Tsɔe be eva hiã be woawɔ dɔ gã aɖe na wò alo ame aɖe si nènya le dɔgboa me. Alo be dɔgbomedɔ sesẽ aɖe le ŋuwò si wɔe be mète ŋu ɖua nu alo noa naneke to nu me o. Aleke nèwɔna naa nunyiame kple ŋusẽ si ŋutilãa hiã? Ɣemaɣie míezãa mɔnu tɔxɛ sia si woyɔna be ‘nunyiame si wodona ɖe ʋuka me’. Esia nye nusi to vovo kura eye wòsesẽ wu dzetsi si wozãna ɖaa. Na míalé ŋku ɖe nyaa ŋu tsitotsito.
Nukae nye nunyiame si wodona le dɔgboa me?
Togbɔ be ŋkɔa ɖi nusi wɔ nuku vie hã la, gɔmesesea le bɔbɔe ŋutɔ. Nya "parenteral" gɔmee nye "nuɖuɖumeŋusẽ godo." Eyae nye be, Parenteral Nutrition nye ne nuɖuɖu si míeɖuna to míaƒe nu me yi dɔgboa me, dɔgbowo xɔe, eye wòtrɔna le aklã me hafi woxɔna ɖe ŋutilã me. Woyɔe be Parenteral Nutrition , eye wotsɔa nunyiame siwo katã ŋutilã hiã la dea ʋuka aɖe me tẽ.
Kpuie ko la, esia nye míaƒe dɔgbo bliboa toto, adze egɔme tso nu me va wu enu le aɖuɖɔtoe me, eye wòatsɔ nunyiamewo katã ayi ʋuka aɖe me tẽ.
Ðewohĩ ŋkeke ʋɛ aɖewo koe ahiã be ame aɖewo nano esia, gake ahiã be ame bubuwo nanoe kwasiɖa geɖe, ɣleti geɖe, alo woƒe agbemeŋkekewo katã gɔ̃ hã.
Mɔnu sia ƒomevi vevi kawoe?
Woate ŋu ama esia ɖe hatsotso vevi eve nu. Ðeka nɔ te ɖe nunyiame agbɔsɔsɔme si wona dzi, eye evelia nɔ te ɖe ʋuka si naa nunyiamea dzi.
| Woma wo ɖe hatsotsowo me le nunyiame agbɔsɔsɔme si wona nu | |
|---|---|
| Ƒomevi | Kpuie ko la,... |
| Nuɖuɖu Si Wotsɔna Toa Nu Me Katã (TPN) . | Wotsɔa esia naa amesiwo mate ŋu azã woƒe dɔgbo ƒe dɔwɔwɔ kura o . Enaa nunyiame si ŋutilã hiã la ƒe alafa memama 100. |
| Nuɖuɖu Si Wotsɔna Toa Nu Me ƒe Akpa aɖe (PPN) . | Wotsɔa esia naa amesiwo ate ŋu aɖu nu vi aɖe to nu me, gake mesɔ gbɔ na ŋutilã o, kple amesiwo meɖua nu nyuie o. Wotsɔa esia naa ame abe nunyiame bubu ene. |
| Woma wo ɖe hatsotsowo me le ʋuka si me woɖua nu le nu | |
| Nuɖuɖu si Wozãna le Titina (CPN) . | Wotsɔa esia naa ʋuka gã aɖe si le kɔ alo akɔta si yia dzia gbɔ tẽ. Esia wɔnɛ be nuɖuɖumeŋusẽ geɖe wu kple nunyiame si me nunyiame le wu sua ame si. Esiae nye mɔnu si wozãna tsɔ naa TPN. |
| Nuɖuɖu si Wotsɔna Toa Nutome (PPN) . | Wotsɔa esia naa ʋuka sue aɖe si le alɔ, afɔ, alo kɔ me. Wozãnɛ tsɔ naa nunyiame si nɔa anyi ɣeyiɣi kpui aɖe, si ƒe akpa aɖe (PPN). Ele bɔbɔe be woadoe, gake menaa nuɖuɖumeŋusẽ si sɔ gbɔ o. |
Nukae le tsi si me nunyiame le sia me?
Menye dzetsi ƒe aŋetu koe esia nye o. Esia le abe ‘cocktail’ si me nunyiame le si wowɔ etɔxɛe na dɔnɔa ene. Wowɔa tsi sia to akɔntabubu le nusi tututu wò ŋutilã hiã ŋu, eye wobua nu geɖe abe wò ƒexɔxɔ, wò kpekpeme, atikewɔwɔ ƒe nɔnɔme, kple ʋu ŋuti nyatakakawo ene ŋu.
Esiawo koŋ dometɔ aɖewoe nye:
- Tsi
- Carbohydrates (hena ŋusẽ) .
- Protein (hena ŋutilã ƒe tsitsi kple lãmenugbagbeviwo ɖɔɖɔɖo) .
- Ami/Ami (hena ŋusẽ geɖe wu) .
- Vitamin siwo le lãme na ame
- Dze siwo wotsɔa mineral wɔe (Electrolytes) .
Egbɔkpɔnu sia de blibo ale gbegbe be ame ate ŋu anɔ agbe ɖe esia ɖeɖeko nu le eƒe agbemeŋkekewo katã me evɔ maɖu naneke to nu me o.
Nɔnɔme kawo mee wonaa nunyiame si wodona ɖe ʋuka me le?
Ne nɔnɔme sesẽ siwo me womate ŋu ana nuɖuɖu dɔnɔa le mɔ bubu aɖeke nu o ko hafi wozãa esia.
Nɔnɔme siwo me wòhiã be woana nunyiame blibo si wotsɔa dɔgbo wɔe (TPN).
- Le amekoko be woaɖe dɔgboa ƒe akpa gã aɖe ɖa vɔ megbe
- Atikewɔwɔ na kansa ƒe nugbegblẽ sesẽwo
- Dɔgbo ƒe mɔxexe
- Ʋu ƒe sisi yi dɔgboa me dzi ɖe kpɔtɔ (Intestinal ischemia) .
- Dɔgbo ƒe dɔléle siwo nana ame ƒe lãme xɔa dzo, abe Crohn ƒe dɔléle sesẽ ene
- Vidzĩ siwo wodzi kaba ŋutɔ eye woƒe dɔgbowo metsi o
- Aɖuɖɔtoe sesẽ si nɔa anyi didi
- Atikewɔwɔ me nɔnɔme sesẽ bubu siwo hiã be woagbɔ ɖe eme bliboe na dɔgboa
Nɔnɔme siwo me wòhiã be woaɖu nunyiame ƒe akpa aɖe (PPN).
Zi geɖe la, wonaa PPN be wòana ŋusẽ geɖe wu dɔnɔ siwo mekpɔa nu nyui ɖuna o le kɔdzi nɔnɔ ɣeyiɣi didi kple nu me nono si mesɔ gbɔ o ta.
Catheter dede kple edada
Menye cannula si nède asi me koe nye esia o. Esia bia be woatsɔ mɔ̃ tɔxɛ aɖe si woyɔna be catheter ade ʋuka gã aɖe me le wò ŋutilã me. Esia le abe amekoko sue aɖe ene. Gake mègatsi dzi o, woatsɔ atike si naa alɔ̃dɔdɔ wò (numb) eye woawɔ esia. Ðɔktaa akɔ wò ŋutigbalẽ ŋu eye wòatsɔ ultrasound alo X-ray ƒe kpekpeɖeŋu ade catheter la ʋukaa me tẽ.
Catheter ƒomevi vevi etɔ̃e li:
- External “tunneled” catheter: Esia nye mɔ̃ si wotsɔ dea ŋutigbalẽa te hena didiƒe kpui aɖe eye emegbe wòdona le teƒe bubu.
- Catheter si wotsɔ de eme bliboe: Esia ɣla eɖokui ɖe ŋutigbalẽa te keŋkeŋ. Do sue aɖe koe le ŋutigbalẽa te si dzi wodoa atike la ɖo.
- PICC line: , . ( 6 ) .
Nunyiame ƒe tsi sia xɔa abe gaƒoƒo 10-12 ene hafi ɖoa ŋutilãa gbɔ. Eyata ame geɖe dea eŋu le zã me ne wole alɔ̃ dɔm. Woate ŋu awɔ atikewɔwɔ sia le kɔdzi, alo le aƒeme kple hehe si hiã. Gake ele be woakpɔ nu siawo gbɔ nyuie ŋutɔ be woaƒo asa na dɔlékuiwo xɔxɔ .
Afɔku kple kuxi kawoe ate ŋu ado tso eme?
Togbɔ be dɔ sia xɔa ame ɖe agbe hã la, ate ŋu ahe afɔku kple kuxi aɖewo vɛ. Esia tae ɖɔktawo zãnɛ le nɔnɔme sesẽwo me ko eye woyia edzi léa ŋku ɖe dɔnɔa ŋu.
| Kuxi si dona tso eme | Numeɖeɖe bɔbɔe |
|---|---|
| Dɔdzedze | Dɔlékuiwo ate ŋu ato ʋuka si me ʋu sina tona me age ɖe ʋukawo me. Esia ate ŋu akaka eye wòahe nɔnɔme aɖe si ate ŋu ade ame ƒe agbe afɔku me si woyɔna be sepsis vɛ. Esiae nye afɔku vevitɔ kple esi nu sẽ wu . |
| Ʋu ƒe Ʋuʋudedi | Ʋu ƒe sisi ate ŋu adzɔ le afisi ʋukaa do ƒome kple ʋukaa le. |
| Aklã me kuxiwo | TPN nono ɣeyiɣi didi ate ŋu agblẽ nu le aklã ŋu. Wogayɔa esia be aklãdɔ si do ƒome kple nunyiame si woyɔna be Parenteral nutrition-associated liver disease (PNALD). |
| Sukli si le ʋu me ƒe masɔmasɔ | Sukli ƒe agbɔsɔsɔ ate ŋu adzi ɖe edzi kasia (Hyperglycemia) alo aɖiɖi (Hypoglycemia). Wokpɔa esia dzi to insulin dodo na ame me. |
| Ƒuwo ƒe ƒuƒu | Le ɣeyiɣi didi me la, tɔtrɔ siwo vaa nuwo abe calcium kple vitamin D ene me ate ŋu ana ƒuwo nagbɔdzɔ (Osteoporosis). |
| Gallbladder ƒe kuxiwo | Esi nuɖuɖumeŋusẽ mele dɔ wɔm nyuie o ta la, ʋumenugbagbeviɣi si le aɖuɖɔtoea me ate ŋu aƒo ƒu eye wòazu kpe. |
Aleke nègava zu numame na wò be nàgaɖu nu to nu me?
Ne dɔgbo ƒe dɔwɔwɔ gadze dɔwɔwɔ gɔme ake ko la, ɖɔktawo dzea agbagba be yewoana dɔnɔa nagaɖu nu me kaba ale si woate ŋui, elabena dɔgboa ateŋu azu "kuviatɔ" ne womezãe edziedzi o.
Wowɔa esia nyuie ŋutɔ.
Womedzea bli ɖuɖu gɔme enumake o. Wodzea egɔme kple ‘nuɖuɖu si me tsi le si me kɔ’. Le kpɔɖeŋu me, nuwo abe tsi si woɖa, mɔli si me wode dzee, kple tsi ene. Ne ŋutilãa te ŋu doa dzi la, ekema woyia nuɖuɖu si me tsi le bliboe dzi. Ema ko hafi wotsɔa wo dea nuɖuɖu sesẽwo me.
Le ɣeyiɣi sia katã me la, atikewɔlawo ƒe ƒuƒoƒoa le ŋku lém ɖe nunyiame si le wò ŋutilã me ŋu nyuie.
Gbedasi si Wotsɔ Yi Aƒeme
- Nunyiame si wodona le nu me nye agbeɖeɖedɔ vevi aɖe ŋutɔ na amesiwo mate ŋu aɖu nu to nu me o.
- Le esia me la, wotsɔa nunyiame siwo katã ŋutilã hiã la yia ʋuka me tẽ.
- Ƒomevi vevi eve li: TPN (nunyiame si wozãna le dɔgboa me bliboa) kple PPN (nunyiame si wotsɔna toa dɔgboa me ƒe akpa aɖe).
- Esi wònye be mɔnu sia hea afɔkuwo abe dɔlékuiwo xɔxɔ, ʋu ƒe sisi, kple aklã me kuxiwo ene vɛ ta la, ɖɔktawo ƒe dzikpɔkpɔ sesẽ ko hafi wowɔa esia.
- Ne woŋlɔ atike sia na wò alo ame aɖe si nènya la, mègavɔ̃ o. Bia wò ɖɔkta tso eŋu eye nàse egɔme nyuie. Wɔ ɖe eƒe mɔfiamewo dzi pɛpɛpɛ.
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