Cachexia - yog dab tsi? Cachexia nyob rau hauv cancer

Cachexia - yog dab tsi? Cachexia, nyob rau hauv lwm yam lus, cov havzoov ntawm lub cev - ib tug complex txheej txheem yus muaj los ntawm ib tug tseem ceeb rau lub cev qhov nyhav thiab kev tsis muaj zog raws li kev hloov nyob rau hauv lub siab. Qhov no dramatically depleted roj thiab carbohydrate reserves, txo cov protein ntau synthesis, thaum nce nws catabolism (neej puas). Cachexia kuj tshwm sim nyob rau hauv oncological kab mob.

Thawj thiab theem nrab qaug

Ob yam ntaub ntawv ntawm cachexia kab mob - thawj thiab. Primary havzoov tseem hu ua lub pituitary, thiab cov theem nrab - symptomatic.

● Primary los yog exogenous cachexia tshwm sim vim tsis txaus kom tsawg ntawm cov as-ham, raws li zoo raws li ib tug rau txim ntawm lub nram qab no mob: cerebral poob plig, mob los yog mauj lesion pituitary, autoimmune hypophysitis, heev nyuaj siab, hemorrhage (los ntshav thaum lub sij hawm thinning cov hlab ntsha), anorexia, embolism ( ingress ntawm txawv teb chaws hais nyob rau hauv cov ntshav tam sim no, yuav ua tau rau vascular occlusion), kev mob kab mob.

● Secondary los yog endogenous cachexia yog ib tug tshwm sim ntawm cov kab mob thiab yog tshwm sim los ntawm yam tseem ceeb xws li gipoinsulinizm (insulin tsis muaj peev xwm), nce synthesis ntawm glucagon, malabsorption (malabsorption cov as-ham), glucocorticoid tsis muaj peev xwm, neoplastic txoj kev loj hlob, ntau heev somatostatin.

ua rau

Cachexia kab mob tshwm sim raws li ib tug tshwm sim ntawm ib tug xov tooj ntawm yog vim li cas thiab yam:
1. ntev malnutrition thiab starvation.
2. Cov kab mob ntawm tus mob huam, tshwj xeeb yog cov hlab pas, raws li zoo li celiac kab mob, enterocolitis.
3. heev intoxication nrog brucellosis, tuberculosis thiab lwm yam kab mob thiab mob mus ntev suppuration dab.
4. Psychogenic anorexia.
5. Mob ntawm lub qog caj pas, adrenal insufficiency.
6. endocrine kab mob txuam nrog metabolic mob.
7. Lub plawv tsis ua hauj lwm.
8. kab mob qog hlav.
9. nkim nyob rau hauv cov me nyuam.

Yuav ua li cas yog cov tsos mob ntawm cachexia yog yus muaj los ntawm? Yuav ua li cas yog cov tsos mob no?

symptomatology

Muaj ib tug xov tooj ntawm cov tsos mob, uas yog yus muaj los ntawm cachexia. Hais tias tus kab mob no li cas rau peb lub cev:
1. Sudden poob txog li 50% ntawm lub cev hnyav, thiab nyob rau hauv loj heev zaum ntau tshaj 50%.
2. cev qhuav dej.
3. Leeg tsis muaj zog.
4. Disability.
5. Pw tsaug zog ntshawv siab.
6. kom swb kab mob.
7. Noj nyob rau hauv cov ntshav siab (arterial siab).
8. daj thiab flabby daim tawv nqaij.
9. tau vitamin tsis muaj peev xwm, thiab hniav poob.
10. Trophic hloov nyob rau hauv cov plaub hau thiab rau tes.
11. Txoj kev loj hlob ntawm stomatitis.
12. Lub tshwm sim ntawm cem quav vim plab hnyuv kom mob.
13. Qhov tsawg protein cov ntsiab lus ntawm cov ntshav, albumin, hlau, B12.
14. Cov poj niam tej zaum yuav tshwm sim amenorrhea (cessation ntawm poj niam).
15. Mental ntshawv siab.

Cachexia thiab psyche

Kuv xav ua kom pom tseeb rau hauv kev puas hlwb kev ntshawv siab nyob rau hauv cachexia. Lawv yuav manifest nws tus kheej nyob rau hauv txob taus, kev nyuaj siab thiab tearfulness uas ntseeg nkaws ntws mus rau hauv apathy, ib tug ua tiav rhuav tshem. Nyob hauv ib lub exacerbation ntawm tus kab mob uas yog qhov ua rau ntawm cachexia tau cai amentia / amential syndrome (kiv taub hau, yus muaj los ntawm ib tug tsis muaj peev xwm ua kom pom tseeb, chaotic zog thiab distraction, thiab incoherence ntawm kev xav thiab kev hais lus) los yog fem (insanity nyob rau hauv uas ib tug txiv neej yog nyob rau hauv ib tug lub xeev qhov kev ntxhov siab vim thiab kev zoo siab pom hallucinations), psevdoparalich.

Cachexia nyob rau hauv Oncology

Cancerous cachexia - ib tug syndrome nyob rau hauv uas tsis tu ncua tau tsawg skeletal leeg loj thiab adipose cov ntaub so ntswg nyob rau hauv txoj kev loj hlob ntawm lub qog formations, ntawm nws tus kheej ntawm lub noj mov. Havzoov yog tshwj xeeb tshaj yog cov lus hais nyob rau hauv cov neeg mob uas muaj mob cancer ntawm tus mob huam los yog ntsws kabmob. Xws li tus neeg yuav poob ntau li ntau 80% ntawm lub cev hnyav, ua rau immobility.

Cancer raws li ib tug ua ntawm cachexia

Cachexia nyob rau hauv cancer tau. Qhov ua rau ntawm cachexia yuav ua tau ib tug mob. Vim hais tias ntawm cov qog metabolism yuav atypical, kho rau nws. Lub qog xav tau kev pab rau substrates, uas muaj peev xwm ua kom nws txoj kev loj hlob thiab kev loj hlob. Nws yog tsis muaj daim card uas cancer cachexia intoxicating nyhuv rau kev noj qab ntaub so ntswg thiab kabmob, Process lawv cov qauv thiab ua malfunctions.

Nyob rau hauv lub tsim ntawm hlav nyob rau hauv lub loj npaum li cas ntawm lactic acid yog puas siab. Nyob rau hauv thiaj li yuav normalize lub concentration ntawm lactic acid, lub cev pib siv cov ntshav qab zib, thiab feem ntau tsis tau ua rau losses.

Thaum cancer cachexia cai:
- ib tug catastrophic txo nyob rau hauv hnyav thiab tsis muaj zog;
- kev ua txhaum ntawm yus tus kheej-kev cai dab;
- yuav txo tau ntawm ntshav cholesterol;
- txoj kev loj hlob ntawm tus kab mob vim ua txhaum ntawm cellular thiab humoral kev tiv thaiv;
- dysphagia (nyuaj nqos);
- ntuav, raws plab;
- ib qho kev nce nyob rau hauv lub zog thov;
- antidiuresis thiab, thiaj li, hyponatremia;
- hypercalcemia;
- o;
- nce nyob rau hauv cov ntshav glucocorticoids;
- nyob rau hauv tej rooj plaub, fem thiab txawm coma.

Lub txim ntawm cancer cachexia

Cancer cachexia yog heev txaus ntshai. Nce glucocorticoid ntshav activates dab gluconeogenesis (glucose synthesis) nyob rau hauv lub siab thiab tej nqaij, tsub kom lub neej puas ntawm cov nqaijrog thiab nqaijrog. Vim hais tias glucose uptake los ntawm cov kev mob hlwb kev hypoglycemia (tsis tshua muaj ntshav qab zib). Nyob rau qhov no tom qab (uas tej zaum yuav muab ntxiv rau kev nyuaj siab), endocrine qog nquag tsim cov tshuaj hormones ntau heev npaum li cas uas ua rau yus qaug cawv thiab hemic hypoxia (txo txawv arteriovenous oxygen gradient). Homeostatic txawv txav tshwm sim. Tag nrho cov no yuav ua tau kom tuag.

cachexia kev kho mob

Feem ntau ntawm cov kev kho mob ntawm cov neeg mob nrog cachexia ua nyob rau hauv cov tsev kho mob los yog tsev kho mob. Lub ntsiab kev kho mob muaj xws li kev kho kom pov tseg ntawm neoplasms. Nyob ntawm tej thiab rov qab hwj chim, uas yog tiav los ntawm pom lub cev nrog cov vitamins, ib txoj lw ntsiab, nqaijrog thiab proteins. Rau lub hom phiaj no yuav siv tau yooj yim digestible khoom noj. Siv xws tshuaj: ib multivitamin rau cov kev kho mob ntawm hypovitaminosis, enzymes los txhim kho digestion. Khoom noj khoom haus yog nkag tau rau hauv ob txoj kev: enteral (thaum nws nkag mus rau hauv cov hnyuv) thiab parenteral (khoom noj khoom haus pheej tsis tshua mus rau hauv cov hnyuv). Parenteral txoj kev yog siv los mus tshem tus neeg mob los ntawm ib tug nyuaj hauv lub xeev (coma) nyob rau hauv cov kev kho mob ntawm cov qog nqaij hlav thiab, tom qab lawv, loj malnourished, mob mob, nqos ntshawv siab. Yog li muab qabzib, vitamins, amino acid mixtures, electrolytes, protein hydrolysates (muab parenterally). Tsis tas li ntawd, nyob rau hauv kev xyaum siv cov cuab yeej uas ua rau kom qab los noj mov. Yog hais tias tus neeg mob suffers los ntawm impaired kev zom khoom noj thiab nws cov haum, siv nyob rau hauv cov kev kho mob ntawm polyenzyme tshuaj (tshuaj "Pancreatin", "Festal" yeeb tshuaj).
Yuav kom tiv thaiv ntuav, muab ib tug txhais tau tias ntawm "Delta-9-tetrahydrocannabinol". Nws yog zoo thiab tom qab cov kws khomob. Cannabinoids muaj nyob rau hauv kev npaj no, hnia qab los noj mov, thiab, ntsig txog, thiab qhov hnyav nce. Poob phaus yuav tso ntses roj, ces nws tseem yog ib feem ntawm cov kev kho mob ntawm cov kab mob xws, xws li cachexia.

Kev kho mob muaj tshuaj.
Yuav kom tshem tawm cov kev siv ntawm cachexia xws tshuaj:
1) "carboxylase" - pab normalize luj, thiaj li mob thiab txhawb lub cev txoj kev tshuab. Sab los - tsis haum. Nws yuav siv tsis tau, yog hais tias tus kab mob yog raug rau tsawg kawg ib feem.
2) "Megeys" los yog "megestrol acetate" - yeej txhawb ib qho kev nce nyob rau hauv cov leeg loj thiab muaj roj. Nws yuav siv tsis tau yog hais tias muaj yog rhiab heev rau lub Cheebtsam ntawm yeeb tshuaj, rau cov neeg nyob rau hauv 18 lub xyoos ntawm hnub nyoog, thaum lub sij hawm cev xeeb tub thiab pub niam mis.
Nyob rau hauv lub xub ntiag ntawm kis kab mob muaj xws li cov kev kho mob ntawm antibacterial txoj kev kho. Yog hais tias tsim nyog, nkag mus rau anaboliticheskie cov tshuaj hormones. Nyob rau hauv tus neeg mob ntawm psychogenic mob muab kev koom tes kev kho mob ntawm tus kws kho mob.
Peb cia siab tias peb tau teb koj cov lus nug "Cachexia - dab tsi nws yog, yuav ua li cas txhais tau thiab yuav ua li cas sib ntaus sib tua."