Cachexia - yog dab tsi? Cachexia, nyob rau hauv lwm yam lus, qaug zog ntawm lub cev, yog ib tug complex txheej txheem uas yog los ntawm ib tug tseem ceeb poob ntawm lub cev qhov hnyav thiab tsis muaj zog, raws li zoo raws li kev hloov nyob rau hauv lub hlwb. Nyob rau tib lub sijhawm, cov rog thiab cov carbohydrates ceev tau poob qis, cov protein synthesis txo qis nrog kev nce ntxiv hauv nws cov catabolism (kev puas tsuaj). Cachexia kuj tseem tuaj yeem tshwm sim hauv cov kab mob oncological.
Kev Ntsig Ntsig thiab theem nrab
Muaj ob hom kab mob cachexia - thawj thiab theem nrab. Thawj qhov khib nyiab tseem hu ua pituitary, thiab theem nrab yog cov tsos mob.
● Thawj los yog exogenous cachexia tshwm sim vim tsis txaus ntawm cov as-ham, nrog rau qhov tshwm sim ntawm cov teeb meem hauv qab no: kev raug mob ntawm lub paj hlwb, qog lossis lub cev puas tsuaj rau lub caj pas pituitary, autoimmune hypophysitis, kev ntxhov siab ntev, hemorrhages (hemorrhages. vim cov hlab ntsha nyias nyias), anorexia, embolism (cov khoom txawv teb chaws nkag mus rau hauv cov hlab ntsha ua rau cov hlab ntsha txhaws), kab mob tshwj xeeb.
● Secondary los yog endogenous cachexia yog tshwm sim los ntawm cov kab mob thiab yog tshwm sim los ntawm tej yam xws li hypoinsulinism (tsis muaj insulin), nce synthesis ntawm glucagon, malabsorption (tsis haum rau cov as-ham.tshuaj), glucocorticoid deficiency, qog loj hlob, somatostatin tshaj.
Kev tshwm sim
kab mob Cachexia tshwm sim los ntawm ntau yam ua rau thiab yam:
1. Ntev mus tsis tau noj thiab tshaib plab.
2. Cov kab mob ntawm txoj hnyuv, tshwj xeeb tshaj yog nyob rau hauv txoj hlab pas, nrog rau kab mob celiac, enterocolitis.
3. Kev qaug cawv ntev ntev nrog brucellosis, tuberculosis thiab lwm yam kab mob sib kis thiab cov txheej txheem suppuration.
4. Psychogenic anorexia.
5. Cov kab mob thyroid, adrenal insufficiency.
6. Cov kab mob endocrine cuam tshuam nrog cov kab mob metabolic.
7. Lub plawv tsis ua hauj lwm.
8. Malignant qog.9. Hypotrophy hauv menyuam yaus.
Cov tsos mob ntawm cachexia yog dab tsi? Cov kev tshwm sim no yog dab tsi?
Symptomatics
Muaj ntau cov tsos mob uas ua rau cachexia. Tus kab mob no ua rau peb lub cev li cas:
1. Sudden yuag poob mus txog 50% ntawm lub cev hnyav, thiab nyob rau hauv mob hnyav tshaj 50%.
2. Lub cev qhuav dej.
3. Cov leeg tsis muaj zog.
4. Disability.
5. Pw tsis tsaug zog.
6. Nce tus kab mob.
7. Txo ntshav siab (ntshav siab).
8. Paleness thiab flabbiness ntawm daim tawv nqaij.
9. Muaj vitamin deficiency thiab hniav poob.
10. Trophic hloov ntawm cov plaub hau thiab rau tes.
11. Kev loj hlob ntawm stomatitis.
12. Qhov tshwm sim ntawm cem quav vim lub plab zom mov tsis zoo.
13. Txo cov ntshav protein, albumin, hlau,Q12.
14. Cov poj niam tej zaum yuav muaj amenorrhea (tas li ntawm kev coj khaub ncaws). 15. Kev puas siab puas ntsws.
Cachexia and the psyche
Kuv xav nyob ntawm kev puas siab puas ntsws hauv cachexia. Lawv tuaj yeem tshwm sim rau lawv tus kheej hauv kev chim siab, kev nyuaj siab thiab kua muag, uas ntws mus rau hauv apathy, ua tiav kev tawg. Nrog rau qhov exacerbation ntawm tus kab mob uas ua rau cachexia, amentia / amental syndrome (pom ntawm kev nco qab, tus cwj pwm los ntawm kev tsis muaj peev xwm taug kev, chaotic txav thiab tsis nco qab, nrog rau kev xav thiab kev hais lus tsis sib xws) lossis delirium (insanity uas tus neeg yog. Nyob rau hauv tas li ntawm kev ntxhov siab vim thiab arousal) tuaj yeem pom, pom kev pom), pseudo-tus tuag tes tuag taw.
Cachexia hauv oncology
Cancerous cachexia yog ib qho mob uas qhov loj ntawm cov leeg pob txha thiab cov ntaub so ntswg adipose txo qis nrog kev loj hlob ntawm cov qog nqaij hlav, tsis hais txog kev noj zaub mov. Kev depletion yog tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj mob qog noj ntshav ntawm lub plab lossis lub ntsws. Cov neeg zoo li no tuaj yeem poob ntau txog 80% ntawm lawv lub cev hnyav, ua rau tsis muaj zog.
mob qog noj ntshav ua rau cachexia
Cachexia hauv cov kab mob oncological yog ua tau. Qhov ua rau cachexia tuaj yeem yog qhov muaj cov qog. Vim lub neoplasm, cov metabolism ua atypical, kho rau nws. Cov qog xav tau cov substrates uas tuaj yeem ua kom nws txoj kev loj hlob thiab kev loj hlob. Nws tsis yog ib qho zais cia tias mob qog noj ntshav cachexia muaj tshuaj lom rau cov kabmob thiab cov ntaub so ntswg, hloov lawv cov qauv thiab ua rau tsis ua haujlwm.
Thaum muaj ntau cov lactic acid tsim nyob rau hauv cov qog, lub siab puas lawm. Yuav kom normalize qhov concentration ntawm lactic acid, lub cev pib siv cov ntshav qab zib thiab feem ntau tsis tuaj yeem ua rau poob.
Thaum kuaj mob qog noj ntshav cachexia:
- poob ceeb thawj thiab tsis muaj zog;
- ua txhaum ntawm tus kheej cov txheej txheem;
- txo cov roj cholesterol hauv ntshav;- kev loj hlob ntawm kev kis kab mob vim tsis muaj kev tiv thaiv kab mob ntawm tes thiab kev ua siab zoo;
- dysphagia (nqus tau yooj yim);
- ntuav, raws plab; - nce lub zog xav tau;- antidiuresis thiab, vim li ntawd, hyponatremia;
- hypercalcemia;
- edema; - nce ntshav glucocorticoids; - qee zaum, delirium thiab txawm coma.
Qhov tshwm sim ntawm mob qog noj ntshav cachexia
Cancer cachexia yog qhov txaus ntshai heev. Kev nce hauv glucocorticoids hauv cov ntshav ua rau cov txheej txheem ntawm gluconeogenesis (glucose synthesis) hauv daim siab thiab cov leeg nqaij, ua rau kom muaj cov protein thiab rog. Raws li kev nqus ntawm cov piam thaj los ntawm cov qog nqaij hlav cancer, hypoglycemia (cov ntshav qabzib tsawg) tshwm sim. Tawm tsam keeb kwm yav dhau los no (qhov kev ntxhov siab tuaj yeem ntxiv), cov qog endocrine nquag tsim cov tshuaj hormones, ntau dhau ntawm qhov ua rau lub cev qaug cawv thiab hemic hypoxia (qhov sib txawv ntawm cov hlab ntsha-venous oxygen gradient txo qis). Homeostatic deviations tshwm sim. Tag nrho cov no tuaj yeem ua rau tuag taus.
Cachexia kho
BFeem ntau ntawm kev kho mob ntawm cov neeg mob cachexia yog nqa tawm hauv tsev kho mob lossis dispensaries. Kev kho mob tseem ceeb suav nrog kev kho kom tshem tawm neoplasms. Kev noj zaub mov tseem raug rov qab los, uas yog ua tiav los ntawm kev txhawb nqa lub cev nrog cov vitamins, microelements, rog thiab proteins. Rau qhov no, cov khoom siv zom tau yooj yim tuaj yeem siv tau. Siv cov tshuaj no: multivitamin rau kev kho mob ntawm hypovitaminosis, enzyme los txhim kho kev zom zaub mov. Khoom noj khoom haus yog siv nyob rau hauv ob txoj kev: enteral (thaum nws nkag mus rau hauv lub plab hnyuv ib ntsuj av) thiab parenteral (khoom noj khoom haus kis los ntawm lub gastrointestinal ib ntsuj av). Txoj kev parenteral yog siv los tshem tawm tus neeg mob los ntawm qhov mob hnyav (coma) nrog mob qog noj ntshav thiab kev kho mob tom qab lawv, kev noj zaub mov tsis zoo, kev kis mob hnyav, thiab kev nqhis dej. Nyob rau tib lub sijhawm, cov piam thaj, cov vitamins, cov amino acid sib tov, electrolytes, protein hydrolysates raug tswj hwm (qhia parenterally). Appetite enhancers kuj tau siv rau hauv kev xyaum. Yog tias tus neeg mob raug kev txom nyem los ntawm kev zom zaub mov thiab kev nqus, cov tshuaj polyenzymatic yog siv rau hauv kev kho mob (Pancreatin, Festal). Nws kuj tseem siv tau tom qab siv tshuaj khomob. Cov cannabinoids muaj nyob rau hauv qhov kev npaj no txhawb kev qab los noj mov, thiab, raws li, qhov hnyav nce. Kev poob phaus tuaj yeem nres nrog cov roj ntses, uas yog vim li cas nws tseem suav nrog kev kho mob xws li cachexia.
Kev kho mob nrog tshuaj.
Cov tshuaj hauv qab no yog siv los tshem tawm cachexia:
1)"Carboxylase" - pab normalize qhov hnyav, txo qhov mob thiab txhawb kev ua haujlwm ntawm lub cev. Kev phiv - kev ua xua. Yuav tsum tsis txhob siv yog tias lub cev raug cuam tshuam rau yam tsawg kawg ib feem.
2) "Megeys" lossis "Megestrol acetate" - txhawb kev nce hauv cov leeg nqaij thiab rog. Tsis txhob siv nyob rau hauv cov ntaub ntawv ntawm rhiab heev rau lub Cheebtsam ntawm cov tshuaj, cov neeg muaj hnub nyoog qis dua 18 xyoo, thaum cev xeeb tub thiab pub niam mis.
Thaum muaj cov kab mob sib kis, cov tshuaj tua kab mob suav nrog hauv kev kho mob. Yog tias tsim nyog, cov tshuaj hormones anabolic raug tswj hwm. Nyob rau hauv cov xwm txheej ntawm kev puas siab puas ntsws, tus kws kho mob puas siab puas ntsws koom nrog kev kho mob. Peb cia siab tias peb tau teb koj cov lus nug "Cachexia - nws yog dab tsi, txhais li cas thiab yuav ua li cas tiv thaiv nws".
