Enteral zakudya - ndichiyani? Michere osakaniza odwala mu nthawi postoperative

Mu moyo pali zochitika zosiyanasiyana pamene munthu wamkulu sitingakhoze kutenga chakudya m'njira bwino. Izi zimachitika makamaka pambuyo opaleshoni. Nthawi ayambe munthu sangathe kutafuna ndi kukwera kugaya chakudya. Komanso pa nthawi ino wodwala akusowa zizipezeka pa zakudya kwa thupi kugwira ntchito kwa ziwalo zonse n'kulola umoyo. Pankhaniyi, polandirira msonkho mtundu ngati chakudya m'thupi monga kudya enteral.

Enteral zakudya - ndichiyani?

Mtundu uwu wa chisamaliro mtima, ndi mbali kuti chakudya abwera kupyolera mu chubu kapena njira yapadera. Nthawi zambiri ngati chakudya zosakaniza apadera ntchito. Amasiyana chakudya zachilendo kwa akulu, monga limati ena a wodwala kutenga mankhwala ena.

Ubwino wa mphamvu

Mtundu uwu wa chakudya ali ubwino wake kwa odwala:

1. Thupi - chakudya akudutsa mwachindunji mu dongosolo m'mimba, polola kuti mosavuta anaphatikizana ndi mphamvu wodwala pambuyo opaleshoni.
2. Cheap chakudya - chifukwa ntchito njira imeneyi sayenera mtengo kwambiri.
3. Zambiri ntchito njira zina - palibe lamulo la kuchuluka sterility, monga zokwanira kusamalira kafukufuku chakudya enteral kapena dongosolo kwa zosakaniza kudya m'kamwa.
4. Sayambitsa mavuto aakulu - kafukufuku ali anaikapo popanda vuto, choncho palibe imabwera yatsoka matendawo zoopsa ndi moyo pachiswe wodwalayo.
5. Zimathandiza kupereka thupi ndi zipangizo zonse zofunikira, ichi ndi chifukwa kusankha zikulumikizana mulingo woyenera kwa anthu.
6. Imathandiza kupewa kuoneka zotsatira atrophic kapepala kakuti m'mimba.

Zikuonetsa kwa zakudya enteral

Development wa mankhwala mu zaka ziwiri zapitazi n'zotheka kudziwa zabwino munthuyo njira opaleshoni amene angamuthandize kuchira msanga ndi kupeza mphamvu zoyenera ndi chiopsezo osachepera. Ndipo chakudya zosakaniza pambuyo opaleshoni ndi zipangizo zina mankhwala ali ndi ubwino ndi zizindikiro. Pali ena zikuonetsa yeniyeni zosakaniza kuti munthu ayenera, komanso njira mukadya. zakudya yokumba ndi kupereka pamene:

1. Wodwala chifukwa cha chikhalidwe sangathe kudya pamene anakomoka kapena sangathe kumeza.
2. Wodwalayo sangathe kudya zakudya - khalidwe la kapamba pachimake kapena magazi kapepala kakuti m'mimba.
3. Munthu wodwala akukana chakudya, ntchito ndiye amakakamizidwa zakudya enteral. Ndi chiyani icho pamene pali boma? Izo zimachitika mu matenda a anorexia nervosa, imene inu simungakhoze basi kutsegula m'mimba chakudya wamba, monga pali chiopsezo cha imfa patapita nthawi yaitali mphamvu kulephera. Komanso, zosiyanasiyana matenda wodwala akukana kudya, zimene zinachitikira dongosolo ntchito zakudya enteral, kudzaza thupi ndi zofunika zakudya kulimbana ndi matenda.
4. Mphamvu si zosowazo, chimachitika ndi kuvulala, catabolism, amayaka.

Anamuika kuti mtundu uwu wa mphamvu ndi zotsatirazi zinthu pathological:

• kusowa kwa mapuloteni mu thupi ndi mphamvu, ngati inu sangathe kupereka wambiri wa zinthu zimenezi mwachibadwa;
• likhoza zotupa zosiyanasiyana za mutu, khosi ndi m'mimba;
• ngati pali matenda pang'onopang'ono kwa chapakati mantha dongosolo, monga matenda Parkinson, cerebrovascular sitiroko, osiyanasiyana limati kukomoka;
• limati khansa pambuyo cheza ndi mankhwala amphamvu;
• Chakudya kawirikawiri analamula kuti matenda aakulu m'mimba: kapamba, njira pathological mu chiwindi ndi kapepala biliary, malabsorption syndromes , ndi waufupi matumbo, ndi matenda amene amatupitsa;
• mwamsanga alowererepo opaleshoni mu thupi;
• amayaka ndipo pachimake poyizoni;
• pamene fistula, sepsis;
• Ngati osauka matenda zovuta opatsirana;
• mu matendawa, chaukali;
• pa madigiri osiyana cheza kuwonongeka wa munthu.

Njira kuyambitsa michere zosakaniza

Enteral zakudya odwala zimasiyanasiyana kuti njira kudya:

1. Ntchito kafukufuku kwa kuyambitsa kusakaniza mu m'mimba.
2. Mphamvu Njira "sipping" - kulandira chakudya chapadera pakamwa pa sips yaing'ono.

Njirazi akutchedwanso chabe ndi akuchitachita. Origin - kudya enteral chubu, kulowetsedwa amapezeka ndi njira yapadera dispenser. The chachiwiri - yogwira, Buku, ikuchitika makamaka kudzera syringe. Ntchito njira imeneyi m'pofunika kukhala kuchuluka kwa osakaniza ndi jekeseni mokoma m'kamwa mwa munthu odwala. Chibwenzi, zokonda zapatsidwa kwa mapampu, ciliates, amene amalowa kudyetsedwa kwa kusakaniza.

Probes chakudya enteral

achibale ambiri odwala funsani zakudya enteral - ndichiyani ndi zipangizo zomwe ndi zofunika izi? Inde, chifukwa njira ngati chodzaza thupi ndi chakudya amafuna probes osiyana. Iwo anawagawa:

• nasogastric (nazoenteralnye) - woonda pulasitiki probes amene mabowo pa msinkhu winawake, ndipo weighting chifukwa chomasuka utsogoleli;
• percutaneous - kutumikiridwa pambuyo opaleshoni (pharyngoscope, gastrostomy, esophagostomy, eyunostomiya).

Modes a kapezedwe thupi

Kumvetsa nkhaniyi, zakudya enteral - chimene icho chiri, sikokwanira kukhazikitsa izo. Pali zambiri zina zabwino oyamba chakudya m'thupi mwa njira iyi, mwachitsanzo, mlingo chakudya cha kusakaniza. Pali modes angapo yodalirika mphamvu mtima.

1. Dyetsani osakaniza mathamangidwe zonse. Gavage wodwala amalandira chakudya pa liwiro ena, ndi 40-60 ml ya / hr. Ndiye katswiri amaona anachita wodwala. Pamene osakaniza bwino analekerera, liwiro akhoza pang'onopang'ono kuchuluka. Pa avareji izo kumawonjezera ndi 25 ml ya / hr kwa maola 8-12, ndiye kuti nthawi yomweyo mukhoza kuwonjezera ngati zambiri kufikira liwiro chofunika kukufika. Ngati opaleshoni umachitika yekha ndi wodwala mu chikhalidwe lalikulu, osakaniza ayenera kuperekedwa zosaposa 20-30 ml ya / hr. M'pofunika mosamala kuyan'ana mkhalidwe wa munthu. Nseru, m'mimba, kusanza, kupotokola kapena amachepetsa mlingo wa oyamba kapena zosakaniza zace, kapena ndende zake. Kumasintha ena chizindikiro chimodzi kuti palibe nkhawa kwa thupi.
2. Amapanga zakudya angathe kuperekedwa mu m'zinthu. Izi chakudya cyclical ndi kuti wodwalayo pambuyo zizipezeka pang'onopang'ono kuchepetsa usiku, pamaso yopuma, kubweretsa pa usiku. Njira yabwino wodwala ndiponso zingathe kuchitika kudzera gastrostomy chubu.
3. Gawo mphamvu (nthawi) sali ikuchitika onse. Iwo anasonyeza kuti odwala amene ali m'mimba kapena opaleshoni m'mimba chitachitidwa. Mphamvu zoterozo amatchedwa nthawi, monga nthawi anagwira maola 4-6.
4. Bolus Adyetsa. mode Izi zikufanana ndi chakudya nthawi zonse. osakaniza jekeseni ndi syringe kapena kudzera chubu, koma malamulo kulowa ali linkalimbikitsa. Pa liwiro uyu alibe upambana 240 ml ya pa theka la ola. Chiwerengero cha chakudya patsiku nthawi 3-5. Koma kuyamba kuwonjezera kusakaniza wokhazikika pa ml ya zana. Ngati wodwala akuvutika palibe vuto, ndiye pang'onopang'ono anawonjezera ndi 50 ml. Koma boma ili ndi owopsa yatsoka kawirikawiri m'mimba, choncho ayenera mankhwala ndi kuyang'anira ndi katswiri.

Mwachibadwa, modes awa sangakhale customizable kwathunthu kwa odwala onse zofuna zakudya enteral. Kusankha njira liwiro, ndiponso mphamvu ngati chakudya yobereka mu thupi chikuchitika ndi makhalidwe munthu.

Katundu zosakaniza kusankha

Osakaniza chakudya enteral ayeneranso asankhidwa kuti zigwirizane ndi zimene anthu odwala. Kusankha kwawo kumatengera zifukwa zingapo.

1. zakudya zabwino odwala postoperative ayenera wabwino mphamvu osalimba. Si zosakwana 1 kcal / ml.
2. The zikuchokera osakaniza ayenera kwina ndi lactose glyutein. zinthu izi zingathe kudzetsa chifuwa.
3. Sitiyenera kuposa osmolarity a 340 mOsm / l.
4. Kupewa mavuto ndi kuloŵerera chakudya chiyenera kukhala sanali viscous.
5. Quality osakaniza sayambitsa owonjezera m'mimba motility.
6. M'pofunika kuti pa izo zinali wa kampani ndi kukhalapo kwa kusinthidwa chibadwa cha mapuloteni.

Tikumbukenso kuti chilinganizo ana, komanso njira anapangidwa kuchokera mankhwala achilengedwe, si oyenera zakudya enteral. Iwo ali anthu akuluakulu osati moyenera, choncho sangathe kubweretsa mukufuna. Kwa odwala akufunikira chakudya, mitundu zosakaniza yapangidwa, tikambirana pansipa.

osakaniza monomeric

Dzina zosakaniza Mzimuyo ntchito zawo. Iwo mulibe zofunika kufufuza zinthu zonse, koma amagwiritsidwa ntchito mu nthawi postoperative. zosakaniza oterowo wapangidwa ndi shuga ndi mchere, kusonyeza kuti ayambe yaing'ono intestine magwiridwe yomweyo pambuyo opaleshoni. Pamaso pa kusanza kapena kutsekula m'mimba ndi chakudya chabwino kuthandiza madzi ndi electrolyte bwino mu thupi. zosakaniza amenewa ndi 'woyendera "," Mafusol "," Regidron "," Tsitroglyukosolan "," Orasan "ndi ena.

The zikuchokera elemental kwa chakudya

kotunga mphamvu odwala zachokera pa zinthu ndendende osankhidwa mankhwala. Iwo ntchito milandu yeniyeni matenda kagayidwe kachakudya mu thupi pathologies monga chiwindi ndi impso kulephera, matenda a shuga ndi kapamba. Pankhaniyi, kapamba, chiwindi ndi impso sangathe ntchito zake zenizeni, kotero zosakaniza izi kuthandiza munthu kuti osachepera pang'ono kubwezeretsa ntchito kwambiri. Zopangira mtundu uwu monga "Vivoneks", "Fleksikal", "Lofenalak" ndi ena.

theka-elemental osakaniza

zosakaniza izi zakudya odwala zambiri ntchito kuposa anthu m'mbuyomo. Ichi ndi chifukwa chakuti iwo ndi mosamala kwambiri ndi oyenera osiyanasiyana odwala amafuna kugwiritsa ntchito zakudya enteral. Apa, mapuloteni ndi mu mawonekedwe a amino zidulo ndi mapeputisayidi, amene amalola kuti mosavuta odzipereka mu thupi. njira zoterezi chagwiritsidwa yomweyo pambuyo opaleshoni pa ntchito m'mimba siudzalandilidwa ngathi lamulo. Zikuphatikizapo "Nutrien elemental", "Nutrilon Pepto TSC", "Peptisorb", "Peptamen".

Chitsanzo polima zikulumikizana

Mtundu ntchito matenda ambiri pambuyo ntchito, pamene munthu ali chikomokere. Iwo ali abwino kwambiri chamoyo wamkulu mu kapangidwe kake. njira amenewa ali ndi mchere zonse zofunika, kufufuza zinthu, mapuloteni, mafuta, chakudya. Iwo agawidwa mu mitundu itatu.

1. Youma kuti sitimadzipereka ndi kuperekedwa ndi gavage. Lotsatira enteral zakudya: "Nutrizon", "Berlamin yodziyimira payokha", "Nutrikomp Standard".
2. Madzi, amene angathe kuperekedwa nthawi yomweyo. Iwo anapangidwa kuti zochitika zimene sitingathe kutaya miniti, kupereka zakudya zofunika anthu. Zikuphatikizapo "Berlamin yodziyimira payokha", "Nutrikomp Phula", "Nutrizon Standard" ndi ena.
3. Zosakaniza ntchito pakamwa. Izi "yodziyimira payokha Berlamin", "Nutridrink", "Fortikrem" ndi zina zotero.

A chisakanizo cha mbali

Mtundu wa magetsi pa cholinga ofanana ndi maganizo a mankhwala elemental. Iwo apangidwa kuti abwezeretse magwiridwe a thupi pa kudwala makamaka. Iwo kukonza kagayidwe kachakudya kupuma kulephera, mkhutu aimpso ndi chitetezo chokwanira chiwindi.