tshuaj hormones poj niam txiv neej, xws li txo estrogen thiab testosterone, lossis, tseem, yog tias muaj qog nyob hauv lub caj pas pituitary. Cov tsos mob tseem ceeb yog:

• Amenorrhea, uas yog kev cuam tshuam ntawm ovulation thiab poj niam coj khaub ncaws;
• Kev sib deev impotence thiab erectile kawg ntawm tus txiv neej;
• Ntxiv lawm tshob thiab txo qis kev sib deev muaj siab;
• Txha caj qaum;
• Mob taub hau;
• Pom kev hloov pauv, xws li kiv cua thiab lub zeem muag ntawm cov pob qaim.

Cov kev hloov hauv Hormonal kuj tuaj yeem ua lub luag haujlwm ntawm cov menyuam hauv plab los ntawm tus txiv neej lossis pojniam.

Yuav kuaj li cas

Galactorrhea yog pom rau kev kuaj mob hauv tsev kho mob, uas tuaj yeem tshwm sim lossis tshwm sim tom qab lub txiv mis hais tawm. Tus mob Galactorrhea muaj tseeb thaum twg cov kua mis tawm tau tshwm sim hauv tus txiv neej, lossis thaum nws tshwm rau cov poj niam uas tsis tau xeeb tub lossis pub niam mis rau hauv 6 lub hlis dhau los.

Txhawm rau txheeb xyuas qhov ua rau mob galactorrhea, tus kws kho mob yuav txheeb xyuas cov keeb kwm ntawm cov tshuaj thiab lwm cov tsos mob uas tus neeg tuaj yeem ntsib. Ntxiv rau, qee qhov kev ntsuas yuav tuaj yeem tshawb xyuas qhov ua rau galactorrhea, xws li ntsuas cov prolactin hauv cov ntshav, ntsuas ntsuas ntawm TSH thiab T4 qhov tseem ceeb, tshawb xyuas cov thyroid muaj nuj nqi, thiab, yog tias tsim nyog, lub hlwb MRI los tshawb xyuas qhov kuaj pom cov qog lossis lwm yam kev hloov pauv ntawm lub qog pituitary.

Yuav kho tus mob li cas

Kev kho tus kabmob galactorrhea yog coj los ntawm tus kws endocrinologist, thiab nws txawv raws li qhov ua rau muaj tus kabmob. Thaum nws yog cov kev mob tshwm sim los ntawm cov tshuaj, koj yuav tsum tham nrog tus kws kho mob txhawm rau soj ntsuam qhov muaj peev xwm ncua lossis tshem tawm cov tshuaj no nrog lwm tus.

Thaum nws mob los ntawm tus kab mob, nws yog ib qho tseem ceeb uas yuav tsum tau kho kom zoo, txhawm rau txhawm rau txhawm rau muaj kev cuam tshuam los ntawm cov tshuaj hormones, xws li, piv txwv, kev hloov cov thyroid cov tshuaj hormones hauv hypothyroidism, lossis siv cov corticosteroids rau pituitary granulomas. Los yog, thaum galactorrhea los ntawm qog, tus kws kho mob yuav pom zoo kom muaj kev kho mob nrog kev phais mob lossis cov txheej txheem xws li kev kho mob radiotherapy.

Tsis tas li ntawd, muaj cov tshuaj uas tuaj yeem txo cov tshuaj prolactin thiab tswj cov galactorrhea, thaum lub sijhawm tseem kho tau, xws li Cabergoline thiab Bromocriptine, uas yog tshuaj nyob hauv chav kawm ntawm dopaminergic antagonists.