Kuv yuav mus ntsib tus kws kho mob twg yog tias kuv cov piam thaj hauv ntshav siab los yog qis? Tus kws kho mob yuav muab tshuaj dab tsi rau ntshav thiab ntshav qab zib?

Lub xaib qhia cov ntawv pov thawj rau cov ntaub ntawv xov xwm nkaus xwb. Kev kuaj thiab kho kab mob yuav tsum tau nqa tawm los ntawm kev saib xyuas ntawm tus kws tshaj lij. Txhua yam tshuaj muaj contraindications. Yuav tsum tau kev sab laj tshwj xeeb!

Kuv yuav mus ntsib tus kws kho mob twg yog tias kuv cov piam thaj hauv ntshav siab los yog qis?

Hauv feem ntau ntawm cov neeg uas muaj ntau zog lossis txo qis ntshav qab zib yuav tsum tiv tauj endocrinologist (neeg laus los yog kws kho mob) (kos npe), txij li feem ntau cov cim qhia txawv txav piam thaj cov ntshav yog tshwm sim los ntawm cov kab mob ntawm cov qog endocrine (txiav, mob caj pas, lub qog ua rau lub qog, thiab lwm yam), kev txheeb xyuas thiab kev kho mob uas yog qhov ua haujlwm ntawm tus neeg endocrinologist.

Ntawd yog, nrog ib qho ntshav qab zib tsis txaus (siab lossis qis), koj yuav tsum tau sab laj nrog kws kho mob endocrinologist, tshwj tsis yog muaj qee kis uas peb muab rau hauv qab no.

Yog tias ib tus neeg tau phais mob rau lub plab lossis duodenum yav dhau los, tom qab ntawv qhov no, nrog cov ntshav qabzib hauv cov ntshav tsawg, koj yuav tsum tiv tauj cov kws kho mob dav (sau npe) lossis kws kho mob plab (zwm npe), vim tias nyob rau qhov xwm txheej zoo li no nws yog qhov yuav tsum tau hloov kho kev noj zaub mov noj thiab xaiv cov tshuaj noj kom tsim nyog thiaj li ua rau cov zaub mov noj kom haum rau lub plab zom mov ntxiv. Tab sis yog tias ib tus neeg tau phais mob rau lub plab lossis duodenum, thiab nws muaj ntshav siab cov ntshav qab zib, tom qab ntawd nws yuav tsum hu rau tus kws kho mob endocrinologist, vim tias qhov xwm txheej no peb tsis tham txog kev mob plab zom mov, tab sis hais txog lwm tus kab mob.

Ib qho ntxiv, yog tias tus neeg muaj ntshav qab zib qis ua ke nrog mob raws plab, mob plab, poob phaus, ntshav tsis txaus, tsis muaj zog, cuam tshuam thiab cuam tshuam ntawm cov dej-electrolyte tshuav, tom qab ntawd nws yuav tsum hu rau tus kws kho mob plab, vim malabsorption syndrome tau xav tias muaj qhov xwm txheej zoo li no. Yog tias, nrog cov tsos mob zoo sib xws, cov ntshav qab zib cov ntshav tau nce siab, ces koj yuav tsum hu rau tus kws kho qhov muag endocrinologist.

Yog tias cov ntshav qabzib nyob hauv qib qis los yog nce vim qhov mob ntawm txoj cai hypochondrium, xeev siab, dryness thiab iab nyob rau hauv lub qhov ncauj, nraus, tsis qab los noj mov, daj ntseg, tawv nqaij ua pob, esophageal thiab hemorrhoidal los ntshav, mob siab mob siab yog xav tau. Hauv qhov no, thov hu rau Kab mob siab (sau npe)Cov. Yog tias koj tsis tuaj yeem mus cuag kws kho kab mob kev nkeeg, koj yuav tsum hu rau tus kws kho mob leeg / kws kho mob.

Tus kws kho mob muab tshuaj dab tsi rau kev kuaj ntshav thiab ntshav qab zib?

Txij li thaum cov ntshav qab zib cov ntshav qab zib tsawg dua lossis nce rau ntau yam, tus kws kho mob tuaj yeem sau cov npe sib txawv thiab kuaj mob hauv txhua kis, nyob ntawm seb nws xav tias muaj tus kab mob. Qhov no txhais tau tias cov npe ntawm kev tshuaj ntsuam thiab kev tshuaj ntsuam uas tus kws kho mob tau hais rau hauv txhua kis yog nyob ntawm cov tsos mob nrog, uas tso cai rau ib tus neeg ua rau xav tias muaj kab mob tshwj xeeb. Xav txog yam kev tshuaj ntsuam thiab kev ntsuas mob tuaj yeem kho los ntawm tus kws kho mob uas muaj ntshav qab zib tsawg lossis muaj ntshav siab, nyob ntawm lwm tus neeg cov tsos mob.

Thaum cov piam thaj hauv ntshav tsawg ua ke nrog mob raws plab, mob plab, poob phaus, ntshav tsis txaus, ua kom tsis muaj zog, cuam tshuam thiab cuam tshuam txog dej-electrolyte tshuav, malabsorption syndrome yog xav tias tsam tsis muaj, thiab hauv qhov no, tus kws kho mob tau sau ntawv thiab kuaj:

Kuaj ntshav ទូទៅ (sau npe),
Coagulogram (PTI, INR, APTTV, TV, fibrinogen, thiab lwm yam) (sau npe),
Kev kuaj ntshav biochemical (kos npe) (tag nrho cov protein, albumin, urea, creatinine, cov roj cholesterol, bilirubin (Tso npe)alkaline phosphatase, AcAT, AlAT, thiab lwm yam),
Cov ntshav electrolytes (calcium, potassium, sodium, chlorine),
Kev soj ntsuam tsom xam cov quav,
Kev kuaj cov kab mob,
Kev soj ntsuam ntawm cov quav rau lub cev muaj mob (cov rog hauv cov quav),
D-xylose xeem
Shilling xeem
Lactose xeem
LUND thiab PABK sim,
Kev txiav txim siab txog qib ntawm sim tshuaj tiv thaiv trypsin hauv cov ntshav,
Kev ntsuas ua pa hydrogen thiab carbon dioxide ua pa
Kev Lom Zem xoo hluav taws xob mob plab (kos npe),
Ultrasound ntawm plab ua plab plab (sau npe),
Tomography (multispiral xam los yog sib nqus resonance (zwm npe)) mob plab plab
Mob hnyuv Endoscopy (cuv npe).

Ua ntej tshaj plaws, thaum lub sijhawm malabsorption, kev kuaj ntshav dav thiab biochemical, coagulogram, kev txiav txim siab cov tshuaj electrolytes hauv cov ntshav, kev kuaj kab mob thiab kab mob bacteriological, kev soj ntsuam kab mob quav, kuaj ntshav D-xylose / kuaj ntshav Schilling, ntxiv rau Ultrasound (kos npe) thiab xoo hluav taws xob ntawm lub plab plab hnyuv siab raum. Nws yog cov kev tshawb fawb no uas tau ua nyob rau hauv thawj qhov chaw, txij li lawv ua rau nws muaj peev xwm txheeb xyuas malabsorption syndrome thiab tsim nws qhov laj thawj hauv feem ntau ntawm cov mob. Yog tias muaj qhov ua tau zaum no, tom qab ntawd muaj qhov tomography txuas ntxiv ua kom pom tseeb cov plab hnyuv pathology.

Kev sim ua pa hydrogen lossis carbon dioxide ntxiv tuaj yeem tsim tshuaj kom ntsuas cov kab mob rau kev ua paug ntawm cov hnyuv. Txawm li cas los xij, yog muab ua haujlwm kev kuaj mob endoscopic (sau npe) txoj hnyuv (siv raws li ib txoj hauv kev ntxiv), uas tso cai soj ntsuam lub xeev hloov khoom nruab nrog thiab coj ib feem ntawm cov ntsiab lus txhawm rau soj ntsuam kev sib kis ntawm cov kab mob nroj tsuag thiab me me (kos npe) rau histology, tom qab ntawv kuaj ua pa tsis ua. LUND thiab PABA cov kev sim, nrog rau qib kev sim tshuaj tiv thaiv kabmob, yog tsuas yog tias muaj kev lees paub txog kab mob pancreatic, uas yog qhov ua rau malabsorption syndrome. Yog tias, vim qhov ua rau malabsorption, qhov tsis txaus ntawm lub lactase enzyme xav tias yog, tom qab ntawd ntxiv rau txoj kev tshawb fawb ua ntej, kev kuaj mob lactose yog raug kho.

Thaum cov ntshav qabzib hauv lub cev yog qhov txawv txav, thiab ntxiv rau, tus neeg muaj mob nyob rau hauv txoj cai hypochondrium, xeev siab, dryness thiab iab nyob rau hauv lub qhov ncauj, ua rau tawv nqaij, tsis qab los noj mov, daj ntseg, ua pob rau ntawm daim tawv nqaij, los ntshav los ntawm cov leeg txoj hlab pas thiab cov leeg ntshav, tus kws kho mob xav tias mob siab mob siab, thiab nyob rau hauv cov ntaub ntawv no los xaiv cov kev tshuaj ntsuam thiab kuaj xyuas hauv qab no:

Ua kom tiav cov ntshav suav
Platelet suav hauv cov ntshav (sau npe),
Mob Lub Hlaus
Ntshav biochemical tsom (tag nrho cov protein, albumin, gamma-glutamyltranspeptidase, bilirubin, urea, creatinine, AcAT, AlAT, alkaline phosphatase, LDH, lipase, amylase, potassium, sodium, chlorine, calcium),
Coagulogram (APTTV, PTI, INR, TV, fibrinogen),
Kuaj ntshav rau kab mob siab A, B, C thiab D (sau npe),
Kuaj ntshav rau qib ntawm immunoglobulins (sau npe),
Ultrasound ntawm daim siab (kos npe),
Tomography (suav los sis lub suab sib nqus),
Siv lub siab ua nqaij hlav (zwm npe).

Feem ntau, tag nrho cov kev ntsuam xyuas no tau sau tseg tam sim ntawd, tshwj tsis yog kev kuaj mob tomography thiab daim siab ua haujlwm, vim tias lawv yuav tsum tau soj ntsuam lub xeev ntawm cov khoom nruab nrog thiab txheeb xyuas tus kabmob tseeb. Tomography feem ntau yog ua ib qhov txuas rau ultrasound, yog tias lub tsev kho mob muaj qhov zoo li no. Ib qho kev kuaj mob rau daim siab yog tawm tsuas yog tom qab ua txoj kev tshawb nrhiav, yog tias, raws li lawv qhov kev tshawb pom, ib lub qog lossis metastases hauv daim siab yog xav tias yog.

Yog tias yav dhau los ib tug neeg tau phais mob rau lub plab lossis duodenum, thiab tam sim no nws tau txo qis cov ntshav qab zib, tom qab noj mov, nws muaj plab, mob plab, mob plab hnyuv, mob plab, tawm hws, mob plawv, tom qab ntawd pov tseg cov tsos mob xav tias yog. vim yog kev phais mob, thiab hauv qhov no, tus kws kho mob tau sau ntawv rau kev sim thiab tshuaj xyuas hauv qab no:

Xoo hluav taws xob ntawm lub plab (kos npe) thiab txoj hnyuv (sau npe) nrog sib piv nruab nrab
Provocative kuaj (kua qab zib yog muab rau ua qhov tshwm sim khib nyiab),
Ua kom tiav cov ntshav suav
Mob Lub Hlaus
Ntshav biochemical tsom (tag nrho cov protein, albumin, urea, creatinine, roj cholesterol, amylase, lipase, alkaline phosphatase, AcAT, AlAT, potassium, calcium, chlorine, sodium, thiab lwm yam),
Kev txiav txim siab txog cov tshuaj insulin ntau ntxiv hauv cov ntshav,
Kev soj ntsuam cov quav ntawm quav.

Feem ntau, tag nrho cov kev ntsuam xyuas saum toj no rau cov kev xav tias khib nyiab cov tshuaj yog sau tseg tam sim ntawd, vim tias lawv yuav tsum tau soj ntsuam cov mob thiab kev ua haujlwm ntawm lub plab zom mov, thiab tsis yog ua kom muaj kev kuaj mob, uas, hauv txoj hauv kev, tau pom tseeb ntawm lub hauv paus ntawm kev taw qhia ntawm kev phais yav dhau los ntawm lub plab lossis duodenum.

Yog tias cov ntshav qab zib qis ua ke nrog poob ntawm potency rau cov txiv neej, amenorrhea (tsis muaj poj niam coj khaub ncaws) hauv cov poj niam, plaub hau poob ntawm qhov pubis, qhov tso tawm, caj pas ntawm caj ces, qhov txo qis hauv lub cev nyhav, nqaij pob txha, ua kom tawv nqaij thiab tawv nqaij ntawm lub cev, txha nqaj qaum, txha hniav laus , qaug zog, nkees, tsis muaj ntshav siab, txo qis kev kis kab mob, kho lub cev tsis zoo, nco tsis zoo, tsis muaj peev xwm saib xyuas, hypopituitarism yog qhov xav, thiab qhov no, tus kws kho mob tau sau tseg rau hauv qab no. Lwm yam tsom xam thiab kev ntsuam xyuas:

Ua kom tiav cov ntshav suav
Kev kuaj ntshav biochemical (tag nrho cov protein, albumin, cov roj cholesterol, bilirubin, amylase, lipase, AcAT, AlAT, alkaline phosphatase, thiab lwm yam),
Kev tsom xam cov ntshav thiab zis rau txiv neej thiab poj niam rau kev saib xyuas cov thyroid stimulating hormone (TSH) (kos npe)thyroxine (T4), adrenocorticotropic hormone (ACTH), kev loj hlob hormone (STH), prolactin (zwm npe)cortisol
Kev kuaj ntshav thiab tso zis rau cov poj niam rau kev saib xyuas ntawm 17-hydroxyprogesterone (17-ACS), luteinizing hormone (LH), follicle-stimulating hormone (FSH) thiab estradiol,
Kuaj ntshav hauv txiv neej rau testosterone concentration,
Cov tshuaj tiv thaiv kev mob siab tshaj tawm nrog kev tso tawm hormone, metirapone, insulin,
Kev kuaj ntshav rau cov ntsiab lus ntawm somatomedin-C (insulin-zoo li qhov kev loj hlob zoo - IGF-1),
Tomography (khoos phis tawj (rau npe), sib nqus resonance (zwm npe) lossis positron emission) ntawm lub hlwb,
Lub khob hliav qab rau lub ntsej muag ntawm lub Turkish eeb,
Cerebral angiography (sau npe),
Xoo hluav taws xob xoo (kos npe), pob txha pob txha (sau npe), pob txha taub hau (rau npe) thiab tus txha nqaj qaum (kos npe),
Txoj kev tshawb ntawm cov pom teb (kos npe).

Txhua yam ntawm cov kev tshawb fawb saum toj no feem ntau tau hais tseg tam sim ntawd, vim lawv yog qhov tsim nyog rau kev kuaj mob thiab kev txiav txim siab lub xeev ntawm ntau yam kabmob thiab cov tshuab, uas yog qhov tseem ceeb rau xaiv cov kev kho kom tsim nyog nyob rau yav tom ntej.

Yog tias cov piam thaj hauv ntshav tsawg ua ke nrog cov xim sib xyaw ua kom tawv nqaij thiab tawv nqaij ua paug, ua kom tsis muaj zog, ntuav, zawv plab, nquag tsaus muag, thiab mob plawv tsis meej, ces Addison tus kab mob yog xav tias tsam tsis muaj, thiab hauv qhov no, tus kws kho mob tau sau ntawv thiab kuaj:

Ua kom tiav cov ntshav suav
Mob Lub Hlaus
Qhia txog ntshav ntshav
Kev kuaj ntshav thiab zis rau kev saib xyuas ntawm cortisol, 17-hydroxyprogesterone,
Kev kuaj ntshav rau lub siab ntawm adrenocorticotropic hormone (ACTH),
Kev kuaj ntshav rau cov tshuaj tiv thaiv rau 21-hydroxylase antigen,
ACTH stimulation xeem,
Qauv ntawm insulin glycemia,
Ultrasound ntawm cov qog adrenal (sau npe),
Tomography (suav los yog sib nqus resonance) ntawm lub qog adrenal los yog lub hlwb.

Ua ntej tshaj plaws, tus kws kho mob tau sau ib qho kev soj ntsuam dav dav ntawm cov ntshav thiab zis, ib qho kev kuaj ntshav biochemical, kuaj ntshav rau lub ntsej muag ntawm cortisol, 17-hydroxyprogesterone, ACTH thiab ultrasound ntawm cov qog adrenal, vim tias cov kev tshawb fawb no ua rau nws muaj peev xwm txheeb xyuas tus mob ntxiv. Yog tias qhov concentration ntawm ACTH yog cov tsis ntseeg, ces qhov kev sim ntsuas ua kom zoo yog tsim. Ntxiv mus, yog tias thawj qhov kev tiv thaiv kab mob ntxiv yog xav tias muaj kev xav (nce ntxiv ACTH cov tshuaj lom neeg), tom qab ntawd cov qog adrenal caj pas thiab kuaj ntshav rau qhov muaj cov tshuaj tiv thaiv rau 21-hydroxylase antigen yog tshuaj kom paub nws cov laj thawj. Yog tias muaj tus mob Addison lwm yam kab mob (ACTH hauv qab ib txwm muaj) yuav xav tias tsam muaj, tom qab ntawv mus tshuaj insulin glycemia thiab lub hlwb tom qab.

Yog tias cov piam thaj hauv ntshav tsawg ua ke nrog kev rov ua dua, kev ntshai, palpitations, hais lus tsis pom kev thiab qhov tsis pom kev, lub pob txha caj qaum (qhov hnov ntawm txha hniav vog, loog, tingling, thiab lwm yam), tom qab ntawd insulinoma (mob qog uas tsim cov tshuaj insulin) xav tias yog. ), thiab hauv qhov no, ua ntej txhua yam, tus kws kho mob sau ntawv tej kev tshuaj ntsuam (sau npe)Cov. Ua ntej, qhov kev ntsuam xyuas kev yoo sai lossis kev kuaj ntshav insulin tau ua tiav, thaum lub sijhawm hloov pauv hauv cov piam thaj hauv cov lus teb rau qhov qis ntawm cov insulin hauv cov ntshav. Feem ntau ib qho ua tiav: ib qho sim nrawm nrawm lossis ntsuas kab mob hauv insulin. Ib qho ntxiv, ib qho kev kuaj xyuas cov kab mob insulin yog ua tiav. Yog tias qhov ntsuas pom los ntawm cov kev xeem no tso cai xav tau cov tshuaj insulin, tom qab ntawd cov kws tshuaj hauv qab no raug tshuaj thiab ua kom paub meej tias nws: Ultrasound ntawm tus txiav (kos npe) thiab scintigraphy plab pancreatic magnetic resonance imaging (sau npe)xaiv angiography (sau npe) nrog cov ntshav piv txwv los ntawm portal veins. Yog tias lub sijhawm ntsuas cov kev sim tshuaj ntawm insulinoma tseem tsis ntseeg, yuav muaj kev kuaj mob ntxiv. laparoscopy (cuv npe).

Yog tias tus neeg muaj cov tsos mob hypothyroidism (ntshav qab zib qis, tsis muaj zog, tsis txaus ntseeg, rog dhau, maj mam xav thiab hais lus, chilliness, hypotension) lossis hyperthyroidism (cov ntshav qab zib, tshee, insomnia, bulging lub qhov muag, tawm hws, kub tsis txaus, mob ntshav siab, ua tsis taus pa, mob nqaij ntshiv, tawv nqaij), tus kws kho mob tau sau ntawv thiab kuaj:

Kev txheeb xyuas biochemical ntawm cov ntshav (ntxiv rau lwm qhov ntsuas, qhov kev txiav txim siab ntawm kev saib xyuas ntawm cov cholesterol, triglycerides, lipoproteins ntau ntom yog qhov tsim nyog)
Kev txiav txim siab cov ntshav ntawm triiodothyronine (T3), thyroxine (T4), cov thyroid stimulating hormone (TSH),
Kev txiav txim siab ntawm qhov muaj cov tshuaj tiv thaiv rau thyroglobulin (AT-TG) thiab thyroperoxidase (AT-TPO) (rau npe),
Ultrasound ntawm cov ua cov thyroid caj pas (sau npe),
Lub qog scintigraphy (zwm npe),
Zoo koob Lub qog ua ntshav (xee npe).

Feem ntau, txhua qhov kev ntsuam xyuas saum toj no tau sau tseg tam sim ntawd, tshwj tsis yog lub koob txhaj koob txhaj, vim tias lawv yuav tsum tau kuaj tus mob hypothyroidism lossis hyperthyroidism, nrog rau txheeb xyuas qhov ua rau ntawm tus kab mob pathology. Muab ib qho nqaij mus kuaj rau cov qog nqaij hlav qog hais tias xav tias.

Yog tias cov piam thaj hauv ntshav siab ua ke nrog kev yug me nyuam hauv plab, mob ntshav liab, liab liab, stomatitis, gingivitis (mob ntawm cov pos hniav), glossitis (mob ntawm tus nplaig), raws plab, vaginitis rau cov poj niam thiab tus mob balanitis rau txiv neej, tom qab ntawd glucagon (mob qog nqaij hlav uas tsim tau glucagon hormone), thiab hauv qhov no, tus kws kho mob tau sau ntawv rau kev tshuaj xyuas thiab kuaj mob hauv qab no:

Ua kom tiav cov ntshav suav
Kev kuaj ntshav biochemical (qib roj cholesterol yuav tsum tau txiav txim siab),
Kuaj ntshav rau hauv glucagon concentration,
Kev sim nrog tolbutamide, arginine thiab somatostatin analogues,
Ultrasound ntawm lub txiav thiab lub plab plab hnyuv siab raum,
Tomography (suav lossis sib nqus resonance) ntawm lub txiav,
Zoo ib scintigraphy,
Xaiv cov ntawv sau keeb kwm.

Yog tias lub plab glucagon xav tias tsis muaj tseeb, tag nrho cov kev kuaj mob no tau sau tseg tam sim ntawd, tshwj tsis yog muaj kev sib piv ntawm cov scintigraphy thiab xaiv cov duab angiography, uas yog cov hauv kev tshawb fawb ntxiv.

Yog tias cov ntshav qab zib ntau ntau ua ke nrog kev rog (ntxiv mus, cov rog nyob rau hauv lub ntsej muag, lub plab, caj dab, lub hauv siab thiab sab nraub qaum nrog cov ceg thiab caj npab), muaj lub cev ua rau lub cev txhawm, ua kom tawv nqaij rau sab nraub qaum ntawm xib teg, cov leeg tsis muaj suab nrov, cov qav loj loj rau tom hauv ntej "mob plab, tawv nqaij tawv, pob txuv, kab laug sab veins, mob plawv tsis txaus, kws kho mob xav tias Itsenko-Cushing's syndrome thiab muab tshuaj rau qhov kev tshuaj xyuas thiab kev kuaj mob hauv qab no kom paub meej tias nws:

Kev txiav txim siab ntawm kev txiav txim siab ntawm cortisol nyob rau hauv cov zis txhua hnub,
Kev xeem Dexamethasone.

Qhov ob txoj kev ntsuam xyuas no tso cai rau koj kom paub meej txog Itsenko-Cushing's disease, thiab tom qab ntawd ntxiv, txhawm rau txhawm rau ntsuas qhov xwm txheej ntawm lub cev thiab paub qhov ua rau muaj tus kabmob, tus kws kho mob tau sau ntawv rau kev kuaj thiab kuaj mob hauv qab no:

Ua kom tiav cov ntshav suav
Kev kuaj ntshav biochemical (nws yog qhov yuav tsum tau txiav txim siab txog qib roj, potassium, calcium, sodium thiab chlorine),
Urinalysis rau kev saib xyuas ntawm 11-hydroxyketosteroids thiab 17-ketosteroids,
Tomography (suav los sis sib nqus resonance) ntawm lub qog adrenal thiab cov qog pituitary,
Adrenal scintigraphy
Xoo hluav taws xob (lossis xaj tomography) ntawm tus nqaj qaum thiab hauv siab.

Yog tias cov ntshav qab zib ntau ntau ua ke nrog lub cev loj heev (gigantism) lossis ua kom lub qhov ntswg, pob ntseg, daim di ncauj, ko taw thiab txhais tes (acromegaly), nrog rau mob taub hau thiab mob pob txha, ces ntau ntxiv ntawm kev loj hlob hormone (somatostatin) xav tias yog, thiab Hauv qhov no, tus kws kho mob tau sau ntawv rau kev sim thiab kuaj mob hauv qab no:

Kev txiav txim siab cov ntshav theem ntawm kev loj hlob hormone thaum sawv ntxov thiab tom qab kuaj ntshav qabzib,
Kev txiav txim siab ntawm insulin-zoo li qhov kev loj hlob zoo (IRF-I) hauv cov ntshav,
Kev txiav txim siab txog somatotropin qib hauv cov ntshav,
Cov qauv nrog cov piam thaj tso nrog kev txiav txim siab ntawm qib kev loj hlob hormone tom qab 30 feeb, 1 teev, 1.5 teev thiab 2 teev tom qab cov piam thaj,
Kuaj ntshav qabzib kuaj (sau npe),
Teb ntawm lub zeem muag
Xoo hluav taws xob pob txha taub hau,
Lub hlwb tomography (suav los sis hais lub suab nrov).

Feem ntau, txhua yam ntawm cov kev xeem thiab kev xeem saum toj no yog sau tseg tam sim ntawd (tshwj tsis yog tomography), vim tias lawv tsim nyog rau kev kuaj mob ntawm acromegaly lossis gigantism. Yog tias cov qog ntshav xav tias yog xoo hluav taws xob los ntawm kev xoo hluav taws xob ntawm lub pob txha taub hau, tom qab ntawd lub hlwb tomography kuj raug ntxiv.

Yog tias ib tus neeg, ntxiv rau cov piam thaj hauv ntshav siab, muaj kev pheej hmoo ntxiv hauv cov ntshav siab, ua rau lub ntsej muag, pallor ntawm daim tawv nqaij ntawm lub ntsej muag thiab lub hauv siab, poob qis thaum muaj kev nyuaj siab thaum sawv los ntawm kev zaum lossis pw ua rau mob, thiab muaj kev tawm tsam thaum lub sijhawm kev ntxhov siab, ntshai, tshee, ua daus no, mob taub hau, tawm hws, cramps, qhov ntshav nce siab ntau, mob lub siab, xeev siab thiab lub qhov ncauj qhuav, tom qab ntawd pheochromocytoma (mob qog uas ua rau cov tshuaj lom xyoob ntoo lom) ua rau xav tias yog, hauv tus kws kho mob xaiv cov kev xeem thiab kev xeem:

Ua kom tiav cov ntshav suav
Qhia txog ntshav ntshav
Kuaj ntshav rau cov kab kawm (potassium, sodium, chlorine, calcium, phosphorus, thiab lwm yam),
Kev kuaj ntshav thiab zis rau kev saib xyuas ntawm catecholamines (adrenaline, norepinephrine, dopamine),
Kuaj ntshav rau lub siab ntawm chromogranin A,
Provocative thiab tshuaj ntsuam kev tsis meej,
Electrocardiogram (ECG) (cov ntaub ntawv),
Ultrasound ntawm qog adrenal,
Tomography (suav los yog sib nqus resonance) ntawm cov qog adrenal,
Adrenal scintigraphy
Kev zam txim urography (rau npe),
Arteriography ntawm lub raum thiab cov hlab ntsha cov hlab ntsha.

Ua ntej tshaj plaws, txhawm rau paub tseeb tias kev kuaj mob pheochromocytoma thiab txiav txim siab nws qhov chaw nyob, tus kws kho mob tau tshaj tawm cov kev kuaj ntshav dav thiab biochemical, kuaj ntshav rau cov kab mob, cov concentration ntawm catecholamines, chromogranin A, ib qho electrocardiogram thiab ultrasound ntawm cov qog adrenal. Nws yog cov kev tshawb fawb no feem ntau tso cai rau koj los txheeb xyuas lub qog thiab ntsuas qhov mob ntawm cov kabmob, uas yog vim li cas lawv tau siv los ua qhov teebmeem tseem ceeb. Yog tias muaj qhov ua tau ntawm kev ua haujlwm, ultrasound yog ntxiv los ntawm tomography, thaum lub sijhawm koj tuaj yeem tau txais cov ntaub ntawv ntau ntxiv txog lub xeev ntawm cov kabmob thiab cov qauv ntawm cov qog. Scintigraphy, urography thiab hlab ntsha feem ntau yog kws kho ntxiv yog tias yuav tsum tau txais cov ntaub ntawv tshwj xeeb ntawm kev ua haujlwm thiab ntshav txaus hauv cov qog adrenal thiab lub raum. Thiab qhov kev sim ua tsis tau thiab tsim kev kub ntxhov yog tshuaj uas tsis tshua muaj, vim tias thaum lub sijhawm lawv ua tiav nws tuaj yeem tau txais cov txiaj ntsig tsis zoo thiab qhov tsis raug, vim qhov txiaj ntsig ntawm cov ntaub ntawv cov ntsiab lus thiab tus nqi ntawm cov kev kuaj mob no muaj tsawg.

Yog tias cov ntshav qab zib cov ntshav nce siab, thiab tus neeg muaj mob polydipsia (nqhis dej), polyuria (nce ntxiv ntawm cov zis), polyphagia (nce ntxiv ntawm lub cev), thiab khaus ntawm daim tawv nqaij thiab hnoos qeev, qaug zog, mob taub hau, kiv taub hau, mob hauv ceg, calf cramps thaum tsaus ntuj, paresthesia ntawm qhov sib txawv (ua kom loog, tingling, kev xav ntawm "Goosebumps"), muaj mob nrawm dhau los, tom qab ntawd mob ntshav qab zib yog xav tias tsam muaj, thiab qhov no, tus kws kho mob tau sau ntawv rau cov kev sim thiab kuaj mob hauv qab no:

Ua kom tiav cov ntshav suav
Mob Lub Hlaus
Urinalysis rau qab zib thiab ketone lub cev,
Kuaj ntshav rau qab zib concentration,
Kuaj ntshav qab zib kuaj
Kev kuaj ntshav rau lub siab ntawm C-peptide thiab insulin,
Kev kuaj ntshav rau cov ntsiab lus ntawm glycosylated hemoglobin.

Yog tias xav tau ntshav qab zib, tag nrho cov kev ntsuam xyuas saum toj no feem ntau tau hais tseg tam sim ntawd, tshwj txoj kev txiav txim siab qhov kev txiav txim siab ntau ntawm C-peptide thiab insulin hauv cov ntshav. Qhov no yog ua los kho kom raug thiab txiav txim qhov txaus ntshai ntshav qab zib uas muaj teeb meem. Kev txiav txim siab txog qib C-peptide thiab insulin yog suav tias yog kev ntsuas qhov ntswg, tsuas yog lees paub ntxiv txog ntshav qab zib.

Tom qab kuaj pom tus kab mob ntshav qab zib, kws kho mob tuaj yeem sau ntawv tawm qhov tsis txaus ntawm tus kab mob. Ultrasound ntawm ob lub raum (sau npe), rheovasography (kos npe) ob txhais ceg rheoencephalography (xee npe), electroencephalography (zwm npe)qhov muag biomicroscopy kev kuaj nyiaj (sau npe).

Tus kab mob no tshwm sim rau cov laus li cas?

Yog tias peb tham txog cov tsos mob uas mob ntshav qab zib ua tau tshwm sim hauv cov neeg laus, ces nws tseem ceeb uas yuav tsum nco ntsoov muaj cov tsos mob li no:

Polyphagy, uas nrog nrog kev poob zoo hauv lub cev nyhav,
Nquag tso zis nrog kev tso zis ntau zaus
Lub qhov ncauj qhuav thiab nqhis dej tas li.

Nws yuav tsum raug sau tseg tias txhua daim phiajcim no tshwm sim yog tias cov piam thaj hauv ntshav siab dhau. Mob ntshav qab zib pib tsim muaj twb

cov ntaub ntawv thaum cov piam thaj nce mus txog qib uas tsis tseem ceeb. Yog li, feem ntau txhua qhov tsos mob tshwm sim tsuas yog pom thaum tus kab mob nyob hauv nws cov theem kawg.

Hauv lub sijhawm thaum ntxov, tus kabmob tuaj yeem tsuas kuaj pom nrog kev pabcuam ntawm kev soj ntsuam kom raug. Piv txwv, nws muaj lub rooj tshwj xeeb hauv kev tso cai rau cov txiaj ntsig zoo ntawm cov ntshav qabzib hauv cov ntshav tau sau tseg. Raws li cov ntaub ntawv no, tus kws kho mob tuaj yeem tsim kho kom paub tseeb seb tus neeg mob puas muaj ntshav qab zib lossis tsis.

Zoo, ntawm chav kawm, nws yog ib qho tseem ceeb kom them sai sai rau cov tsos mob nrog tus kab mob. Piv txwv li, yog hais tias tsis muaj loog ntawm qis qis tshaj feem ntau pom, tsis muaj kev tawm tsam ntawm xeev siab, cramps hauv qis qis, muaj ntau yam mob rau ntawm daim tawv nqaij, zoo li hauv lub qhov ncauj ntawm qhov ncauj, qhov no tseem tuaj yeem suav tau tias yog cov paib ntawm cov ntshav qab zib.

Mob ntshav qab zib Latent - yuav ua li cas thiaj paub?

Nws yuav tsum raug sau tseg tias tus kabmob no tuaj yeem muab zais. Yog li, txhua tus neeg yuav tsum nkag siab txog qhov xwm txheej twg nws xav tau kev pab tswv yim kho mob nrawm.

Feem ntau cov ntshav qab zib muaj peev xwm ua tsis tiav asymptomatic. Nov yog daim ntawv latent ntawm tus kab mob nyob rau hauv uas tsis muaj cov cim qhia pom pom.

Yog li ntawd, kab mob tuaj yeem kuaj pom tsuas yog thaum kuaj ib txwm lossis thaum kuaj tus mob lwm yam kabmob.

Nws yuav tsum nco ntsoov tias mob ntshav qab zib yog ib txwm nrog kev ua rau qaug zog, ntau cov txheej txheem ua rau ntawm daim tawv nqaij, thiab kho tsis zoo. Cov piam thaj siab muaj qhov tsis zoo ntawm kev tiv thaiv kab mob. Hauv qhov no, tus neeg mob feem ntau txom nyem los ntawm ntau yam kab mob kis, cov kab mob purulent tshwm rau ntawm daim tawv nqaij thiab cov qog ua kua, uas tau nrog cov mob hnyav.

Tsis txhob hnov qab txog qhov ua puas rau cov nkoj me me. Tias nws yog vim qhov tseeb hais tias ntau yam mob thiab raug mob kho kom qeeb qeeb

Cov npe ntawm cov neeg uas muaj kev pheej hmoo suav nrog:

Cov poj niam uas raug mob los ntawm polycystic ovary.
Cov neeg mob kuaj mob kub siab, nrog rau cov kev txom nyem los ntawm cov poov tshuaj tsis txaus.
Cov neeg mob nyhav dhau los lossis rog dhau
Yog tias muaj cov tib neeg hauv tsev neeg uas muaj ntshav qab zib, tshwj xeeb yog tias lawv yog cov neeg txheeb ze cov ntshav.

Nws yuav tsum tau nco ntsoov hais tias yog tias sijhawm sijhawm los qhia txog cov ntshav qabzib nyob rau hauv lub cev, tom qab ntawv nws yuav pom tias muaj ntshav qab zib ua ntej.

Yuav ua li cas tshem tawm cov ntshav qab zib siab?

Nws yog qhov tseeb tias ntshav qab zib ntau dhau lawm yuav tsum muaj kev cuam tshuam. Txwv tsis pub, cov txheej txheem tsis hloov pauv yuav pib, piv txwv li, qee qhov hloov pauv ntawm cov ntaub so ntswg uas ua rau kev txhim kho ntawm neuropathy, kab mob vascular, teeb meem ntawm daim tawv nqaij, pw tsis txaus, kev nyuaj siab thiab ntau yam mob.

Thaum mus ntsib tus neeg mob thawj zaug, tus kws kho mob yuav tsum txiav txim siab nce qib ntawm cov piam thaj hauv cov ntshav, tom qab ntawd nws tau hais tawm txoj kev kho kom raug. Piv txwv li, kev kho mob nrog kev pab ntawm cov tshuaj tshwj xeeb, uas muaj kev cuam tshuam ncaj qha rau kev txo cov ntshav qab zib hauv cov ntshav, yog qhov txiav txim siab zoo heev. Yog tias lawv tsis pab, tom qab ntawd txhaj tshuaj ntawm tib neeg cov tshuaj insulin.

Nws yog ib qho tsim nyog yuav tsum tau tshem tawm tag nrho cov laj thawj uas tau coj mus rau kev txhim kho ntawm tus kab mob. Nws yog ib qho tsim nyog yuav tsum tau ua rau kev coj ua lub neej kom zoo, nco ntsoov tias tsis muaj kev coj ua tsis zoo, thiab thauj koj tus kheej nrog qhov kev tawm dag zog lub cev txaus. Muaj tseeb, nrog rau qhov no peb yuav tsum tsis txhob hnov qab tias kev qoj ib ce ntau dhau kuj tseem tuaj yeem ua rau kev loj hlob ntawm cov piam thaj.

Qhov tshwj xeeb yuav tsum tau ua tshwj xeeb hauv kev kho mob ntshav qab zib rau poj niam cev xeeb tub. Hauv kev sib txuas nrog qee yam kev hloov pauv hauv lawv lub cev, cov txheej txheem thim rov qab feem ntau pib tshwm sim.

Ib ntawm lawv tuaj yeem ua rau lub ntsej muag zoo nyob hauv ntshav qab zib. Tej zaum qhov kev loj hlob ntawm cov ntaub so ntswg mob tiv thaiv kab mob rau kev ua ntawm cov tshuaj insulin. Qhov no ua qhov ua rau muaj ntshav qab zib hauv cov poj niam cev xeeb tub.

Nws yuav tsum raug sau tseg tias qhov xwm txheej no tau faib ua ib daim foos sib txawv ntawm tus kabmob no, nws hu ua kev mob ntshav qab zib hauv nruab hnub. Feem ntau nws ua tau yam tsis muaj cov tsos mob qhia meej meej thiab kuaj tau los ntawm kev kuaj tshwj xeeb.

Hauv kev hais txog qhov no, nws yog ib qho tsim nyog yuav tsum tau ua ntu zus los kawm kev kawm txog cov piam thaj hauv cov poj niam cev xeeb tub. Tshwj xeeb tshaj yog nyob rau lub sijhawm txij li hnub plaub mus txog lub yim hli uas cev xeeb tub. Yog tias qhov ua tsis tiav, tom qab ntawd muaj kev pheej hmoo loj uas tus me nyuam hauv plab tuaj yeem ua lub siab tsis zoo, nrog rau lwm qhov chaw mob lub cev, mus txog rau lub cev puas hlwb.

Lub xeev ntawm hypo- thiab hyperglycemia tau piav qhia hauv video hauv kab lus no.

Kuv yuav tsum hu leej twg nyob hauv tsev kho mob txog cov teeb meem no?

Rau ib qho kev ua txhaum hauv lub cev, peb xub tig mus rau tus kws kho mob hauv zos. Nws yuav muab cov kev taw qhia rau kev ntsuam xyuas, ultrasound ntawm cov txiav thiab lub qog caj pas, thiab raws li cov txiaj ntsig tau, nws yuav ua kev kuaj mob. Coob leej tsis paub tus kws kho mob twg kho tus mob ntshav qab zib, thiab leej twg yuav tiv tauj ua ntej yog kev kuaj pom tseeb hais tias tus tsos mob ntawm tus mob.

Yog tias cov kev kuaj pom tseeb kev kuaj mob thawj zaug, tus kws kho mob yuav qhia koj kom sab laj nrog kws tshaj lij hu ua endocrinologist. Tus kws kho mob ntshav qab zib no yuav soj ntsuam ntxiv cov kab mob, sau ntawv kho mob. Nws tseem yuav qhia rau tus neeg mob txog hom kev noj haus dab tsi uas nws xav kom ua raws li, kev siv dag zog lub cev pub rau nws yog dab tsi. Nws yuav qhia koj yuav ua li cas thiaj ua haujlwm nrog hypoglycemia.

Yog tias tus menyuam yaus mob, cov niam txiv txhawj xeeb txog kws kho mob kho mob ntshav qab zib tshwj xeeb hauv cov menyuam. Hauv qhov xwm txheej no, cov niam txiv yuav tsum tau hu rau tus kws endocrinologist uas muaj qhov tshwj xeeb nqaim dua. Piv txwv li, tus kws tu menyuam yaus mob raum kho cov neeg mob me. Cia peb xav txog hauv kev qhia ntxiv yam twg hom tshwj xeeb endocrinologist muaj.

Kev tshwj xeeb los ntawm endocrinologist

Mob nqaijrog

Nws tshwj xeeb hauv kev mob qog.

Tus kws kho mob no xav tau yog tias tus menyuam muaj kab mob ntawm lub qog endocrine, nrog rau ntau yam kev sib txawv hauv kev loj hlob thiab kev loj hlob. Nws tseem cuam tshuam txog kev kho cov suab thaj hauv cov menyuam yaus. Yog tias koj pom cov tsos mob ntawm tus kab mob no hauv menyuam yaus, ces koj tuaj yeem hu ncaj qha rau tus kws saib xyuas menyuam yaus endocrinologist. Nws tus kheej yuav sau ntawv rau kev kuaj mob tsim nyog, ua qhov kev kuaj mob kom raug. Tsis txhob ncua kev kuaj ntawm tus menyuam, vim hais tias tus kab mob no hauv menyuam yaus loj hlob sai. Nws cov teeb meem tseem tshwm sim sai, yog li nws yog qhov zoo rau kev nyab xeeb nyob rau lub sijhawm dua li ntawm kev nkim sijhawm. Txoj kev kho kom raws sijhawm yuav pab tswj kev noj qab haus huv ntawm tus menyuam.

Geneticist endocrinologist

Nws tawm tswv yim rau cov neeg uas tau txais cov kabmob hauv tsev neeg, thiab tseem ua haujlwm los tsom kwm cov kabmob no. Yog tias pom cov tsos mob ntawm cov kab mob caj ces, nws tso tus neeg mob rau hauv cov ntaub ntawv thiab cuam tshuam nrog nws txoj kev kho. Piv txwv li, tus kws kho mob no kawm txog cov txuj ci tseem ceeb xws li gigantism, dwarfism. Kev mob nkeeg qab zib kuj tuaj yeem kho nrog tus kws kho mob no.

Tus kws tshaj lij no cuam tshuam txog kev kho tus poj niam thiab txiv neej ntxiv ntshav, nrog rau pathologies ntawm zes qe menyuam thiab noob qes.

Tus kws kho mob no cuam tshuam nrog qee kis uas yuav tsum muaj kev phais mob. Nws txiav txim siab qhov hnyav ntawm kev phais mob.

Qhov no yog tus kws endocrinologist tshwj xeeb hauv kev kho mob hom 1 thiab ntshav qab zib 2, nrog rau cov kab mob xws li ntshav qab zib insipidus. Nws paub txog txhua yam khoom noj tsis zoo hauv cov kab mob no, yuav pab koj xaiv tshuaj, ua zaub mov noj.

Tus endocrinologist yuav pab tau li cas

Yog tias ib tus neeg tau lees tias hom ntshav qab zib hom 1 lossis hom 2, kws kuaj cov kabmob endocrinologist tau sau cia. Txij lub sijhawm no nws dhau los ua tus cob qhia ntawm tus neeg mob. Tus kws kho mob uas koom nrog yuav xaiv cov kev kho mob, tshuaj noj, qhia kev yuav ua raws li kev noj haus zoo rau ntshav qab zib.

Cov neeg nyuam qhuav kawm tias lawv muaj tus kab mob no thaum xub thawj tsis nkag siab tias lawv yuav tsum hloov pauv lawv lub neej. Nws yog qhov nyuaj rau lawv tau txais los tswj hwm nruj thiab soj ntsuam tas li ntawm cov piam thaj. Lawv yuav tsum tau kawm kom nkag siab txog lawv lub siab thaum nce thiab txo cov ntshav qabzib.

Nyob rau thawj theem, txhawm rau tsim kom muaj kev noj zaub mov, khaws cov tshuaj yuav pab nyob rau hauv chav pw. Tus kws kuaj mob endocrinologist yuav qhia koj kom paub siv cov lej glycemic index ntawm cov khoom, nrog rau suav cov khoom noj ua kom zoo.

Kev sab laj ntawm endocrinologist yuav xav tau rau txhua qhov teeb meem kev noj qab haus huv hauv tus neeg muaj ntshav qab zib. Tsuas yog nrog kev tso cai ntawm tus kws tsim tshuaj endocrinologist yuav yog lwm tus kws kho mob tau sau ntawv noj tshuaj kom thiaj li ua rau cov piam thaj hauv ntshav qab zib tsis txaus siab rau tus neeg mob.