Title Sestrinska skrb kod pacijenata oboljelih od karcinoma pankreasa Title (english) Nursing are in patients with pancreatic cancer Author Nataša Matoš Mentor Valentina Novak (mentor) Committee member Duško Kardum (predsjednik povjerenstva)Committee member Melita Sajko (član povjerenstva)Committee member Valentina Novak (član povjerenstva) Granter University North Defense date and country 2020-10-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Gušterača ili latinski pancreas, žlijezda ustrojena slično podušnoj žlijezdi, nalazi se poprijeko
na stražnjoj trbušnoj stijenci te iza želuca u razini prvog slabinskog kralješka. Poznata je još
kao mješovita žlijezda zbog obnašanja uloge žlijezde s vanjskim i unutarnjim izlučivanjem.
Karcinom gušterače pripada u rjeđe oblike karcinoma probavnog sustava, a gotovo 95%
pacijenata umire u roku od dvije godine od postavljene dijagnoze. Karcinomi gušterače se
mogu naći u egzokrinom i endokrinom
... More dijelu. U egzokrinom dijelu najčešće su cistične
novotvorevine i karcinom, dok se u endokrinom dijelu nalaze tumori koji su građeni od
stanica koje izlučuju inzulin. Karcinom je najčešće smješten u glavi gušterače (60%) te se u
manjem broju slučaja nalazi u trupu ili repu. Kod karcinoma gušterače dugoročna prognoza
ovisi o veličini i vrsti tumora, o metastaziranju, te zahvaćenosti limfnih čvorova. Simptomi
karcinoma gušterače su zanemarivi sve do uznapredovalog stadija bolesti. Kada se počinju
manifestirati, najčešće ovise o lokalizaciji i veličini tumora. Najčešće su prisutni bolovi u
epigastriju koji se šire u leđa ili pod lopatice. Zatim, opća slabost, gubitak apetita i gubitak na
težini neki su od simptoma koji su specifični za karcinom gušterače. Od ostalih simptoma
javljaju se mučnina i povraćanje, žutica zbog narušene funkcije gušterače te promjene
konzistencije i boje stolice. Kako se pacijenti najčešće javljaju zbog bolova i žutice, prvo se
provjeravaju laboratorijski nalazi te se radi UZV abdomena. Ostale tehnike koje se koriste za
postavljanje dijagnoze su endoskopski ultrazvuk (EUS), pozitronsko-emisijska tomografija
(PET/CT), kompjutorizirana tomografija (CT), magnetska rezonanca (MR), te endoskopska
retrogradna kolangiopankreatografija (ERCP). Prognoza pacijenata oboljelih od karcinoma
gušterače gotovo je uvijek loša zbog neadekvatnih metoda za rano otkrivanje. U trenutku
postavljanja dijagnoze gotovo 50% pacijenata ima već prisutnu metastatsku bolest. Ukupno
petogodišnje preživljavanje za sve stadije manje je od 4%. Mogućnosti liječenja ovise o
uznapredovalosti karcinoma. Neke od mogućnosti su operacija, kemoterapija, zračenje,
palijativno liječenje ili kombinacija svega navedenoga. Kod nedostatka mogućnosti liječenja
započinje se s palijativnom njegom. S primjenom palijativnog liječenja i njege potrebno je
započeti u ranim fazama bolesti, kako bi se i pacijentu i obitelji olakšalo cjelokupno shvaćanje
bolesti i svega što ona za sobom nosi te kako bi se uklonila bol i patnja, te pružila psihološka i
duševna skrb. Less Abstract (english) The pancreas or Latin pancreas, is gland formed similar to the long gland and is located across
the back abdominal wall and behind the stomach at the level of the first spinal cord. It is also
known as a mixed gland due to its role as gland with external and internal secretion.
Pancreatic cancer belongs to less frequent forms of GI cancer, and almost 95% of patients die
within two years of diagnosis. Pancreatic cancer can be found in the exocrine and endocrine
parts. In the exocrine part,
... More cystic neoplasms and carcinoma are the most common, while in the
endocrine part there are tumors that are made of insulin secreting cells. The cancer is most
often found in the pancreas head (60%) and in a small number of cases it is found in the
pancreas body or tail. In pancreatic cancer, the long-term prognosis depends on tumour size
and type, on metastasis, and lymph node involvement. Symptoms of pancreatic cancer are
negligible up to advanced stage of disease. When they start to manifest, they usually depend
on the localisation and size of the tumor. Epigastric pain, which spreads in the back or under
the shoulder blades, is usually present. Then, general weakness, loss of appetite and weight
loss are some of the symptoms specific to pancreatic cancer. Other symptoms include nausea
and vomiting, jaundice due to impaired pancreatic function and changes in stool consistency
and colour. As patients most often develop due to pain and jaundice, laboratory tests are first
performed and the abdominal UZV is performed. Other techniques used for diagnosis are
endoscopic ultrasound (EUS), positron emission tomography (PET/CT), computerised
tomography (CT), magnetic resonance (MRI), and endoscopic retrograde
collangiopancreatography (ERCP). The prognosis of patients with pancreatic cancer is almost
always poor due to inadequate early detection methods. At the time of diagnosis, almost 50%
of patients already have metastatic disease. A total of five years of survival for all stages is
less than 4%. Treatment options depend on the progression of cancer. Some of the
possibilities are surgery, chemotherapy, radiation, palliative treatment or a combination of all
of the above. Palliative care is initiated in the absence of treatment options. The use of
palliative treatment and care should be initiated in early stages of the disease, in order to
facilitate the entire understanding of the disease and everything it carries and to eliminate pain
and suffering, as well as to provide psychological and mental care. Less Keywords
karcinom gušterače
bol
palijativna skrb
Keywords (english)
pancreatic cancer
pain
palliative care
Language croatian URN:NBN urn:nbn:hr:122:769405 Study programme Title: Nursing Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-12-14 11:51:20
