Cachexia - chii? Cachexia mu kenza

Cachexia - chii? Cachexia, mune mamwe mashoko, Kuparadzwa muviri - kunzwisisa mutoo dzinoratidzwa chinokosha kurasikirwa uremu muviri uye vakawanda utera uyewo shanduko pfungwa. Izvi zvinoshamisa kwezvinoshandiswa mafuta uye carbohydrate reserves, akaderedza mapuroteni usage, apo kuwedzera catabolism kwayo (Kuparara). Cachexia kunogona kuitika munguva oncological zvirwere.

Nesekondari kuneta

Two siyana cachexia chirwere - nesekondari. Primary kuparadzwa inonziwo pituitary, uye yechipiri - symptomatic.

● Primary kana exogenous cachexia kunoitika nokuda kukwana yaunodya nezvinovaka muviri, uyewo migumisiro zvinotevera zvirwere: chepfungwa kunotevera, bundu kana systemic lesion pituitary, autoimmune hypophysitis, kwenguva refu kushushikana, ropa (ropa panguva rive dete midziyo), kudya embolism ( ingress vokune dzimwe nyika inoramba muropa ano, zvichikonzera vascular occlusion), zvakananga chisingaperi noutachiona.

● Secondary kana endogenous cachexia uri mugumisiro zvirwere uye kunokonzerwa zvinhu zvakadai gipoinsulinizm (jekiseni kushaikwa), vakawedzera kwetunhu glucagon, malabsorption (malabsorption muviri), glucocorticoid kushaikwa, neoplastic kukura, zvakawandisa somatostatin.

zvinokonzera

Cachexia chirwere kunoitika pamusana kwezvikonzero uye zvinhu:
1. kwenguva zvokudya zvinovaka muviri uye nzara.
2. Hosha pakati nemudumbu, kunyanya yegurokuro, uyewo celiac chirwere, enterocolitis.
3. kwenguva refu kudhaka pamwe brucellosis, tiibhii nezvimwe zvirwere uye chirwere suppuration pezvakaitwa.
4. Psychogenic neanorexia.
5. Akakomba of thyroid shwanu, adrenal insufficiency.
6. kwemakemikari anobudiswa zvirwere chokuita metabolic zvirwere.
7. Heart kukundikana.
8. akaipa bundu.
9. Kutambisa muvana.

Chii zviratidzo cachexia kunoratidzwa? Ndezvipi zviratidzo izvi?

symptomatology

Kune nezviratidzo zvinoverengeka, iyo inozivikanwa nokuva cachexia. Kuti chirwere ichi anoita kuti miviri yedu:
1. Sudden uremu anosvika 50% kurema muviri, uye mune Muzviitiko zvakaipisisa kupfuura 50%.
2. Kushaya mvura mumuviri.
3. Muscle simba.
4. Disability.
5. Kurara zvirwere.
6. Increase kukundwa zvirwere.
7. Decrease BP (arterial nevezera).
8. Pale uye flabby ganda.
9. Vanogona vhitamini kushaikwa, uye mavende.
10. Trophic kuchinja bvudzi uye nezvipikiri.
11. Kugadzirwa stomatitis.
12. The panowanikwa kupatirwa nokuda intestinal motility zvirwere.
13. The pasi mapuroteni tigutsikane ropa, sealbumin, simbi, B12.
14. Vakadzi zvingaitika amenorrhea (kumira kumwedzi).
15. Chepfungwa.

Cachexia uye psyche

Ndinoda pfungwa chirwere chepfungwa mu cachexia. Ivo kungazviratidza mu kushatirwa, kuora mwoyo uye tearfulness kuti zvakanaka dzinoyerera kupinda vasingakendengi, kusagarisana wakakwana. Panguva exacerbation chirwere chakanga chakonzera cachexia anogona kuonekwa amentia / amential chirwere (dzungu, ichazivikanwa noku kutadza kufunga, runobva rwokufamba kudzongonyedzwa, uye incoherence kwepfungwa uye kutaura) kana delirium (kupenga umo munhu ari kuramba ezvinhu mwoyo uye kufara anoona zvisipo), psevdoparalich.

Cachexia mu oncology

Kenza cachexia - munhu chirwere umo anoramba zvinoderedza skeletal kwetsandanyama uye adipose zvinyama kukura bundu idzodzo, tisingatungamirirwi kudya. Kuparadzwa kuri kunyanya kutaurwa varwere vane kenza nemudumbu kana mumapapu nhengo. vanhu vakadaro vanogona kurasikirwa zvakawanda 80% kurema muviri, zvichitungamirira kutadza kufamba.

Kenza somunhu chinokonzera cachexia

Cachexia mune kenza zvinobvira. Chinokonzera cachexia kungava bundu. Nokuda namamota muviri inova atypical, kugara nayo. Bundu anofanira substrates, zvinokwanisa kuita kuti uve nechokwadi kukura kwayo uye kubudirira. Hapana chakavanzika kenza cachexia doro kubatsira munyama utano uye nhengo, rinochinja nechivako dzavo uye anokonzera malfunctions.

In nokuumbwa namamota iri yakawanda lactic asidhi ndiyo hunenge chiropa. Kuti normalize wevasungwa pamusoro lactic acid, muviri unotanga kushandisa ropa shuga, uye kazhinji havagoni kuita nazvo.

Kana kenza cachexia vakacherechedza:
- aiparadza kuderera uremu uye utera;
- kutyora kuzvidzora pezvakaitwa;
- rutapudzo pamusoro yeplasma remafuta akawandisa;
- kukura kutapukirwa nokuda zvaipesana cellular uye humoral kutapata;
- dysphagia (zvakaoma pakuparadza);
- kurutsa, manyoka;
- kuwedzera simba kwokudiwa;
- antidiuresis uye, naizvozvo, hyponatremia;
- hypercalcemia;
- kuzvimba;
- kuwedzera ropa glucocorticoids;
- dzimwe nguva, delirium uye kunyange pakoma.

Zvakaipira kenza cachexia

Kenza cachexia kune ngozi chaizvo. Inosimudzira glucocorticoid ropa zvaanopa simba pezvakaitwa gluconeogenesis (shuga usage) muna chiropa uye tsandanyama rinenge anowedzera yokuparara kwemapurotini uye mafuta. Nekuti shuga uptake nemasero kenza hwapedyo yomuropa (yakaderera ropa shuga). On kumashure ichi (zvingafananidzwe kuwedzera kunetseka), kwemakemikari anobudiswa mumasero nokushingaira kubudisa mahormone zvakawandisa mari iyo inotungamirira kudhaka uye hemic hypoxia (akaderedza musiyano arteriovenous yakachena gradient). Homeostatic abnormalities kuitika. izvi zvose zvinogona kukonzera rufu.

cachexia kurapwa

Vazhinji pakurapa varwere cachexia anoitwa muzvipatara kana zvipatara. Huru Kurapa kunosanganisira mushonga nokuda Kuraswa neoplasms. Waya uye kupora simba, iyo zvinoitwa huchiita kuti muviri pamwe mavhitamini, zvisaririra okunze, kwemafuta uye mapurotini. Nokuti chinangwa ichi chinogona kushandiswa nyore digestible zvokudya. Aishandisa zvinodhaka zvakadai: a multivitamin kuti kurapa hypovitaminosis, makemikari kuvandudza kugaya. Food kutaurwa nenzira mbiri: enteral (kana anopinda zvomudumbu turakiti) uye parenteral (zvokudya unotipotsei zvomudumbu turakiti). Parenteral nzira inoshandiswa kubvisa murwere kubva zvakaoma ezvinhu (chaanoziva) pakurapa kenza uye, pashure pavo, vakaperezeka zvikuru, zvirwere zvikuru, pakuparadza zvirwere. Saka raitongwa shuga, mavhitaminzi, amino asidhi wemisanganiswa, electrolytes, mapuroteni hydrolysates (dzakabatwa parenterally). Uyewo, pane tsika kushandisa maturusi kuti kuwedzera kudya. Kana murwere anotambura havachanyatsogoni kugaya zvokudya uye ayo Absorção de Água, anoshandiswa kurapa polyenzyme zvinodhaka (zvinodhaka "Pancreatin", "wokupembera" chinodhaka).
Kudzivirira kurutsa, akarayira senzira "Delta-9-tetrahydrocannabinol". Hazvina inoshanda uye pashure mishonga. Cannabinoids huri uchigadzirirwa ichi, kukurudzira kudya, uye ukuwo, uye uremu. Uremu kunogona vakarega kushandisa mafuta hove, saka zviri zvakare chikamu kurapa zvirwere zvakadai, zvakadai cachexia.

Treatment pamwe nemishonga.
Kurambidza kushandiswa cachexia mishonga yakadaro:
1) "carboxylase" - inobatsira normalize uremu, kunoderedza marwadzo uye anotsigira muviri hurongwa. Side Migumisiro - sema. Hazvigoni kushandiswa, kana nhengo iri kubatwa pane chimwe chazvo.
2) "Megeys" kana "megestrol acetate" - anosimudzira kuwedzera kwetsandanyama uye mafuta. Hazvigoni kushandiswa kana pane aikanganiswa zvakamisa hurongwa zvinodhaka, vanhu pasi nemakore 18, panguva yepamuviri uye achiyamwa.
In pamberi zvinotapukira zvinosanganisira mishonga antibacterial mishonga. Kana zvakakodzera, kupinda anaboliticheskie mahormone. Muzviitiko psychogenic zvirwere zvaisanganisira kurapa imwe chiremba wepfungwa.
Tinovimba tava akapindura mubvunzo wako "Cachexia - chii, sei kutsanangura uye sei kurwa."