Zviratidzo, kukosha, uye kurapa kweCcercer Cachexia
Cachexia chinhu chinowanzosangana nekenza (uye zvimwe zvimwe zvirwere zvakadai seHIV / AIDS) iyo inonzi inofanirwa ne20 muzana yevanouraya kenza muUnited States . Izvozvo zvakati, hazviwanzoongororwa kusvikira zvave zviripo kwenguva yakareba. Chaizvoizvo cachexia, chii zviratidzo nezviratidzo, chii chinokonzerwa, uye chinoshandiswa sei?
Overview
Cachexia chirwere chinoratidzwa nezviratidzo zvekurasikirwa kwekuzvidzivirira kusingatarisirwi, kupera kwemisumbu kunofambira mberi, uye kurasikirwa nechido. Inowanikwa mune makumi mashanu kubva muzana yevanhu vane kenza yakakurumbira, inofungidzirwa kuti inopa zvakananga ku20 muzana yevanhu vanouraya kenza .
Kunyange zvazvo zviratidzo uye zviratidzo zvecachexia zvinowanzoonekwa munguva pfupi yekenza, tiri kudzidza kuti nzira inotungamirira kumasimba ekudengenyeka inotanga kunyanya kutanga mushure mekuonekwa kwekenza. Mukudaro, cachexia inowanzovapo vasati vambosara.
Cachexia dzimwe nguva inonzi inonzi paraneoplastic syndrome , iyo inongoreva zviratidzo zvinokonzerwa nezvinhu zvakagadzirwa nekenza kana nemararamiro anoita kenza. Zvinogona kuonekwa sekuti cachexia inofanira kutorwa nyore nyore pakutanga, asi kurapa kwakanaka kunoshaikwa. Izvi ndezvokuti cachexia inopfuura kungoshaya kwekoriki mumuviri.
Kushamwaridzana neKenza
Cachexia inowanzoonekwa nekenza asi inoonekwawo nezvirwere zvakadai seAIDS / HIV, mwoyo kusakwanisa , emphysema , uye kushaya kwepvo. Nezvekenza, inowanzoonekwa nekenza yemapapu, kenza yepancreatic , uye kenza yemudumbu.
Cachexia haisi kungowedzera kupona kwevanhu vane kenza, asi inopesana nehupenyu hwehupenyu.
Vanhu vane cachexia havakwanisi kubvumira kurapwa, zvakadai sekemotherapy , uye vanowanzova nemigumisiro yakawanda. Kune avo vanovhiyiwa , zvinetso zve postoperative zvakawanda. Cachexia inowedzerawo kukonzera kenza , chimwe chezvivhiringidzika zvikuru zvekenza.
Zviratidzo
Zviratidzo zvikuru zve cachexia dzinosanganisira:
- Kupindira (kusingabatsiri) kurasikirwa kwekurema: Kurasikirwa kweutema ne cachexia hazviiti, zvichireva kuti zvinoitika pasina kuedza. Asi zvinopfuurira mberi kudarika kurasikirwa kwekurema. Kurasikirwa kweuviri kunogona kuitika kunyange iwe uri kuwana huwandu huwandu hweakoriyamu mune zvekudya kwako, uye kana koriori inowedzera kuwanda kwemagetsi emagetsi.
- Skeletal muscle kuparara: Utachiona kuparara ndiko chiratidzo checachexia uye chinoitika pamwe nekurasikirwa kwamafuta. Inogonawo kunge isina kunyengera. Muvanhu vane kuwandisa kwemazuva panguva yekuongororwa kwavo, kurasikirwa kukuru kwemasimba mashoma kunogona kuitika kunze kwekuoneka kwekunze kwekureruka kwekureruka.
- Anorexia / kurasikirwa kwechido: Kufa kwechido chimwe chiratidzo che cachexia, uye zvakare, ichi chiratidzo chinopesana nezviratidzo zve "kurasikirwa kwechido". Ne cachexia, haisi kungoita kuderera kwechido chekudya, asi kune kurasikirwa kwechido chekudya.
- Kuderedza hutano hwehupenyu: Kusvibiswa kwemisungo kunogona kuderedza simba rako rokutamba uye kubatanidzwa mumabasa angawanzofadza.
Zvinokonzera
Cachexia inogona kukonzerwa ne "chiremera chezvinhu" - zvinhu zvakagadzirwa uye zvakavanzwa nemarara, kana ne "mhinduro yekugamuchira." Kupindura kwechigarire kunoreva kungoita muviri kumuviri. Mhinduro yezvirwere zvemuviri kune kenza uye zvimwe zvinokonzera cachexia zviri kuongororwa kuedza nekunyatsonzwisisa zvikonzero zvinokonzera cachexia.
Cachexia inotungamirirwa ne catabolic metabolism. Kana iwe uchifunga nezvekugadzikana kwemasabolism kuva chivako chemashuga uye musumbu (anabolic metabolism), zvakasiyana ndezvechokwadi ne cachexia, iyo iri kuparara kwemagadzirirwo emuviri.
Kuongorora
Pane nzira dzakawanda dzokuti cachexia inogona kuongororwa.
Zvimwe zvezviyero izvi zvinosanganisira:
- Muviri mass index (BMI): Muviri wehutu hunotsanangura kwete uwandu hwenyama chete asi hunogona kupa mamwe mashoko pamusoro pehutano hwakanaka. BMI inotaridzirwa kushandiswa kwemaitiro ekukwirira nekurema.
- Kuonda kwemisimba miviri: Kuenzanisa kuumbwa kwemuviri kunogona kubatsira kuziva kuti chiyero chemaviri mashoma chiine mafuta mumuviri. Miedzo inoshandiswa kuita izvi inogona kusanganisira zvipfeko zveganda uye kugadzirwa kwemhuka.
- Zvokudya zvinotora diaries: Kuchengeta diary yezvokudya ibasa rinokosha kana uchitsvaga kudzivirira kana kutarisana ne cachexia. Panguva imwecheteyo, zvakakosha kuchengetedza mupfungwa kuti kusadya kwekudya kwemazuva ano kunogona kuitika kunyange nekudya kwakakwana kwekoriyori.
- Kuongorora Ropa: Mimwe miedzo yebasa inobatsira pakutsvaga cachexia inosanganisira nyemba yeropa yekare (WBC), serum albumin, mazinga ekutumira, uric acid, uye zvirwere zvinopisa, zvakadai seC-reactive protein (CRP) .
Kurapa
Kurapwa kunosvika kusvika iye zvino kwave kusinganyadziswi, uye kunyange nekodori yakakwana kudya, zvakaoma kuchinja nzira ye cachexia. Chinangwa chekurapa ndechekusimudzira "vanabolic" (izvo zvinoreva, kuvaka chivako) asi uchidzivisa "maitiro ezvinyorwa" (zviito zvinokonzera kuparara kwemasumbu). Mishonga inogona kusanganisira:
- Zvokudya: Kusiyana nezvingaita sezviri pachena, kutora uye kuwedzera zviyero muzvokudya hazvina kuita musiyano mukuru mu syndrome ye cachexia. Izvozvo zvakati, zvakakosha zvikuru kuve nechokwadi chokuti vanhu vanorwara nekenza (uye mamiriro akafanana anokonzera cachexia) vane kudya kwakanaka. Imwe pfungwa inokosha yekuchengeta mupfungwa ndeyokuti kana mumwe munhu asina kudya nguva kwenguva, kudya kunofanira kuwedzerwa zvishoma nezvishoma. Kana makorikiti akakurumidza kukurumidza, chimwe chinhu chinonzi "overfeeding syndrome" chinogona kuitika. Kana kudya kusingakwanisi (kana kukwana) mumuromo, tube yekudya inogona kukurudzirwa.
- Nutritional Supplements: Zvakanaka kana michero inogona kuwanikwa kuburikidza nekudya, asi tinoziva kuti haisi nguva dzose. Mafuta ehove ave akaongororwa nokuda kwekwanisiro rwekubata chichekesi pamwe nedzimwe dzidzo (asi kwete dzose) zvinoratidza kuti zvingabatsira. Mune rumwe ruzivo, kuwedzera pfupa yekuwedzera ye eicosapentaenoic acid (EPA) , chimwe chezvikamu zvitatu zvikuru zve omega-3 fatty acids izvo vanhu vanowanikwa mukudya kwavo nekudya hove, vanovandudza mazinga ezvokuvhiringidza mavara anoenda pamwe ne cachexia. Zvigadzirwa zveEPA zvaibatanidzawo nekugara kwenguva refu muchipatara uye zvishoma nezvirwere uye zvinetso.
- Kudzidzira: Izvozvo zvingaita sedhirongwa, asi kuwedzera basa (kana zvichibvira) kunogona kubatsira. Chimwe chikomborero chakajeka chokurovedza muviri chinowedzera chido, asi kudzidzisa kunotsvaira kunopfuura kudarika kudya kunobatsira kuderedza kuderera kwemaviri emasumbu anoonekwa ne cachexia.
- Mishonga: Mishonga yakawanda uye zvinowedzera izvo zvakave zvichiedzwa nekuda kwecachexia ine kubudirira zvishoma zvinosanganisira:
- Megace (megestrol)
- Thalidomide
- Zyloprim (allopurinol)
- Celebrex (celecoxib)
- L-Carnitine
- Medroxyprogesterone
- Testosterone
- Marijuana yeArape uye Marinol
The Future of Cachexia Treatment
Mishonga inoverengeka ikozvino mumakiriniki anotarisa anoratidza chivimbiso pakubatsira vanhu kutsungirira zviratidzo zve cachexia. Mamwe mashoma aya ari iye zvino muchitsauko 3 miedzo - zvidzidzo zvedzidzo dzinoongorora mishonga kana nzira iyo yakatoonekwa yakachengeteka uye inoshanda. Kubva ikozvino, uye akapiwa chokwadi chokuti cachexia inowanzotanga nguva refu isati yaoneka pakuongorora kwemuviri, zvakakosha kugadzirisa dambudziko iri kune vanhu vane mamiriro akadai semukenza wemapapu nokukurumidza kana zvichizoitika mushure mekuonekwa.
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