{"id":7691,"date":"2014-04-08T17:00:00","date_gmt":"2014-04-08T10:00:00","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/tuyen-yen-va-cac-loai-u-tuyen-yen\/"},"modified":"2024-04-29T18:27:58","modified_gmt":"2024-04-29T11:27:58","slug":"tuyen-yen-va-cac-loai-u-tuyen-yen","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/tuyen-yen-va-cac-loai-u-tuyen-yen\/","title":{"rendered":"Tuy\u1ebfn y\u00ean v\u00e0 c\u00e1c lo\u1ea1i u tuy\u1ebfn y\u00ean"},"content":{"rendered":"<p>Tuy\u1ebfn y\u00ean l\u00e0 m\u1ed9t tuy\u1ebfn nh\u1ecf \u0111\u00ednh v\u00e0o ph\u1ea7n n\u1ec1n n\u00e3o (ph\u00eda sao m\u0169i) \u1edf v\u00f9ng g\u1ecdi l\u00e0 h\u1ed1 tuy\u1ebfn y\u00ean hay h\u00f5m y\u00ean (sella turcica). Tuy\u1ebfn y\u00ean th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201ctuy\u1ebfn ch\u1ee7 \u0111\u1ea1o\u201d v\u00ec n\u00f3 ki\u1ec3m so\u00e1t vi\u1ec7c ti\u1ebft ra c\u00e1c n\u1ed9i ti\u1ebft t\u1ed1 (hormone) kh\u00e1c. Tuy\u1ebfn y\u00ean b\u00ecnh th\u01b0\u1eddng n\u1eb7ng d\u01b0\u1edbi m\u1ed9t gram, v\u00e0 c\u00f3 k\u00edch th\u01b0\u1edbc c\u1ee1 1 h\u1ea1t \u0111\u1eadu t\u00e2y.<\/p>\n<p><span style=\"line-height: 1.6em\"> Ch\u1ee9c n\u0103ng c\u1ee7a tuy\u1ebfn y\u00ean c\u00f3 th\u1ec3 v\u00ed nh\u01b0 b\u1ed9 ch\u1ec9nh nhi\u1ec7t trong nh\u00e0. B\u1ed9 ch\u1ec9nh nhi\u1ec7t li\u00ean t\u1ee5c \u0111o nhi\u1ec7t \u0111\u1ed9 trong nh\u00e0 v\u00e0 g\u1eedi t\u00edn hi\u1ec7u \u0111\u1ebfn m\u00e1y \u0111i\u1ec1u h\u00f2a \u0111\u1ec3 t\u1eaft hay m\u1edf n\u00f3 v\u00e0 duy tr\u00ec nhi\u1ec7t \u0111\u1ed9 d\u1ec5 ch\u1ecbu \u1ed5n \u0111\u1ecbnh trong c\u1ea3 c\u0103n nh\u00e0. Tuy\u1ebfn y\u00ean li\u00ean t\u1ee5c \u201ctheo d\u00f5i\u201d c\u00e1c ch\u1ee9c n\u0103ng c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 g\u1eedi t\u00edn hi\u1ec7u \u0111\u1ebfn c\u00e1c c\u01a1 quan v\u00e0 tuy\u1ebfn n\u1ed9i ti\u1ebft \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang v\u00e0 duy tr\u00ec m\u1ed9t m\u00f4i tr\u01b0\u1eddng \u1ed5n \u0111\u1ecbnh b\u00ean trong c\u01a1 th\u1ec3. C\u00e0i \u0111\u1eb7t t\u1ed1i \u01b0u cho \u201cb\u1ed9 ch\u1ec9nh nhi\u1ec7t\u201d ph\u1ee5 thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0 m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng, gi\u1edbi t\u00ednh, c\u1ea5u ph\u1ea7n c\u01a1 th\u1ec3,\u2026 <\/span><\/p>\n<h2 id=\"tuyen-yen-chiu-trach-nhiem-kiem-soat-va-dieu-hoa-cac-qua-trinh\"><span style=\"line-height: 1.6em\"> Tuy\u1ebfn y\u00ean ch\u1ecbu tr\u00e1ch nhi\u1ec7m ki\u1ec3m so\u00e1t v\u00e0 \u0111i\u1ec1u h\u00f2a c\u00e1c qu\u00e1 tr\u00ecnh: <\/span><\/h2>\n<ul>\n<li>T\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3;<\/li>\n<li>Ho\u1ea1t \u0111\u1ed9ng c\u1ee7a nhi\u1ec1u c\u01a1 quan kh\u00e1c nhau trong c\u01a1 th\u1ec3 (th\u1eadn, v\u00fa, t\u1eed cung,\u2026);<\/li>\n<li>Ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c tuy\u1ebfn kh\u00e1c (nh\u01b0 tuy\u1ebfn gi\u00e1p, sinh d\u1ee5c, tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn);<\/li>\n<\/ul>\n<h2 id=\"cau-truc-va-chuc-nang-tuyen-yen\"><span style=\"line-height: 1.6em\"> C\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng tuy\u1ebfn y\u00ean <\/span><\/h2>\n<p><span style=\"line-height: 1.6em\"> Tuy\u1ebfn y\u00ean g\u1ed3m hai ph\u1ea7n ri\u00eang bi\u1ec7t g\u1ecdi l\u00e0 y\u00ean tr\u01b0\u1edbc v\u00e0 y\u00ean sau. M\u1ed7i ph\u1ea7n c\u00f3 nh\u1eefng lo\u1ea1i t\u1ebf b\u00e0o chuy\u00ean bi\u1ec7t, ti\u1ebft ra nh\u1eefng hormone kh\u00e1c nhau, ph\u1ee5 tr\u00e1ch c\u00e2n b\u1eb1ng nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c nhau trong c\u01a1 th\u1ec3. Tuy\u1ebfn y\u00ean tr\u01b0\u1edbc c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb h\u1ea7u h\u1ecdng. Tuy\u1ebfn y\u00ean sau ph\u00e1t tri\u1ec3n t\u1eeb ph\u1ea7n \u0111\u00e1y n\u00e3o, ch\u00ednh x\u00e1c h\u01a1n l\u00e0 ph\u1ea7n k\u00e9o d\u00e0i ra c\u1ee7a v\u00f9ng h\u1ea1 \u0111\u1ed3i (hypothalamus). B\u1ea3n th\u00e2n tuy\u1ebfn y\u00ean c\u0169ng ch\u1ecbu s\u1ef1 chi ph\u1ed1i c\u1ee7a v\u00f9ng h\u1ea1 \u0111\u1ed3i, v\u00f9ng n\u00e3o ngay tr\u00ean tuy\u1ebfn y\u00ean. V\u00f9ng h\u1ea1 \u0111\u1ed3i v\u00e0 tuy\u1ebfn y\u00ean h\u1ee3p l\u1ea1i t\u1ea1o th\u00e0nh h\u1ec7 th\u1ea7n kinh n\u1ed9i ti\u1ebft. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> Tuy\u1ebfn y\u00ean tr\u01b0\u1edbc chi\u1ebfm kho\u1ea3ng 80% tuy\u1ebfn y\u00ean, bao g\u1ed3m th\u00f9y tr\u01b0\u1edbc v\u00e0 v\u00f9ng trung gian (intermediate zone). Tuy\u1ebfn y\u00ean tr\u01b0\u1edbc \u0111\u1ea3m tr\u00e1ch ph\u1ea7n l\u1edbn t\u00edn hi\u1ec7u n\u1ed9i ti\u1ebft g\u1eedi v\u00e0o m\u00e1u. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> Tuy\u1ebfn y\u00ean sau h\u00ecnh th\u00e0nh t\u1eeb r\u1ea5t s\u1edbm nh\u01b0ng th\u00fa v\u1ecb l\u00e0 n\u00f3 l\u1ea1i kh\u00f4ng t\u1ea1o hormone c\u1ee7a ri\u00eang n\u00f3 m\u00e0 ch\u1ec9 mang nh\u1eefng \u0111\u1ea7u t\u1eadn c\u00f9ng th\u1ea7n kinh c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o th\u1ea7n kinh (neuron) xu\u1ea5t ph\u00e1t t\u1eeb h\u1ea1 \u0111\u1ed3i. Nh\u1eefng neuron n\u00e0y s\u1ea3n xu\u1ea5t c\u00e1c hormone vasopressin v\u00e0 oxytocin r\u1ed3i v\u1eadn chuy\u1ec3n theo cu\u1ed1ng tuy\u1ebfn y\u00ean \u0111\u1ebfn tuy\u1ebfn y\u00ean sau. Ch\u00fang \u0111\u01b0\u1ee3c tr\u1eef \u1edf \u0111\u00e2y v\u00e0 ti\u1ebft v\u00e0o m\u00e1u khi c\u1ea7n. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> Tuy\u1ebfn y\u00ean v\u00e0 h\u1ea1 \u0111\u1ed3i c\u00f9ng l\u00e0m vi\u1ec7c \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh nh\u1eefng ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a c\u01a1 th\u1ec3, c\u0169ng nh\u01b0 gi\u1eef vai tr\u00f2 thi\u1ebft y\u1ebfu trong s\u1ef1 t\u0103ng tr\u01b0\u1edfng, ph\u00e1t tri\u1ec3n v\u00e0 sinh s\u1ea3n. H\u1ea1 \u0111\u1ed3i ti\u1ebft c\u00e1c hormone \u0111\u1ec3 \u0111i\u1ec1u h\u00f2a ti\u1ebft ra c\u00e1c hormone c\u1ee7a tuy\u1ebfn y\u00ean tr\u01b0\u1edbc. C\u00e1c hormone c\u1ee7a h\u1ea1 \u0111\u1ed3i c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u00e1c y\u1ebfu t\u1ed1 k\u00edch ti\u1ebft hay y\u1ebfu t\u1ed1 \u1ee9c ch\u1ebf, t\u00f9y v\u00e0o \u1ea3nh h\u01b0\u1edfng c\u1ee7a ch\u00fang l\u00ean tuy\u1ebfn y\u00ean tr\u01b0\u1edbc. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> Nhi\u1ec7m v\u1ee5 c\u1ee7a tuy\u1ebfn y\u00ean l\u00e0 ph\u00e1t c\u00e1c t\u00edn hi\u1ec7u b\u1eb1ng hormone \u0111\u1ec3 \u0111i\u1ec1u khi\u1ec3n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c c\u01a1 quan kh\u00e1c. Tuy\u1ebfn y\u00ean ti\u1ebft c\u00e1c hormone sau: <\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.6em\"> <span style=\"font-size: 18px\"> <strong> Hormone h\u01b0\u1edbng v\u1ecf th\u01b0\u1ee3ng th\u1eadn <\/strong> <\/span> <span style=\"font-size: 20px\"> <strong> <span style=\"font-size: 18px\"> (ACTH)\u00a0<\/span><\/strong><\/span>k\u00edch th\u00edch tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn ti\u1ebft c\u00e1c hormone nh\u01b0 cortisol hay aldosterone. C\u00e1c hormone n\u00e0y \u0111i\u1ec1u h\u00f2a chuy\u1ec3n h\u00f3a \u0111\u1ea1m (protein) v\u00e0 \u0111\u01b0\u1eddng, v\u00e0 c\u00e2n b\u1eb1ng mu\u1ed1i\/ n\u01b0\u1edbc. <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Hormone t\u0103ng tr\u01b0\u1edfng (GH) <\/span> <\/strong> \u2013 \u0110\u00e2y l\u00e0 hormone ch\u00ednh \u0111i\u1ec1u h\u00f2a qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a v\u00e0 t\u0103ng tr\u01b0\u1edfng. <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Hormone t\u1ea1o ho\u00e0ng th\u1ec3 (LH) and hormone k\u00edch th\u00edch nang no\u00e3n (FSH) <\/span> <\/strong> &#8211; Hai hormone n\u00e0y tham gia ki\u1ec3m so\u00e1t vi\u1ec7c ti\u1ebft ra c\u00e1c hormone sinh d\u1ee5c (estrogen v\u00e0 testosterone). <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Hormone k\u00edch h\u1eafc t\u1ed1 b\u00e0o (MSH) <\/span> <\/strong> \u2013 MSH \u0111i\u1ec1u khi\u1ec3n qu\u00e1 tr\u00ecnh t\u1ea1o melanin, ch\u1ea5t s\u1eafc t\u1ed1 da, th\u00f4ng qua c\u00e1c t\u1ebf b\u00e0o h\u1eafc t\u1ed1 \u1edf da. S\u1ef1 t\u0103ng s\u1ea3n xu\u1ea5t melanin s\u1ebd l\u00e0m s\u1eadm m\u00e0u da. M\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd g\u00e2y t\u0103ng s\u1ea3n xu\u1ea5t MSH s\u1ebd g\u00e2y \u0111en da. <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Prolactin (PRL) <\/span> <\/strong> \u2013 Hormone n\u00e0y k\u00edch th\u00edch tuy\u1ebfn v\u00fa ti\u1ebft ra s\u1eefa. <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Hormone k\u00edch gi\u00e1p (TSH) <\/span> <\/strong> \u2013 TSH k\u00edch th\u00edch tuy\u1ebfn gi\u00e1p ti\u1ebft c\u00e1c hormone c\u1ee7a tuy\u1ebfn gi\u00e1p. Hormone tuy\u1ebfn gi\u00e1p ki\u1ec3m so\u00e1t chuy\u1ec3n h\u00f3a c\u01a1 b\u1ea3n v\u00e0 gi\u1eef vai tr\u00f2 quan tr\u1ecdng trong s\u1ef1 t\u0103ng tr\u01b0\u1edfng v\u00e0 tr\u01b0\u1edfng th\u00e0nh. Hormone tuy\u1ebfn gi\u00e1p \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ea7u h\u1ebft c\u01a1 quan trong c\u01a1 th\u1ec3. <\/span><\/li>\n<li><span style=\"line-height: 1.6em\"> <strong> <span style=\"font-size: 18px\"> Vasopressin, hay hormone kh\u00e1ng l\u1ee3i ni\u1ec7u (ADH) <\/span> <\/strong> \u2013 Hormone n\u00e0y t\u0103ng s\u1ef1 gi\u1eef n\u01b0\u1edbc \u1edf th\u1eadn. <\/span><\/li>\n<\/ul>\n<h2 id=\"u-tuyen-o-tuyen-yen-adenoma\"><span style=\"line-height: 1.6em\"> U tuy\u1ebfn \u1edf tuy\u1ebfn y\u00ean (Adenoma) <\/span><\/h2>\n<p>U tuy\u1ebfn \u1edf tuy\u1ebfn y\u00ean \u0111\u1ee9ng h\u1ea1ng th\u1ee9 4 trong c\u00e1c u th\u01b0\u1eddng g\u1eb7p trong n\u00e3o (u n\u1ed9i s\u1ecd), sau u sao b\u00e0o, u m\u00e0ng n\u00e3o v\u00e0 u t\u1ebf b\u00e0o bao s\u1ee3i th\u1ea7n kinh (schwannoma). Ph\u1ea7n l\u1edbn u l\u00e0 <strong>l\u00e0nh t\u00ednh<\/strong> v\u00e0 <strong>l\u1edbn kh\u00e1 ch\u1eadm<\/strong>. Ngay c\u1ea3 u tuy\u1ebfn y\u00ean \u00e1c t\u00ednh c\u0169ng hi\u1ebfm khi lan \u0111\u1ebfn c\u00e1c n\u01a1i kh\u00e1c trong c\u01a1 th\u1ec3. U tuy\u1ebfn (adenomas) l\u00e0 lo\u1ea1i u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf tuy\u1ebfn y\u00ean. \u0110\u1ed9 tu\u1ed5i 30-40 l\u00e0 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, d\u00f9 u c\u0169ng c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf tr\u1ebb em. H\u1ea7u h\u1ebft nh\u1eefng u n\u00e0y c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c t\u1ed1t. U tuy\u1ebfn y\u00ean r\u1ea5t \u0111a d\u1ea1ng v\u1ec1 k\u00edch th\u01b0\u1edbc v\u00e0 bi\u1ec3u hi\u1ec7n. Nh\u1eefng u ti\u1ebft ra hormone \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 u ch\u1ebf ti\u1ebft, trong khi u kh\u00f4ng ti\u1ebft ra hormone g\u1ecdi l\u00e0 u kh\u00f4ng ch\u1ebf ti\u1ebft.<\/p>\n<h2 id=\"trieu-chung\"><span style=\"line-height: 1.6em\"> Tri\u1ec7u ch\u1ee9ng <\/span><\/h2>\n<p><span style=\"line-height: 1.6em\"> Nh\u1eefng u nh\u1ecf h\u01a1n 10 mm \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 &#8220;microadenomas&#8221; v\u00e0 th\u01b0\u1eddng ti\u1ebft ra hormone. Nh\u1eefng u tuy\u1ebfn nh\u1ecf c\u00f3 ch\u1ee9c n\u0103ng n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm h\u01a1n v\u00ec s\u1ef1 t\u0103ng ti\u1ebft hormone g\u00e2y nh\u1eefng bi\u1ebfn \u0111\u1ed5i b\u1ea5t th\u01b0\u1eddng tr\u00ean c\u01a1 th\u1ec3. Kho\u1ea3ng 50% u tuy\u1ebfn y\u00ean \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n khi ch\u00fang nh\u1ecf h\u01a1n 5 mm. Nh\u1eefng u l\u1edbn h\u01a1n 10mm \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 &#8220;macroadenomas&#8221; v\u00e0 th\u01b0\u1eddng l\u00e0 u kh\u00f4ng ch\u1ebf ti\u1ebft. Nh\u1eefng u n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n khi ch\u00fang ch\u00e8n \u00e9p n\u00e3o v\u00e0 c\u00e1c c\u1ea5u tr\u00fac th\u1ea7n kinh xung quanh v\u00e0 g\u00e2y ra tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng \u1ee9ng. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> Ph\u1ea7n l\u1edbn tri\u1ec7u ch\u1ee9ng c\u1ee7a u tuy\u1ebfn y\u00ean b\u1eaft ngu\u1ed3n t\u1eeb c\u00e1c r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft. R\u1ed1i lo\u1ea1n c\u00f3 th\u1ec3 l\u00e0 t\u0103ng ti\u1ebft hormone t\u0103ng tr\u01b0\u1edfng (GH), g\u00e2y ch\u1ee9ng to \u0111\u1ea7u m\u00fat tay ch\u00e2n (to \u0111\u1ea7u chi) ho\u1eb7c ch\u1ee9ng ng\u01b0\u1eddi kh\u1ed5ng l\u1ed3 (giantism). R\u1ed1i lo\u1ea1n c\u0169ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ea3n xu\u1ea5t hormone nh\u01b0 trong b\u1ec7nh <a href=\"https:\/\/yhoccongdong.com\/thongtin\/suy-giap\/\" target=\"_blank\" rel=\"noopener\">suy gi\u00e1p<\/a>. S\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng n\u1ed9i ti\u1ebft c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng kh\u1ea3 n\u0103ng sinh con, kinh nguy\u1ec7t, kh\u1ea3 n\u0103ng ch\u1ecbu n\u00f3ng hay l\u1ea1nh, c\u0169ng nh\u01b0 nhi\u1ec1u ph\u01b0\u01a1ng di\u1ec7n kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> V\u00ec tuy\u1ebfn y\u00ean n\u1eb1m \u1edf m\u1ed9t v\u1ecb tr\u00ed r\u1ea5t \u0111\u1ed9c \u0111\u00e1o trong s\u1ecd, khi u tuy\u1ebfn y\u00ean to l\u00ean c\u00f3 th\u1ec3 ch\u00e8n \u00e9p c\u00e1c c\u1ea5u tr\u00fac n\u00e3o quan tr\u1ecdng. T\u00ecnh hu\u1ed1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 ch\u00e8n \u00e9p th\u1ea7n kinh th\u1ecb gi\u00e1c (th\u1ea7n kinh s\u1ed1 2), d\u1ea7n d\u1ea7n l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng nh\u00ecn. \u0110\u01b0\u1ee3c g\u1ecdi l\u00e0 m\u1ea5t th\u1ecb tr\u01b0\u1eddng ngo\u1ea1i bi\u00ean, hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng kho\u1ea3ng nh\u00ecn b\u00ean ngo\u00e0i (ph\u00eda th\u00e1i d\u01b0\u01a1ng) \u1edf c\u1ea3 hai b\u00ean. <\/span><\/p>\n<p style=\"text-align: center\"><img decoding=\"async\" src=\"\/\/yhoccongdong.org\/Documents\/1680_tuyen-yen.jpg\" alt=\"tuy\u1ebfn y\u00ean\" \/><\/p>\n<p style=\"text-align: center\"><span style=\"font-size: 14px\"> U tuy\u1ebfn y\u00ean ch\u00e8n \u00e9p th\u1ea7n kinh th\u1ecb l\u00e0m b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ea5y ph\u1ea7n b\u00ean ngo\u00e0i c\u1ee7a quang c\u1ea3nh. <\/span><\/p>\n<p style=\"text-align: center\"><span style=\"font-size: 14px\">H\u00ecnh tr\u00ean: \u1edf ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. H\u00ecnh d\u01b0\u1edbi: \u1edf b\u1ec7nh nh\u00e2n <\/span><\/p>\n<p style=\"text-align: center\"><img decoding=\"async\" src=\"\/\/yhoccongdong.org\/Documents\/1681_tuyen-yen.png\" alt=\"Tuy\u1ebfn y\u00ean c\u00e1c u tuy\u1ebfn y\u00ean\" \/><\/p>\n<p style=\"text-align: center\"><span style=\"font-size: 16px\"> N\u1ebfu che 1 m\u1eaft l\u1ea1i, hi\u1ec7n t\u01b0\u1ee3ng kh\u00f4ng th\u1ea5y ph\u1ea7n b\u00ean ngo\u00e0i khung c\u1ea3nh s\u1ebd r\u00f5 h\u01a1n. <\/span><\/p>\n<p><span style=\"font-size: 16px\"> N\u1ebfu b\u1ea1n c\u00f3 nhi\u1ec1u h\u01a1n 3 tri\u1ec7u ch\u1ee9ng trong c\u00e1c tri\u1ec7u ch\u1ee9ng d\u01b0\u1edbi \u0111\u00e2y, b\u1ea1n c\u00f3 th\u1ec3 b\u1ecb u tuy\u1ebfn y\u00ean: <\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.6em\"> B\u1ea5t th\u01b0\u1eddng th\u1ecb gi\u00e1c (nh\u00ecn m\u1edd, nh\u00ecn \u0111\u00f4i hay s\u1ee5p mi);<\/span><\/li>\n<li>\u0110au \u0111\u1ea7u v\u00f9ng tr\u00e1n;<\/li>\n<li>Bu\u1ed3n n\u00f4n v\u00e0 \u00f3i;<\/li>\n<li>M\u1ea5t kh\u1ea3 n\u0103ng ng\u1eedi m\u00f9i;<\/li>\n<li>R\u1ed1i lo\u1ea1n t\u00ecnh d\u1ee5c;<\/li>\n<li><a href=\"https:\/\/yhoccongdong.com\/thongtin\/tram-cam\/\" target=\"_blank\" rel=\"noopener\">Tr\u1ea7m c\u1ea3m<\/a>;<\/li>\n<li>M\u1ec7t m\u1ecfi;<\/li>\n<li>V\u00f4 sinh;<\/li>\n<li>R\u1ed1i lo\u1ea1n t\u0103ng tr\u01b0\u1edfng;<\/li>\n<li>Lo\u00e3ng x\u01b0\u01a1ng;<\/li>\n<li>T\u0103ng c\u00e2n kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c;<\/li>\n<li>S\u1ee5t c\u00e2n kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c;<\/li>\n<li>D\u1ec5 b\u1ea7m da;<\/li>\n<li>\u0110au kh\u1edbp;<\/li>\n<li><a href=\"https:\/\/yhoccongdong.com\/thongtin\/hoi-chung-ong-co-tay\/\" target=\"_blank\" rel=\"noopener\">H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay<\/a>;<\/li>\n<li>Gi\u00e1n \u0111o\u1ea1n kinh nguy\u1ec7t;<\/li>\n<li>M\u00e3n kinh s\u1edbm;<\/li>\n<li>Y\u1ebfu c\u01a1;<\/li>\n<li>Ch\u1ea3y s\u1eefa (v\u00fa ti\u1ebft s\u1eefa t\u1ef1 ph\u00e1t m\u00e0 kh\u00f4ng c\u00f3 mang thai hay cho con b\u00fa).<\/li>\n<\/ul>\n<h2 id=\"chan-doan\"><span style=\"line-height: 1.6em\"> Ch\u1ea9n \u0111o\u00e1n <\/span><\/h2>\n<p>Khi nghi ng\u1edd u tuy\u1ebfn y\u00ean, b\u00e1c s\u0129 s\u1ebd ph\u1ea3i kh\u00e1m to\u00e0n di\u1ec7n, bao g\u1ed3m c\u1ea3 kh\u00e1m m\u1eaft \u0111\u1ec3 ph\u00e1t hi\u1ec7n m\u1ea5t th\u1ecb tr\u01b0\u1eddng ngo\u1ea1i bi\u00ean n\u1ebfu c\u00f3. C\u00e1c x\u00e9t nghi\u1ec7m \u0111o \u0111\u1ea1c n\u1ed3ng \u0111\u1ed9 c\u00e1c hormone trong m\u00e1u v\u00e0 n\u01b0\u1edbc ti\u1ec3u c\u00f9ng v\u1edbi ch\u1ee5p h\u00ecnh s\u1ecd n\u00e3o s\u1ebd gi\u00fap x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n. Ph\u01b0\u01a1ng ti\u1ec7n h\u00ecnh \u1ea3nh ch\u00ednh x\u00e1c nh\u1ea5t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n l\u00e0 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) n\u00e3o, k\u00e8m v\u00e0 kh\u00f4ng k\u00e8m ch\u1ea5t t\u01b0\u01a1ng ph\u1ea3n.<\/p>\n<h2 id=\"dieu-tri\"><span style=\"line-height: 1.6em\"> \u0110i\u1ec1u tr\u1ecb <\/span><\/h2>\n<p>Can thi\u1ec7p s\u1edbm gi\u00fap tr\u1ecb kh\u1ecfi hay ki\u1ec3m so\u00e1t u v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a u t\u1ed1t nh\u1ea5t. C\u00f3 3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb u tuy\u1ebfn y\u00ean l\u00e0 ph\u1eabu thu\u1eadt l\u1ea5y u, x\u1ea1 tr\u1ecb tia X li\u1ec1u cao hay b\u1ee9c x\u1ea1 proton \u0111\u1ec3 di\u1ec7t t\u1ebf b\u00e0o u, v\u00e0 thu\u1ed1c \u0111\u1ec3 l\u00e0m nh\u1ecf ho\u1eb7c lo\u1ea1i tr\u1eeb u.<\/p>\n<h3 id=\"phau-thuat\"><span style=\"line-height: 1.6em\"> Ph\u1eabu thu\u1eadt <\/span><\/h3>\n<ul>\n<li>\u0110\u01b0\u1eddng m\u1ed5 qua xoang b\u01b0\u1edbm ti\u1ebfp c\u1eadn kh\u1ed1i u t\u1eeb ph\u00eda s\u00e0n s\u1ecd, th\u00f4ng qua m\u0169i v\u00e0 hai qua \u0111\u01b0\u1eddng r\u1ea1ch tr\u00ean n\u01b0\u1edbu r\u0103ng h\u00e0m tr\u00ean. \u0110\u01b0\u1eddng m\u1ed5 n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ecdn v\u00ec n\u00f3 \u00edt x\u00e2m h\u1ea1i c\u01a1 th\u1ec3 nh\u1ea5t, mang \u00edt bi\u1ebfn ch\u1ee9ng, v\u00e0 b\u1ec7nh nh\u00e2n h\u1ed3i ph\u1ee5c nhanh h\u01a1n. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 xu\u1ea5t vi\u1ec7n kho\u1ea3ng 2-4 ng\u00e0y sau khi m\u1ed5.<\/li>\n<li>\u0110\u01b0\u1eddng m\u1ed5 qua s\u1ecd th\u01b0\u1eddng \u00e1p d\u1ee5ng cho nh\u1eefng u l\u1edbn \u1edf m\u1ee9c kh\u00f4ng an to\u00e0n n\u1ebfu m\u1ed5 qua xoang b\u01b0\u1edbm.<\/li>\n<\/ul>\n<p><span style=\"line-height: 1.6em\"> Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt m\u1edbi, v\u1edbi kh\u1ea3 n\u0103ng x\u00e2m h\u1ea1i t\u1ed1i thi\u1ec3u l\u00ean c\u01a1 th\u1ec3. Ph\u1eabu thu\u1eadt vi\u00ean s\u1ebd d\u00f9ng \u1ed1ng n\u1ed9i soi nh\u1ecf \u0111i qua cu\u1ed1ng m\u0169i \u0111\u1ebfn tr\u01b0\u1edbc kh\u1ed1i u \u1edf xoang b\u01b0\u1edbm v\u00e0 c\u1eaft b\u1ecf kh\u1ed1i u b\u1eb1ng nh\u1eefng d\u1ee5ng c\u1ee5 \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf chuy\u00ean bi\u1ec7t. Nh\u1eefng kh\u00f3 ch\u1ecbu sau m\u1ed5 th\u01b0\u1eddng r\u1ea5t \u00edt v\u00e0 nh\u1eb9. Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn cho m\u1ed5 u tuy\u1ebfn y\u00ean, tuy nhi\u00ean ph\u01b0\u01a1ng ph\u00e1p n\u00e0y ch\u1ec9 \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c cho nh\u1eefng ca ph\u00f9 h\u1ee3p. <\/span><\/p>\n<p style=\"text-align: center\"><img decoding=\"async\" src=\"\/\/yhoccongdong.org\/Documents\/1682_tuyen-yen-2.jpg\" alt=\"Tuy\u1ebfn y\u00ean\" \/><\/p>\n<h3 id=\"xa-tri\">X\u1ea1 tr\u1ecb<\/h3>\n<p>X\u1ea1 tr\u1ecb d\u00f9ng b\u1ee9c x\u1ea1 gi\u00e0u n\u0103ng l\u01b0\u1ee3ng \u0111\u1ec3 di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0, t\u1ebf b\u00e0o tuy\u1ebfn y\u00ean b\u1ea5t th\u01b0\u1eddng v\u00e0 l\u00e0m nh\u1ecf kh\u1ed1i u. X\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi kh\u1ed1i u kh\u00f4ng th\u1ec3 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 b\u1eb1ng ph\u1eabu thu\u1eadt hay n\u1ed9i khoa.<\/p>\n<ul>\n<li>X\u1ea1 tr\u1ecb ngo\u00e0i th\u00f4ng th\u01b0\u1eddng\u00a0(Standard External Beam Radiotherapy) d\u00f9ng ngu\u1ed3n tia X kh\u00f4ng ch\u1ecdn l\u1ecdc v\u00e0 chi\u1ebfu t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o tr\u00ean \u0111\u01b0\u1eddng \u0111i c\u1ee7a ch\u00f9m tia. C\u00e1c ph\u1ea7n kh\u00e1c c\u1ee7a n\u00e3o quanh tuy\u1ebfn y\u00ean c\u00f3 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng do \u0111\u01b0\u1eddng \u0111i c\u1ee7a tia x\u1ea1.<\/li>\n<li>B\u1ee9c x\u1ea1 Proton\u00a0d\u00f9ng lo\u1ea1i b\u1ee9c x\u1ea1 l\u00e0 h\u1ea1t proton chuy\u00ean bi\u1ec7t chi\u1ebfu t\u1eadp trung v\u00e0o tuy\u1ebfn y\u00ean. \u01afu \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 \u00edt t\u1ed5n th\u01b0\u01a1ng c\u00e1c m\u00f4 l\u00e2n c\u1eadn.<\/li>\n<li>X\u1ea1 ph\u1eabu l\u1eadp th\u1ec3 (nh\u01b0 Gamma Knife, hay Cyberknife)\u00a0k\u1ebft h\u1ee3p k\u1ef9 thu\u1eadt x\u1ea1 tr\u1ecb ngo\u00e0i th\u00f4ng th\u01b0\u1eddng v\u1edbi k\u1ef9 thu\u1eadt \u0111\u1ecbnh v\u1ecb 3 chi\u1ec1u gi\u00fap t\u1eadp trung tia x\u1ea1 v\u00e0o kh\u1ed1i u t\u1eeb r\u1ea5t nhi\u1ec1u h\u01b0\u1edbng chi\u1ebfu kh\u00e1c nhau, gi\u00fap gi\u1ea3m l\u01b0\u1ee3ng tia \u1ea3nh h\u01b0\u1edfng l\u00ean c\u00e1c m\u00f4 n\u00e3o xung quanh.<\/li>\n<\/ul>\n<h3 id=\"dieu-tri-noi-khoa\"><span style=\"line-height: 1.6em\"> \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa <\/span><\/h3>\n<p>Prolactinoma (hay u ti\u1ebft prolactin) l\u00e0 th\u1ec3 u tuy\u1ebfn y\u00ean th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong th\u1ef1c t\u1ebf. N\u00f3i chung, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean trong \u0111i\u1ec1u tr\u1ecb prolactinoma. Kho\u1ea3ng 80% b\u1ec7nh nh\u00e2n s\u1ebd \u0111\u01b0a \u0111\u01b0\u1ee3c prolactin v\u1ec1 m\u1ee9c b\u00ecnh th\u01b0\u1eddng sau khi u\u1ed1ng thu\u1ed1c \u0111\u1ed3ng v\u1eadn dopamine (dopamine agonist therapy). Thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng nh\u1ea5t l\u00e0 bromocriptine (Parlodel) hay cabergoline. U s\u1ebd nh\u1ecf d\u1ea7n \u1edf h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n tuy m\u1ee9c \u0111\u1ed9 s\u1ebd kh\u00e1c nhau t\u00f9y tr\u01b0\u1eddng h\u1ee3p. B\u1ec7nh nh\u00e2n n\u1eef s\u1ebd c\u00f3 kinh l\u1ea1i v\u00e0 c\u00f3 th\u1ec3 c\u00f3 thai. Bromocriptine c\u00f3 m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 n\u00ean th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u00ea toa t\u0103ng li\u1ec1u d\u1ea7n d\u1ea7n.<\/p>\n<p><span style=\"line-height: 1.6em\"> Cabergoline l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c m\u1edbi c\u00f3 t\u00e1c d\u1ee5ng d\u00e0i n\u00ean c\u00f3 \u01b0u \u0111i\u1ec3m l\u00e0 ch\u1ec9 u\u1ed1ng hai l\u1ea7n m\u1ed9t tu\u1ea7n v\u00e0 nh\u00ecn chung l\u00e0 c\u00f3 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n so v\u1edbi bromocriptine. Cabergoline c\u0169ng cho th\u1ea5y c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi bromocriptine. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb microadenoma, thu\u1ed1c \u0111\u1ed3ng v\u1eadn dopamine th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1eed tr\u01b0\u1edbc trong v\u00e0i th\u00e1ng, khuy\u1ebfn c\u00e1o chung l\u00e0 6 th\u00e1ng. N\u1ebfu u kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c, khi \u0111\u00f3 ph\u1eabu thu\u1eadt s\u1ebd \u0111\u01b0\u1ee3c xem x\u00e9t. <\/span><\/p>\n<p><span style=\"line-height: 1.6em\"> U ti\u1ebft GH c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u1edbi thu\u1ed1c t\u01b0\u01a1ng t\u1ef1 somatostatin, l\u00e0 m\u1ed9t hormone \u1ee9c ti\u1ebft ra GH. <\/span><\/p>\n<h2><strong> <span style=\"font-size: 20px\"> <span style=\"line-height: 1.6em\"> T\u00e0i li\u1ec7u tham kh\u1ea3o <\/span> <\/span> <\/strong><\/h2>\n<p><a href=\"http:\/\/www.aans.org\/en\/Patient%20Information\/Conditions%20and%20Treatments\/The%20Pituitary%20Gland%20and%20Pituitary%20Tumors.aspx\" target=\"_blank\" rel=\"noopener\"> <span style=\"line-height: 1.6em\"> http:\/\/www.aans.org\/en\/Patient%20Information\/Conditions%20and%20Treatments\/The%20Pituitary%20Gland%20and%20Pituitary%20Tumors.aspx <\/span> <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>U tuy\u1ebfn \u1edf tuy\u1ebfn y\u00ean \u0111\u1ee9ng h\u1ea1ng th\u1ee9 4 trong c\u00e1c u th\u01b0\u1eddng g\u1eb7p trong n\u00e3o (u n\u1ed9i s\u1ecd), sau u sao b\u00e0o, u m\u00e0ng n\u00e3o v\u00e0 u t\u1ebf b\u00e0o bao s\u1ee3i th\u1ea7n kinh (schwannoma). <\/p>\n","protected":false},"author":135,"featured_media":4275,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2461,2460,2506],"tags":[2530],"series":[1296],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Tuy\u1ebfn y\u00ean v\u00e0 c\u00e1c lo\u1ea1i u tuy\u1ebfn y\u00ean - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"U tuy\u1ebfn \u1edf tuy\u1ebfn y\u00ean \u0111\u1ee9ng th\u1ee9 4 trong c\u00e1c u th\u01b0\u1eddng g\u1eb7p trong n\u00e3o, sau u sao b\u00e0o, u m\u00e0ng n\u00e3o v\u00e0 u t\u1ebf b\u00e0o bao s\u1ee3i th\u1ea7n kinh. 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