Treatment of surgical, medical mentoznoe, radiotherapeutic.
- SUMMARY Surgical treatment of diseases Itsenko- Cushing is to remove about them, at least one of the adrenal gland and the syndrome Itsenko- Cushing removal GTC holy corresponding adrenal or other localization. Produ ditsya and subtotal adrenektomiya , but the further mo gut relapses occur. After adrenektomii appointed Deputy naya therapy. After the suppression of the function about their adrenal glands, if the Vice naya therapy is not Dolj prefecture level, enhances the secretion of ACTH-RF and the likelihood of developing or pituitary adenoma formation increases. Subjecting the surgical treatment are patients who medikamentoz Noe treatment and radiotherapy diencephalic-pituitary region does not lead to stable remission, and rapidly progressive forms of the disease.
- Radiotherapy is effective in the early stage of the disease, CCA cially young at the age of 16- 30 years. Radiation therapy is not recommended for children. Radiotherapy pro is found in the pituitary different methods: accruing decreases conductive doses, etc. A number Meto. Poisons fields and dose (from 1500 to 15000; roentgen per course).
- In recent years there has been le chenie Gamma Irradiation pituitary 4-6 fields. Gamma therapy was more effective than x-ray therapy . The improvement occurs at approximately 60% of cases, get well of-33.3%. Relatively better results were obtained with the use of hens from 1500 to 2000 rad. In the treatment of diseases Itsenko- Cushing more zffektivnym turned distance of luchenie pituitary by heavy, high energy charged particles ogy, in particular protons. Thus pituitary healthy cells are not damaged, therefore, hormonal disorders not crust paet.
- Pharmacotherapy conclude chaetsya in applying inhibitors.
- The proposed drugs: aminoglutetamide , amphenone , metopyron , elipten , parlodel .
- Reserpine in pain Shih doses inhibits the secretion of ACTH, but the jet lag does not regulate.
- Derivatives of dichloroethane – DDD , etc. Among them, DDD turned out to be more or less active . However, the latter has a number of toxic properties. At the Institute of Endocrinology for Metabolism of the Ukrainian SSR, a new drug was synthesized, which is a derivative of DDD – chloditan . Toxic governing this drug is much lower, and the selective effect on the adrenal cortex is much higher than the DDD. Hloditan selectively at leads to atrophy of the adrenal cortex Cove, without damaging the brain howling layer and other organs. Chloditan is prescribed orally, starting with 2-3 g per day for the first 2-3 days, then at the rate of 0.1 g / 1 kg per day. The daily dose is given in 3 divided doses after 15-20 minutes. after meal. In the future, the dose is adjusted taking into account clinical symptoms and the level of 17-ACS and 17-CS in the urine. Per course of treatment desig chaetsya about 200-300 grams of the drug. Clinical signs of improvement in the tread on the 18-20 day and gradually increase. When relapse rate le cheniya repeated. Treatment hloditanom recommended combi nirovanno with surgical treatment: is made less burdensome for the patient sided adrenektomiya and appointed course hloditana . As with other methods of treatment, hloditan more effective when the wounds are stages of disease. Hloditan at Itsenko- Syndrome Cushing about presents cytostatic effect with respect to corticosteroma .
- Desig chaetsya also parlodel for suppressing Nia ACTH production.
- Treatment of Diseases Itsenko- Cushing held com bine. First at light formah- parlodel with hloditanom , radiotherapy combined with hlodi Thane . Surgical treatment combined with hloditanom – after delete Niya one adrenal gland. When optionally go function Another inscription chechnika suppressed hloditanom , aminoglutethimide , etc