Damdawi inah damlo hmui hmanga ei thei lo, bag lian tak kaltlangin vein kaltlangin tui pek an nih lai i hmu ngai em? Saline angin kan ngai fo thin. Mahse, saline chauh a ni ngai lo. A châng chuan mi pakhat dam khawchhuahna atana a mamawh nutrient zawng zawng awmna tui bik a ni. Chu chu ‘intravenous nutrition’ kan tih chu a ni a, damdawi lam hawi chuan Parenteral Nutrition .
A awlsam zawngin, Parenteral Nutrition hi eng nge ni?
A awlsam zawngin, hei hi i digestive system (i kâ atanga i hnute thlenga system pumpui) i bypass vek a, thisen kalna hmanga i taksaah nutrients direct-a i thlen hian a ni. "Paranteral" tih thumal hi "digestive system pawn lam" tihna a ni.
Enteral nutrition chungchang hi i hre tawh mai thei. Hei hian hnar emaw, pum chhunga kawngkhar te tak te hmanga dah tube hmangin chaw tui tak chu pum emaw, intestine tenau emaw-ah direct-a pek a ni. Mahse parenteral nutrition hmang hian he system pumpui hi bypass a ni a, thisenah hian nutrients te chu direct-in an dah lut a ni. Damdawi lam dinhmun thenkhatah chuan he hmanrua hi hun rei lote emaw, rei tak emaw chhung atan a ngai thei a ni. Mi thenkhat chu an ei tur ei tur tihpun nan hei hi pek an ni. Midangte chuan he intravenous nutrition hmang hian an calorie zawng zawng an hmuh vek a ngai a ni.
Hetiang hmanraw chi hrang hrangte hi engte nge ni?
Hetiang parenteral nutrition hman dan hi chi hnih ah then theih a ni. Pakhat chu ei leh in pek zat a zirin a ni a, pakhat zawk chu ei leh in pekna atana hman tur vein chi hrang hrang a zirin a ni. Heng pahnih hi chiang takin i hrethiam ang u.
1. Nutrition pek zat atanga thliar hran
Hei hi chi hnih lian tak a ni.
| Nutritional system a ni | A awlsam zawngin... |
|---|---|
| Parenteral Nutrition (PPN) hmanga ei leh in tur thenkhat (partial Parenteral Nutrition) 1.1. | Hei hi nutritional method dang bakah pek a ni. Miin a hmuiah tlem a ei thei a, mahse taksain a mamawh ei tur pe turin a tawk lo va, ei leh in tha lo a tuar a ni tih han ngaihtuah teh. Chutiang hunah chuan he hmanrua hi ei tur awm lo thenkhat emaw, calorie tam zawk emaw pek nan hman a ni. |
| Parenteral Nutrition zawng zawng (TPN) 1.1. | Hei hi vein hmanga ei leh in kimchang pek dan a ni. Hei hi an chaw ei dan hmang thei lo tak tak tan chuan a tul hle. Damdawi lam thil thenkhat avang hian chaw an ei thei lo va, nutrient an la lut thei lo bawk. Hun dangah chuan chaw ei chakna (digestive system) chu chawlh hahdamna pe a, a dam theih nan phalsak a ngai a ni. Chutiang hunah chuan TPN hman a ni. |
2. Vein hman chi hrang hranga thliar hran
| Vein chi hrang hrang | Hrilhfiahna |
|---|---|
| Vein lian tak kaltlangin (Central Parenteral Nutrition - CPN) . | Hei hian taksa chhunga vein lian tak, main-ah chaw pek a huam a ni. Hei hi a tlangpuiin Superior Vena Cava, collarbone hnuaia vein lian tak, thinlung lam pan nghal mai a ni. He vein hi a lian avangin concentrated zawk, calorie tamna liquid nutrient a pe rang thei hle. Hei vang hian total parenteral nutrition (TPN) pek nan hman a ni. |
| Vein te tak te, a sir lam (Peripheral Parenteral Nutrition - PPN) kaltlangin . | Hei hian kut, ke, a nih loh leh kawr chhunga vein te tak tea chaw pek a huam a ni. A tih a awlsam avangin he method hi temporary partial nutrition (PPN) pekna atan hman a ni. |
He nutritional liquid hian eng nge a pai?
Hei hi chemical formula a ni. Mahse hei hi mi zawng zawng hnena pek dan inang vek a ni lo. I taksa mamawh dan azirin i thisen test result a zirin customized nutritional solution pek i ni .
Taksa tana ei tur pawimawh paruk zawng zawng hi a zat hrang hrangin a pai thei vek a:
- Tui
- Carbohydrates (thawhrimna atan) .
- Protein (taksa thanna leh siamthatna tur) .
- Fat (energy leh essential fatty acids atan) 1.1.
- Vitamin a awm lo
- Mineral chi hrang hrang a awm
He nutritional formula hi a famkim em em a, duh chuan mi pakhat chu a dam chhung zawng he system hmang hian ka ei lovin engmah a ei thei lo.
Eng dinhmunah nge heng hmanrua te hi hman a nih?
Engtikah nge partial nutrition (PPN) hi a tul?
PPN hi hun eng emaw chen hman a ni fo. Entirnan, mi pakhat chu tube feeding emaw oral feeding emaw-a zawi zawiin a thlak hmain chakna tihpunna rang tak pek nan hman a ni. Tin, damlo hun rei tak damdawi ina awmte chu chhan hrang hrang avangin ei leh in lama harsatna an tawk thei bawk. PPN hi ei tur dang pek belh nan pawh an hmang tlangpui bawk.
Engtikah nge total parenteral nutrition (TPN) hi a mamawh?
I digestive system a thawk tha lo tak tak a nih chuan, emaw, chu system tana chawlh hahdam kim ngai gastrointestinal disease i neih chuan TPN i mamawh mai thei.
TPN a tulna tur dinhmun bik thenkhat chu hetiang hi a ni:
- Abdominal surgery lian tak tak neih a ni
- Cancer natna damdawi chemotherapy a ni
- Intestinal-a thisen kal tlem (Intestinal ischemia) .
- Intestine tenau emaw, intestine lian emaw-a intestinal obstruction awm
- Intestinal dysfunction (Ileus rei tak) 1.1.
- Gastrointestinal atanga thisen chhuak
- Radiation hmanga enkawlna avanga intestine chhiatna (Radiation enteritis) .
- Nau piang hma lutuk
- Nausen te zingah necrotizing enterocolitis a awm thin
- Hun rei tak chhunga ril\am
- Inflammatory bowel natna, Crohn natna ang chi te
- Short bowel syndrome (intestine thenkhat surgery hmanga lakchhuah hnua lo awm thin) .
- Graft-versus-host natna a ni
He enkawlna hi engtin nge buatsaih leh kalpui a nih?
Hei hi doctor team pakhatin ruahmanna fel tak leh thawhhona tha tak an neih a ni.
Enkawlna atana inbuatsaih
I medical team (doctor, nurse, leh nutritionist) te chuan i hriselna chanchin, body mass index (BMI), leh thisen test result te uluk takin an enfiah ang a, i mamawh nutritional formula chu an hre thei ang. He nutritional liquid hi specialist-in darkar 24 chhunga a mamawh zat a siam a ni. I mamawh ni thlengin refrigerator-ah dah tur a ni. Hman hma darkar tlemteah lakchhuah a ni a, room temperature-ah a lo thleng turin dah a ni.
Taksa chhunga catheter dah dan tur
Tube, catheter an tih chu i taksaa dah chu surgery tenau tak a ni. Chutianga tih a nih hma chuan i natna tihziaawmna tur leh i rilru tihreh nan numbing medication pek i ni ang. Tichuan, catheter dahna tur hmun chu uluk takin tihfai a ni ang a, disinfected a ni ang.
Doctor chuan needle hmangin guidewire chu vein chhungah a dah a, chutah chuan needle chu a la chhuak a, wire kaltlangin catheter chu vein chhungah a thread lut a ni. Ultrasound emaw X-ray emaw hmangin hmun dik takah a awm leh awm loh enfiah theih a ni.
Catheter chi thum hman a ni a, chungte chu:
- External “tunneled” catheter: Hei hi vun hnuaia hla vak lo kal tur leh hmun dang atanga chhuak thei tura siam a ni.
- Fully implanted catheter: Hei hi vun hnuaiah a awm vek. Chaw pek a ngaih hunah chuan vun hnuaia port bik pakhatah needle dahin a inzawm khawm thin.
- Peripherally inserted central catheter (PICC): Hei hi kut chunglam vein kaltlangin dahin, thinlung bula vein lian takah threaded a ni. Hei hi kar 6 aia rei lo ei leh in mamawh tan hman a ni tlangpui.
A pawimawh ber chu he thil zawng zawng hi thianghlim tak, sterile tak hnuaiah tih a ni a, natna kai theihna a awm avangin.
Engtin nge nutrition pek leh enkawl a nih?
Chaw pek hi darkar 10-12 chhung a ni tlangpui a, chuvangin mi tam tak chuan zanah an mut dawnin an ti thin. He enkawlna hi damdawi inah te, hun rei tak enkawlna hmunah te, a nih loh leh in lamah pawh tih theih a ni .
In lama i tih a nih chuan medical team chuan nangmah emaw, i enkawltu emaw hnenah training kimchang an pe ang a, chutah chuan natna hrik kai chhinchhiahna hriat theih dan tur, hmanrua thianghlim taka vawn dan tur leh tube thlak dan tur te pawh a tel ang.
Medical team chuan enkawl lai hian an lo enkawl reng ang che.
- I taksaa tui lut leh chhuak zat a teh a ni.
- Rih zawng leh san zawng enfiah fo thin a ni.
- Thisen test hi a hun takah tih thin a ni a, nutritional formula tihdanglam a ngai em tih enfiah thin a ni.
A bik takin heng thilte hi an ngaihtuah ber a ni:
- Electrolytes leh kal hnathawh (BUN/Creatinine) .
- Thisen sugar level (hyperglycemia emaw hypoglycemia emaw pumpelh) .
- Mineral level a ni
- Liver hnathawh dan chhinchhiahna (Aminotransferases, Bilirubin) .
Hetiang hmanrua hian eng nge a thatna leh a hlauhawmna?
Damdawi dang ang bawkin he damdawi hian hlawkna leh hlauhawmna a nei vek a ni.
Hlawkpuina
Hetiang hmanraw hlawkna ber chu i chaw ei dan (digestive system) hian natna khirh tak emaw, operation emaw i neih hnua a dam theihna tura a mamawh chawlhna a pe a ni.. Damlo, hun rei tak damdawi ina awm, a bik takin kum upa lam tan ei leh in mamawh a pe a, taksa tichak turin a pui bawk. Chaw ei kawng a chhiat vek tawhte leh nausen piang hmaa ei tur pangngai ei thei lo tan nunna chhanhimtu a ni.
Risk leh Complication awm thei te
Hetiang method hian enteral feeding aiin complication a thlen theihna a sang zawk. Harsatna lian ber pahnih chu catheter kaltlangin thisenah hrik a lut thei a, hun rei tak hman loh vanga chaw ei chakna a chak lo thei bawk.
| Complication awm fo thin | A sawifiahna awlsam tak |
|---|---|
| Kaichhawng | Catheter kaltlangin thisenah bacteria a lut thei a ni. He natna hi taksa pum puiah a darh chuan nunna atana hlauhawm tak sepsis tih chu a thlen thei a ni. |
| Thisen a chhuak thin | Catheter leh vein inzawmna hmunah hian thisen zam a lo awm thei a ni. |
| Chaw ei chak lohna (GI atrophy) . | Kar hnih vel zet system hman loh hnuah a performance a tlahniam tan ta a ni. Mahse, chaw i ei leh chuan zawi zawiin a pangngaiin a lo kir leh thin. |
| Sugar level inthlauhna a awm | Hyperglycemia emaw hypoglycemia emaw hi a awm fo a, insulin leh nutritional regimen siamrem hmanga enkawl theih a ni. |
| Liver lama harsatna a awm | He damdawi hi hun rei tak ei thin zinga 50% vel chuan kum 5-7 chhungin liver disease (PNALD) an nei thei a ni. Hei hi a chhan dik tak hriat a la ni lo. |
| Gallbladder lama harsatna a awm | Digestive system a thawh that loh avangin gallbladder-a bile chu a chhuak thei lo va, a pungkhawm thei a, lung a siam thei a ni. |
| Ruh demineralization tih a ni | Hetiang enkawlna hi rei tak dawng thinte hian vitamin leh mineral tlakchhamna (calcium, magnesium, vitamin D) vangin ruh ti na thei natna, ruh natna ( osteoporosis) te an nei thei a ni. |
Tin, hlauhawm dang pawh a awm a, chu chu catheter dah laiin hliam, tui tam lutuk, leh riltam tih te hi a ni.
Engtin nge hmui hmanga ei i tan leh ang?
Parenteral nutrition hi hun rei tak chhung tih theih ni mahse, doctor-te chuan a rang thei ang bera tube feeding emaw oral feeding emaw-ah thlak leh an tum fo thin. Hei hi a chhan chu hun rei tak chhunga harsatna awm lo turin a ni.
He inthlak danglamna hi zawi zawiin leh zawi zawiin tih a ni a, a chhan chu i damdawi lam dinhmun hnuaia awm ang bawkin, hun engemaw chen "dormant" tawh digestive system chuan hna a thawk tan nghal dawn lo.
1. Liquid diet chiang tak hmangin tan la rawh .
2. Taksain a chhang tha a nih chuan full liquid diet ah switch rawh .
3. A tawp berah chuan zawi zawiin solid foods te chu rawn luh tir rawh .
He enkawlna hi i chawlhsan hnuah pawh medical team chuan hun engemaw chen chu i rihna leh i ei leh in level chu an enfiah chhunzawm zel ang.
Parenteral Nutrition hi damdawi hmanga enkawl a ni a, natna khirh ber berte pawhin an hmang thin a, mahse a chang chuan nunna chhanhim nan a ngai thin. Hei hi nangmah emaw, i hmangaih tak emaw tan a tul a nih chuan thil harsa leh thil thar deuh a ni thei. Mahse hun engemaw chen hnuah chuan i nitin nunphungah a tel ve tawh dawn a ni. A pawimawh ber chu medical team-in thupek an pek ang chiah zawm a, harsatna an neih chuan hriattir hi a ni.
Take-Home Thuchah a ni
- Parenteral Nutrition hi chaw ei leh in (digestive system) hman theih loh laiin vein hmanga thisenah direct-a nutrition thlen dan a ni.
- A chi hnih a awm a, chungte chu PPN, supplemental nutrition anga pek leh TPN, complete nutrition pe thei te an ni.
- Hei hi nunna chhanhim thei damdawi ni mah se, hlauhawmna lian tak tak a awm a, chu chu natna hrik, thisen zam, leh thin lama harsatna te a ni.
- He enkawlna hi doctor, nurse leh nutritionist team enkawlna hnuaiah tih tur a ni.
- Nangmah emaw, i hmangaih tu emaw hian in lama he enkawlna hi i neih a ngai a nih chuan training mumal tak dawng a, faina kawngah nasa taka fimkhur a pawimawh hle. Thil ngaihtuah leh zawhna i neih chuan i doctor nen inbia nghal rawh.
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