Waa maxay galactorrhea, sababaha ugu waaweyn iyo daaweynta

Qanacsan

• Sababaha ugu waaweyn
• Calaamadaha caanka ah
• Sida loo ogaado
• Sida daaweynta loo sameeyo

Galactorrhea waa dheecaan aan habbooneyn oo ah dareere ay ku jirto caano naaska ka soo baxa, oo ku soo baxa ragga ama dumarka aan uur lahayn ama naas nuujinayn. Badanaa waa astaamo ay keento kororka prolactin, hormoon maskaxda laga soo saaro oo shaqadeedu tahay inay soo saarto caano ay yeeshaan naasaha, xaalad la yiraahdo hyperprolactinemia.

Sababaha ugu muhiimsan ee kororka prolactin waa uur iyo naas nuujin, waxaana jira sababo dhowr ah oo ku saabsan kororkeeda aan habboonayn, oo ay ku jiraan burooyinka maskaxda ku dhaca ee maskaxda ku dhaca, isticmaalka daawooyinka, sida qaar ka mid ah neuroleptics iyo antidepressants, kicinta naasaha ama qaar ka mid ah cudurrada endocrine, sida hypothyroidism iyo cudurka 'polycystic ovary syndrome'.

Sidaa darteed, si loo daaweeyo hyperprolactinemia iyo galactorrhea, waxaa lagama maarmaan ah in la xalliyo sababihiisa, ama iyada oo laga saaro daawo ama la daaweeyo cudur ku kicinaya soo saarista caanaha naasaha.

Sababaha ugu waaweyn

Sababaha ugu muhiimsan ee soosaarida caanaha naasaha waa uur iyo naas nuujin, si kastaba ha noqotee, galactorrhea wuxuu dhacaa, badanaa sababo xaalado sida:

• Pituitary adenoma: waa buro aan fiicnayn oo qanjirka 'pituitary gland', oo mas'uul ka ah soo saarista dhowr hoormoon, oo ay ku jiraan prolactin. Nooca ugu weyn waa prolactinoma, oo badanaa sababa kororka heerarka prolactin ee dhiigga oo ka weyn 200mcg / L;
• Isbedelada kale ee qanjirka pituitary: kansarka, qolofta, caabuq, shucaaca ama istaroogga maskaxda, tusaale ahaan;
• Kicinta naasaha ama gidaarka laabta: tusaalaha ugu weyn ee kicinta waa nuugista naasaha ee cunuga, kaasoo dhaqaajiya qanjidhada naaska isla markaana xoojiya soo saarida maskaxda ee prolactin iyo, sidaas awgeed, soosaarka caanaha;
• Cudurada keena cilladaha hormoonka: qaar ka mid ah kuwa ugu waawayn waa hypothyroidism, cirrhosis of beerka, kelyaha oo joogto ah, cudurka Addison iyo polycystic ovary syndrome;
• Kansarka naasaha: wuxuu ku sababi karaa galactorrhea hal ibta ibta, badanaa dhiig;
• Isticmaalka daawooyinka: 
  • Daawooyinka maskaxda lagu daaweeyo, sida Risperidone, Chlorpromazine, Haloperidol ama Metoclopramide;
  • Opiates, sida Morphine, Tramadol ama Codeine;
  • Waxyaabaha yareeya caloosha, sida Ranitidine ama Cimetidine;
  • Dawooyinka lidka ku ah diiqadda, sida Amitriptyline, Amoxapine ama Fluoxetine;
  • Qaar ka mid ah daawooyinka dhiig karka, sida Verapamil, Reserpina iyo Metildopa;
  • Isticmaalka hormoonnada, sida estrogens, anti-androgens ama HRT.

Hurdada iyo walbahaarku waa xaalado kale oo sababa kororka wax soo saarka prolactin, si kastaba ha noqotee, marar dhif ah ayey u keenaan isbeddello ku filan oo sababa galactorrhea.

Calaamadaha caanka ah

Galactorrhea waa astaanta ugu weyn ee cudurka 'hyperprolactinemia', ama xad-dhaafka ah ee prolactin-ka jirka, waxayna noqon kartaa mid hufan, mid caano leh ama midab dhiig leh, waxayna ka muuqataa hal ama labada naas.

Si kastaba ha noqotee, calaamado iyo astaamo kale ayaa soo bixi kara, maaddaama kororka hormoonkan uu sababi karo isbeddello ku dhaca hormoonnada galmada, sida yareynta estrogen iyo testosterone, ama, sidoo kale, haddii ay jiraan burooyin ku yaal qanjirka 'pituitary gland'. Calaamadaha ugu waaweyn waa:

• Amenorrhea, oo ah joojinta ugxaanta iyo caadada haweenka;
• Caqli galmo la'aan iyo kacsi la'aanta ragga;
• Madhalaysnimo iyo rabitaan galmo oo yaraaday;
• Lafaha;
• Madax xanuun;
• Isbedelada muuqaalka, sida jahwareerka iyo aragtida dhibco dhalaalaya.

Isbedelada hormoonku sidoo kale waxay mas'uul ka noqon karaan dhalmo la'aanta ragga ama dumarka.

Sida loo ogaado

Galactorrhea waxaa lagu ogaadaa baaritaanka caafimaad ee caafimaadka, oo noqon kara mid iskaa-wax-u-qabso ah ama u muuqda ka dib muujinta ibta. Galactorrhea waxaa la xaqiijiyaa markasta oo dheecaanka caanuhu ku yimaado ragga, ama markuu ku soo baxo dumarka aan uur lahayn ama aan naas nuujin 6dii bilood ee la soo dhaafay.

Si loo aqoonsado sababta galactorrhea, dhakhtarku wuxuu qiimeyn doonaa taariikhda daawooyinka iyo astaamaha kale ee qofku la kulmi karo. Intaa waxaa dheer, baaritaannada qaarkood ayaa la samayn karaa si loo baaro sababaha galactorrhea, sida cabbirka prolactin ee dhiigga, cabbiraadda qiyamka TSH iyo T4, si loo baaro shaqada tayroodhka, iyo, haddii loo baahdo, maskaxda maskaxda si loo baaro jiritaanka burooyinka. ama isbeddelo kale oo ku dhaca qanjirka 'pituitary gland'.

Sida daaweynta loo sameeyo

Daaweynta loo yaqaan 'galactorrhea' waxaa haga cilmiga cilmu-nafsiga ee loo yaqaan 'endocrinologist', waana ku kala duwan yahay sababaha cudurka. Marka ay tahay saameyn dhinaca daawada ah, waa inaad la hadashaa dhakhtarka si loo qiimeeyo suurtagalnimada ka joojinta ama bedelida daawadan mid kale.

Markuu cudur keeno, waxaa muhiim ah in si sax ah loo daaweeyo, si loo xasiliyo carqaladeynta hoormoonka, sida, tusaale ahaan, beddelka hormoonnada tayroodhka ee hypothyroidism, ama isticmaalka corticosteroids ee pituitary granulomas. Ama, markii galactorrhea uu sababo buro, dhakhtarku wuxuu kugula talin karaa daaweyn qalliin ka saaris ama nidaamyo sida shucaac shucaac ah.

Intaa waxaa dheer, waxaa jira daawooyin yareyn kara wax soo saarka prolactin iyo xakameynta galactorrhea, halka daaweynta saxda ah la sameeyo, sida Cabergoline iyo Bromocriptine, oo ah daawooyin ku jira fasalka dopaminergic antagonists.