{"id":10905,"date":"2010-09-18T18:00:00","date_gmt":"2010-09-18T18:00:00","guid":{"rendered":""},"modified":"2016-03-24T18:23:48","modified_gmt":"2016-03-24T18:23:48","slug":"mitybos-svarba-onkologiniams-pacientams","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/mitybos-svarba-onkologiniams-pacientams\/10905\/","title":{"rendered":"Mitybos svarba onkologiniams pacientams"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Remiantis 2009 m. ESMO (angl. European Society for Medical Oncology) organizuoto simpoziumo \u0160veicarijoje, skirto onkologini\u0173 ligoni\u0173 mitybos ypatumams ir sukeliamoms problemoms analizuoti, gair\u0117mis<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u012eVADAS<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tarp da\u017eniausi\u0173 onkologin\u0117mis ligomis sergan\u010di\u0173 pacient\u0173 problem\u0173 \u2013 mitybos sutrikimai. Juos gali lemti \u012fvair\u016bs veiksniai. \u012erodyta, kad nepakankamas gaunamos energijos kiekis gali suma\u017einti i\u0161gyvenamum\u0105, ta\u010diau \u0161iai problemai skiriama vis dar per ma\u017eai d\u0117mesio. 2009 m. ESMO <i>(<\/i>angl. <i>European Society<\/i> <i>for Medical Oncology) <\/i>organizuotas simpoziumas \u0160veicarijoje buvo skirtas onkologini\u0173 ligoni\u0173 mitybos ypatumams ir problemoms analizuoti. Tai dar kart\u0105 \u012frodo, kad \u0161i tema i\u0161 ties\u0173 aktuali.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">MITYBOS IR ONKOLOGIN\u0116S LIGOS GYDYMO RY\u0160YS<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Onkologin\u0117mis ligomis sergan\u010di\u0173 ligoni\u0173 gydymas sukelia daug r\u016bpes\u010di\u0173. Vienas da\u017eniausi\u0173 \u2013 tai mitybos problemos. Nacionalinio v\u0117\u017eio instituto duomenimis, d\u0117l \u0161io sutrikimo ken\u010dia 80 proc. pacient\u0173, o 20\u201340 proc. mir\u010di\u0173 susijusios su mitybos nepakankamumu (1, 2). Ry\u0161ys tarp mitybos ir v\u0117\u017eio pirm\u0105 kart\u0105 fi ksuotas dar 1940 m., eksperimentuojant su pel\u0117mis. 1970\u20131980 m. prad\u0117ta ypa\u010d aktyviai ie\u0161koti mityb\u0105 gerinan\u010di\u0173 veiksni\u0173, kurie lemt\u0173 geresn\u0119 pacient\u0173 b\u016bkl\u0119 ir gydym\u0105. Daug tyrim\u0173 atlikta ir atliekama siekiant i\u0161siai\u0161kinti mitybos nepakankamumo vaidmen\u012f onkologinio paciento b\u016bklei, atsakui \u012f gydym\u0105, naviko progresavimui (3).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Gydymo specifika (taikyta chemoterapija, spindulin\u0117 terapija ir kt.) gali nulemti mitybos sutrikimus, ta\u010diau gali veikti ir gr\u012f\u017etamasis ry\u0161ys: esant sutrikusiam maitinimuisi, suma\u017e\u0117ja gydymo veiksmingumas, ribojamos gydymo metod\u0173 galimyb\u0117s. Jeigu gydymas trunka ilgai arba skiriamas paliatyviai, da\u017enai pasirei\u0161kia mitybos nepakankamumas, kuris lemia svorio ma\u017e\u0117jim\u0105 (4).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Daugelis klinikini\u0173 tyrim\u0173 rodo, kad esant normaliam k\u016bno svoriui ir visavertei mitybai ne tik lengviau toleruojamas v\u0117\u017eio gydymas, bet ir suma\u017e\u0117ja nepageidaujam\u0173 gydymo reakcij\u0173, pooperacini\u0173 komplikacij\u0173, pailg\u0117ja gyvenimo trukm\u0117<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ir pager\u0117ja kokyb\u0117 (5).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">SVARBIAUSIOS MITYBOS NEPAKANKAMUMO PRIE\u017dASTYS<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Su onkologine liga susij\u0119s mitybos nepakankamumas gali b\u016bti d\u0117l \u012fvairi\u0173 prie\u017eas\u010di\u0173: d\u0117l organizmo atsako \u012f v\u0117\u017ein\u012f proces\u0105, augan\u010dio naviko sukelto lokalaus poveikio, ikiv\u0117\u017ein\u0117s terapijos (6). V\u0117\u017eiu sergantiems pacientams da\u017enai pasirei\u0161kia vir\u0161kinamojo trakto obstrukcija, l\u0117tinis skausmas, viduri\u0173 u\u017ekiet\u0117jimas, vir\u0161kinimo sutrikimai, nepageidaujami gydymo rei\u0161kiniai. Visi \u0161ie veiksniai turi \u012ftakos prastai paciento mitybai. Nacionalinis v\u0117\u017eio institutas si\u016blo apibendrintas mitybos nepakankamumo prie\u017eastis: <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/nervine-anoreksija-2\/72708\">anoreksija<\/a>\u00a0ir neoplastinis kacheksijos sindromas. Nustatyta, kad onkologine liga sergantiems pacientams ypa\u010d padid\u0117ja energijos sunaudojimas, tod\u0117l n\u0117ra u\u017etikrinamas pakankamas energijos kiekis (7).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Onkologin\u0117 liga \u017emogaus organizm\u0105 veikia \u012fvairiai: d\u0117l gydymo pasirei\u0161kia nepageidaujami rei\u0161kiniai, tokie kaip pykinimas, v\u0117mimas, jie lemia nepakankam\u0105 mityb\u0105, svorio poky\u010dius. Taip pat atsiranda \u012fvairi\u0173 metabolini\u0173 poky\u010di\u0173. Gaunamos energijos kiekis neatitinka poreikio, tod\u0117l atsiranda riebal\u0173, baltym\u0173, angliavandeni\u0173 metabolizmo sutrikim\u0173, galin\u010di\u0173 nulemti anoreksij\u0105, kuri yra pagrindin\u0117 kacheksijos sindromo prie\u017eastis. D\u0117l vis\u0173 \u0161i\u0173 pamin\u0117t\u0173 veiksni\u0173 krinta svoris, kuris v\u0117liau gali tur\u0117ti \u012ftakos gydymo parinkimui (8, 9).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Anoreksija gali b\u016bti diagnozuojama nustatant onkologin\u0119 lig\u0105, ypa\u010d jei procesas<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u012fsisen\u0117j\u0119s, taip pat gali pasireik\u0161ti v\u0117lesn\u0117mis v\u0117\u017eio stadijomis. Svarbus nepakankamos mitybos veiksnys yra kacheksija. Tai organizmo i\u0161sekimas, kuris pasirei\u0161kia bendru fi ziniu silpnumu, ma\u017e\u0117jan\u010diu svoriu, raumen\u0173 ir riebal\u0173 mase, apetito stoka, pykinimu, nuotaikos blog\u0117jimu ir d\u0117l to nenoru valgyti. Sindromas da\u017eniau pasirei\u0161kia sergantiems plau\u010di\u0173, kasos, vir\u0161utin\u0117s dalies vir\u0161kinamojo trakto v\u0117\u017eiu, re\u010diau \u2013 kr\u016bties ar apatin\u0117s dalies vir\u0161kinamojo trakto v\u0117\u017eiu.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Nustatyta, kad leptino suma\u017e\u0117jimas ir grelino padid\u0117jimas, b\u016bdingi onkologiniams ligoniams, turi \u012ftakos mitybos nepakankamumui ir didesniam energijos poreikiui, esant ramyb\u0117s b\u016bsenos. Ilgainiui tai nulemia kacheksij\u0105. \u0160\u012f sindrom\u0105 reik\u0117t\u0173 \u012ftarti, jeigu pacientas per \u0161e\u0161is m\u0117nesius nuo diagnoz\u0117s nustatymo neteko daugiau kaip 5 proc. k\u016bno mas\u0117s (8, 10). Sindromas da\u017enesnis vaikams ir vyresniems asmenims, taip pat sergantiems i\u0161plitusia onkologine liga.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Siekiant \u0161alinti \u0161iuos sutrikimus, anoreksij\u0105 ir kacheksij\u0105, kurios da\u017enai pasirei\u0161kia kartu, geriausia rinktis kompleksin\u012f gydymo b\u016bd\u0105. Tam b\u016btinas \u012fvairi\u0173 sri\u010di\u0173 specialist\u0173 bendradarbiavimas, u\u017etikrinta ankstyva onkologin\u0117s ligos ir jos nulemt\u0173 neoplastini\u0173 sindrom\u0173 diagnostika, tinkamai parinktas mitybos planas ir fiziniai pratimai. Taip pat b\u016btina gydyti anemij\u0105, u\u017edegim\u0105, individualiai parinkti slaugos prie\u017ei\u016br\u0105 (9, 10, 18).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">NEPAKANKAMA MITYBA IR PSICHOLOGIN\u0116 PACIENTO B\u016aKL\u0116<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Nevisavert\u0117 onkologinio ligonio mityba da\u017enai diagnozuojama, kai smarkiai kei\u010diasi svoris. Tai gali nulemti blogesn\u012f atsak\u0105 \u012f gydym\u0105, prastesn\u0119 gyvenimo kokyb\u0119, trumpesn\u012f i\u0161gyvenamum\u0105 ir, \u017einoma, \u2013 didesnes gydymo i\u0161laidas. Pasteb\u0117ta, kad tokie pacientai jau\u010dia ir didesn\u0119 psichologin\u0119 \u012ftamp\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Kanados mokslininkai atliko tyrim\u0105 su 213 pacient\u0173, kuriems buvo diagnozuota onkologin\u0117 liga. Nustatyta, kad psichologinio diskomforto augimas statisti\u0161kai reik\u0161mingai susij\u0119s su prasta mityba (r=0,17, p=0,01), ypa\u010d su svorio netekimu (r=0,18645, p=0,064). Taip pat \u012frodyta, kad d\u0117l krintan\u010dio svorio ir besikei\u010dian\u010dios i\u0161vaizdos pacientai atsiskiria nuo aplinkini\u0173, jau\u010diasi nelaimingi ir ilgainiui gali susirgti <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/depresija\/4455\">depresija<\/a>. D\u0117l min\u0117t\u0173 psichologini\u0173 problem\u0173 pacientai nenoriai valgo, neturi apetito. Tai dar labiau sekina, svoris nepaliaujamai<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ma\u017e\u0117ja, taip pat prast\u0117ja gydymo veiksmingumas. Mokslininkai pri\u0117jo i\u0161vad\u0105, kad b\u016btina steb\u0117ti mityb\u0105 ir svorio poky\u010dius, siekiant geresn\u0117s onkologinio paciento psichologin\u0117s b\u016bkl\u0117s ir veiksmingesnio gydymo (11).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">RACIONO \u012eTAKA MITYBOS NEPAKANKAMUMUI<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Taigi, mityba yra labai svarbus veiksnys tiek gydymui, tiek visaver\u010diam onkologinio ligonio gyvenimui. Ta\u010diau retai atsi\u017evelgiama \u012f ligonio gyvenam\u0105j\u0105 viet\u0105, j\u0105 siejant su maisto raciono skirtumais. Rumunijos mokslininkai i\u0161k\u0117l\u0117 hipotetin\u012f klausim\u0105: ar skirtingas miesto ir kaimo racionas lemia onkologinio gydymo veiksmingum\u0105?<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tyrimu buvo lyginama, koki\u0105 \u012ftak\u0105 turi skirtingas racionas svorio poky\u010diams ir anemijai. Kaime gyvenan\u010di\u0173 tiriam\u0173j\u0173 grup\u0117je buvo u\u017efiksuotas spartesnis svorio kritimas negu gyvenan\u010di\u0173 mieste. Skirtingo raciono \u012ftakos anemijai atsirasti neu\u017efiksuota. Detaliau ai\u0161kinantis \u0161iuos skirtumus, reikalingi tolesni ir didesnio masto tyrimai (12).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u0160veicar\u0173 mokslininkai rekomendavo sudaryti diet\u0105, kuri u\u017etikrint\u0173 pakankam\u0105 energijos kiek\u012f, reikaling\u0105 onkologin\u0117mis ligomis sergantiems pacientams. Atlikus tyrim\u0105 paai\u0161k\u0117jo, kad \u012fprastas \u0160veicarijos ligonini\u0173 maistas suteikia tik apie pus\u0119 reikalingos energijos. Tod\u0117l rekomenduojama, pasitelkus dietolog\u0105, sudaryti individualios mitybos planus (13).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Nustatyta, kad stacionarizuotiems pacientams nepakanka baltym\u0173 kiekio, o jo stoka lemia ilgesn\u012f \u017eaizd\u0173 gijim\u0105, silpnesn\u0119 imunin\u0119 sistem\u0105, \u0161irdies ir kraujagysli\u0173 sistemos sutrikimus, bendr\u0105 silpnum\u0105, apatij\u0105. Daugyb\u0117 pacient\u0173 jau stacionarizavimo metu b\u016bna i\u0161sek\u0119 ir dar labiau i\u0161senka d\u0117l nepakankamo energijos kiekio gydymo \u012fstaigose. \u017dinotina, kad baltym\u0173 nepakankamumas da\u017enesnis vyresniems pacientams. \u012e \u0161iuos veiksnius b\u016btina atsi\u017evelgti koreguojant maitinimo plan\u0105 (14).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ANOREKSIJOS IR KACHEKSIJOS SINDROMO DIAGNOSTIKA<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Atliekant daugyb\u0119 tyrim\u0173 u\u017efi ksuota itin da\u017ena nevisavert\u0117 mityba tarp onkologini\u0173 pacient\u0173. Tod\u0117l rekomenduojama atid\u017eiai steb\u0117ti mitybos \u012fpro\u010di\u0173 kait\u0105 gydymo metu, kad b\u016bt\u0173 galima kuo anks\u010diau pasteb\u0117ti jos tr\u016bkum\u0105. Deja, apibr\u0117\u017et\u0173 metodik\u0173, kaip tai daryti, n\u0117ra (15). Ta\u010diau pacient\u0173 mityb\u0105 galima vertinti \u012fprastais metodais: ap\u017ei\u016bra ir antropometriniai tyrimai (k\u016bno mas\u0117s, odos rauk\u0161li\u0173 apimties, dilbio apimties vertinimas). Kaip min\u0117ta, \u012ftarti \u0161i\u0105 lig\u0105 reik\u0117t\u0173, jeigu pacientas per pus\u0119 met\u0173 neteko daugiau kaip 5 proc. k\u016bno mas\u0117s. Nutukusiems<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">pacientams taikomas 10 proc. limitas. Nurodoma, kad d\u0117l kacheksijos netenkama ne tik riebal\u0173, bet ir raumen\u0173 mas\u0117s, tod\u0117l sutrinka \u012fvairi\u0173 element\u0173 pusiausvyra.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Taip pat atliekami laboratoriniai tyrimai. Vienas i\u0161 pagrindini\u0173 \u2013 serumo albumino koncentracijos apskai\u010diavimas. Nustatyta, kad baltymo albumino koncentracija suma\u017e\u0117ja daugiau kaip 80 proc. onkologin\u0117mis ligomis sergan\u010di\u0173 ligoni\u0173 (16, 20).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">MITYBOS REKOMENDACIJOS<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tinkamai parinktas racionas prie\u0161 gydym\u0105, chemoterapijos metu ar po jos gali suma\u017einti nepageidaujamus rei\u0161kinius ir sustiprinti organizm\u0105. Tam, kad b\u016bt\u0173 u\u017etikrintas pakankamas gaunamos energijos kiekis, reikia pasirinkti nauding\u0173 med\u017eiag\u0173 prisotintus produktus, kuriuose yra vitamin\u0173, mineral\u0173, baltym\u0173, angliavandeni\u0173, vandens (18). Onkologin\u0117mis ligomis sergan\u010di\u0173 pacient\u0173 mityboje da\u017eniausiai tr\u016bksta baltym\u0173, tiamin\u0173 (vitaminas B1), riboflavin\u0173 (vitaminas B2), nikotino, folio r\u016bg\u0161ties, K+ jon\u0173 (20).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u0160veicarijoje vykusiame simpoziume savo atlikt\u0105 tyrim\u0105 pristat\u0117 Meksikos mokslininkai, jie pateik\u0117 mitybos rekomendacijas, kaip suma\u017einti chemoterapijos nepageidaujam\u0105 poveik\u012f (pykinim\u0105, v\u0117mim\u0105, kurio \u012ftaka labai svarbi svoriui). Rekomenduojama:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 valgyti da\u017enai, ta\u010diau ma\u017eomis porcijomis,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 nevartoti skys\u010di\u0173 (ypa\u010d alkoholini\u0173) valgant;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 valgyti aplinkos temperat\u016bros maist\u0105,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 valgyti ir kramtyti l\u0117tai,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 valgyti skrudint\u0105 duon\u0105,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 daugiau vartoti \u0161alt\u0173 \u0161vie\u017ei\u0173 sul\u010di\u0173,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 maist\u0105 ruo\u0161ti su imbierais,<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 vengti saldaus, kepto, riebaus maisto (17).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Jeigu pacientas negali valgyti pats, reikia u\u017etikrinti parenterin\u012f maitinim\u0105, kuris u\u017etikrint\u0173 b\u016btin\u0173 maisto med\u017eiag\u0173 poreik\u012f (19). Parenterinis maitinimas pagerina organizmo atsak\u0105 \u012f onkologin\u012f gydym\u0105, sustiprina imunin\u0117s sistemos b\u016bkl\u0119.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Atlikus tyrim\u0105, kuriame onkologine liga sergantys vaikai buvo maitinami parenteriniu b\u016bdu, po 28 dien\u0173 fiksuotas k\u016bno mas\u0117s padid\u0117jimas, atsik\u016brusi albumino ir transferino koncentracija (20). Lyginant parenteri\u0161kai maitintus pacientus su tais, kurie maitinosi patys, nustatyta, kad pirmiesiems grei\u010diau ir optimaliau u\u017etikrinamas reikiamas kalorij\u0173, baltym\u0173 ir kit\u0173 b\u016btin\u0173 med\u017eiag\u0173 kiekis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b style=\"mso-bidi-font-weight: normal;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">APIBENDRINIMAS<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Remiantis atliktu tyrimu, nustatyta, kad gaunamas didesnis energijos kiekis padidina vidutin\u012f i\u0161gyvenamum\u0105 480 dien\u0173, o nepakankamas energijos kiekis \u2013 suma\u017eina 331 diena (8).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Onkologin\u0117mis ligomis sergantys pacientai negali tinkamai maitintis ne tik d\u0117l tiesiogini\u0173 ligos padarini\u0173, bet ir d\u0117l nepageidaujamo gydymo poveikio: pykinimo, v\u0117mimo, vir\u0161kinimo sutrikim\u0173, burnos gleivin\u0117s pa\u017eeidim\u0173, skausm\u0173, psichologin\u0117s b\u016bsenos.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tinkamai nereaguojant \u012f prarast\u0105 k\u016bno svor\u012f, gali i\u0161sivystyti mitybos nepakankamumas. Tod\u0117l ligoniai jau\u010dia dar didesn\u012f silpnum\u0105, nuovarg\u012f, did\u0117ja imlumas infekcijoms, ma\u017e\u0117ja gydymo galimyb\u0117s ir veiksmingumas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tod\u0117l b\u016btina atkreipti d\u0117mes\u012f \u012f paciento mityb\u0105, laiku pasteb\u0117ti jos nepakankamum\u0105 ir pasitelkus \u012fvairi\u0173 sri\u010di\u0173 specialistus \u0161i\u0105 problem\u0105 spr\u0119sti.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Pareng\u0117: Dainora BUTKUT\u0116,<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Kazys BUTKUS.<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u017durnalas Internistas<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tarp da\u017eniausi\u0173 onkologin\u0117mis ligomis sergan\u010di\u0173 pacient\u0173 problem\u0173 \u2013 mitybos sutrikimai. Juos gali lemti \u012fvair\u016bs veiksniai. \u012erodyta, kad nepakankamas gaunamos energijos kiekis gali suma\u017einti i\u0161gyvenamum\u0105, ta\u010diau \u0161iai problemai skiriama vis dar per ma\u017eai d\u0117mesio. 2009 m. ESMO <i>(<\/i>angl. <i>European Society<\/i> <i>for Medical Oncology) <\/i>organizuotas simpoziumas \u0160veicarijoje buvo skirtas onkologini\u0173 ligoni\u0173 mitybos ypatumams ir problemoms analizuoti. Tai dar kart\u0105 \u012frodo, kad \u0161i tema i\u0161 ties\u0173 aktuali.<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[689,791,328,24772,5972,21,1041,549],"site":[],"post_item_type":[27345],"class_list":["post-10905","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-diagnostika","tag-mases","tag-nepakankamumas","tag-oncology","tag-pacientas","tag-sindromas","tag-svoris","tag-vitaminas"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=10905"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/10905\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=10905"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=10905"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=10905"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=10905"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=10905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}