Tangoganizani kuti inuyo kapena munthu amene mumamudziwa wachitidwa opaleshoni yaikulu ya m'mimba. Kapena muli ndi vuto lalikulu la m'mimba lomwe lakupangitsani kuti musadye kapena kumwa chilichonse pakamwa. Kodi mumapatsa bwanji thupi zakudya ndi mphamvu zomwe limafunikira? Pamenepo ndi pamene timagwiritsa ntchito njira yapaderayi yotchedwa 'zakudya zamkati'. Ichi ndi chinthu chosiyana kwambiri komanso chovuta kuposa njira yachizolowezi ya saline. Tiyeni tiwone tsatanetsatane.
Kodi zakudya za parenteral ndi chiyani?
Ngakhale dzinali likumveka lachilendo pang'ono, tanthauzo lake ndi losavuta. Mawu oti "parenteral" amatanthauza "kunja kwa dongosolo la m'mimba." Izi zikutanthauza kuti, Parenteral Nutrition ndi pamene chakudya chomwe timadya kudzera mkamwa mwathu chimapita m'mimba, chimayamwa ndi matumbo, ndipo chimasinthidwa m'chiwindi chisanalowe m'thupi. Chimatchedwa Parenteral Nutrition , ndipo michere yonse yomwe thupi limafunikira imaperekedwa mwachindunji mumtsempha wamagazi.
Mwachidule, izi zikupitirira matumbo athu onse, kuyambira pakamwa mpaka ku anus, ndikupereka michere yonse mwachindunji mumtsempha wamagazi.
Anthu ena angafunike kumwa mankhwalawa kwa masiku ochepa okha, pomwe ena angafunike kumwa kwa milungu ingapo, miyezi, kapena moyo wawo wonse.
Kodi mitundu ikuluikulu ya njira iyi ndi iti?
Izi zitha kugawidwa m'njira ziwiri zazikulu. Choyamba chimadalira kuchuluka kwa zakudya zomwe zaperekedwa, ndipo china chimadalira mtsempha womwe umapereka zakudyazo.
| Kugawa m'magulu malinga ndi kuchuluka kwa zakudya zomwe zimaperekedwa | |
|---|---|
| Mtundu | Mwachidule... |
| Zakudya Zonse za Parenteral (TPN) | Izi zimaperekedwa kwa iwo omwe sangathe kugwiritsa ntchito matumbo awo konse . Zimapereka 100 peresenti ya zakudya zomwe thupi limafunikira. |
| Zakudya Zopatsa Thanzi Pang'ono (PPN) | Izi zimaperekedwa kwa iwo omwe angathe kudya pang'ono pakamwa, koma sizikwanira thupi, komanso kwa iwo omwe ali ndi vuto la kudya. Izi zimaperekedwa ngati chakudya chowonjezera. |
| Kugawa malinga ndi mtsempha wodyetsa | |
| Zakudya Zapakati pa Mabanja (CPN) | Izi zimaperekedwa mumtsempha waukulu pakhosi kapena pachifuwa womwe umapita mwachindunji kumtima. Izi zimathandiza kuti munthu akhale ndi ma calories ambiri komanso zakudya zambiri. Iyi ndi njira yomwe imagwiritsidwa ntchito popereka TPN. |
| Zakudya Zam'mimba za Parenteral (PPN) | Izi zimaperekedwa mumtsempha waung'ono m'dzanja, mwendo, kapena khosi. Zimagwiritsidwa ntchito popereka zakudya zochepa (PPN) kwa kanthawi kochepa. N'zosavuta kupereka, koma sizipereka ma calories ambiri. |
Kodi madzi opatsa thanzi awa ali ndi chiyani?
Iyi si botolo la mchere lokha. Ili ngati 'cocktail' yopatsa thanzi yopangidwira wodwala. Madzi awa amapangidwa powerengera zomwe thupi lanu likufuna, poganizira zinthu zambiri monga zaka zanu, kulemera kwanu, matenda anu, ndi malipoti a magazi anu.
Izi zikuphatikizapo makamaka:
- Madzi
- Chakudya (cha mphamvu)
- Mapuloteni (othandizira kukula kwa thupi ndi kukonzanso maselo)
- Mafuta/Mafuta (kuti mupeze mphamvu zambiri)
- Mavitamini
- Mchere wa mchere (Electrolytes)
Yankho ili ndi lathunthu kotero kuti munthu akhoza kukhala ndi izi yekha kwa moyo wake wonse osadya chilichonse pakamwa.
Kodi ndi nthawi ziti pamene zakudya zopatsa thanzi zimaperekedwa m'mitsempha?
Izi zimagwiritsidwa ntchito pokhapokha ngati wodwalayo sangathe kudyetsedwa mwanjira ina iliyonse.
Nthawi zina pamafunika zakudya zonse za parenteral (TPN)
- Pambuyo pa opaleshoni yochotsa gawo lalikulu la m'mimba
- Zotsatira zoyipa kwambiri za chemotherapy pa khansa
- Kutsekeka kwa m'mimba
- Kuchepa kwa magazi kupita ku matumbo (Ischemia ya m'mimba)
- Matenda otupa m'matumbo, monga matenda aakulu a Crohn
- Makanda obadwa msanga kwambiri komanso matumbo awo osakula bwino
- Kutsegula m'mimba kwambiri, kwa nthawi yayitali
- Matenda ena akuluakulu omwe amafunika kupuma mokwanira m'matumbo
Pakakhala vuto la kudya zakudya zochepa (PPN)
Kawirikawiri PPN imaperekedwa kuti ipereke mphamvu zowonjezera kwa odwala omwe ali ndi vuto la kusowa zakudya m'thupi chifukwa chokhala kuchipatala kwa nthawi yayitali komanso osamwa mokwanira.
Kuika ndi kuchiza catheter
Iyi si njira yokhayo yomwe mumayika m'dzanja lanu. Izi zimafuna chubu chapadera chotchedwa catheter kuti chiyikidwe mu mtsempha waukulu m'thupi lanu. Izi zili ngati opaleshoni yaying'ono. Koma musadandaule, mudzamva dzanzi (mudzasanduka dzanzi) ndipo izi zimachitika. Dokotala adzayeretsa khungu lanu ndikuyika catheter mwachindunji mu mtsempha pogwiritsa ntchito ultrasound kapena X-ray.
Pali mitundu itatu ikuluikulu ya ma catheter:
- Katheta wakunja "wokhala ndi ngalande": Iyi ndi chubu chomwe chimayikidwa pansi pa khungu kwa mtunda waufupi kenako chimatuluka pamalo ena.
- Katheta woyikidwa kwathunthu: Iyi imabisika kwathunthu pansi pa khungu. Pali kampata kakang'ono kokha pansi pa khungu komwe mankhwala amalowetsedwa.
- Mzere wa PICC: Uwu ndi chubu chomwe chimalowetsedwa kudzera mu mtsempha womwe uli pamwamba pa mkono ndikulowa mu mtsempha waukulu pachifuwa. Chimagwiritsidwa ntchito pochiza kwakanthawi kochepa (masabata osakwana 6).
Mankhwala opha tizilombo toyambitsa matenda amenewa amatenga maola 10-12 kuti afike m'thupi. Chifukwa chake, anthu ambiri amawagwiritsa ntchito usiku akamagona. Mankhwalawa angachitike kuchipatala, kapena kunyumba ndi maphunziro ofunikira. Komabe, zinthuzi ziyenera kusamalidwa bwino kuti tipewe matenda .
Kodi zoopsa ndi zovuta zomwe zingachitike ndi ziti?
Ngakhale kuti njira imeneyi ndi yopulumutsa moyo, ingakhale ndi zoopsa komanso zovuta zina. Ndicho chifukwa chake madokotala amagwiritsa ntchito pokhapokha ngati pali zovuta kwambiri ndipo amapitiriza kuyang'anira wodwalayo.
| Mavuto | Kufotokozera kosavuta |
|---|---|
| Matenda | Mabakiteriya amatha kulowa m'magazi kudzera mu catheter. Izi zitha kufalikira ndikuyambitsa matenda oopsa otchedwa sepsis . Ichi ndiye chiopsezo chachikulu komanso chachikulu kwambiri . |
| Magazi Oundana | Magazi amaundana amatha kupangika pamene catheter imalumikizana ndi mitsempha. |
| Mavuto a chiwindi | Kumwa TPN kwa nthawi yayitali kungayambitse kuwonongeka kwa chiwindi. Izi zimatchedwanso Parenteral nutrition-associated liver disease (PNALD). |
| Kusalingana kwa shuga m'magazi | Kuchuluka kwa shuga kumatha kukwera mwadzidzidzi (Hyperglycemia) kapena kutsika (Hypoglycemia). Izi zimayendetsedwa ndi kupereka insulin. |
| Kuchepa kwa mafupa | Pakapita nthawi, kusintha kwa zinthu monga calcium ndi vitamini D kungayambitse mafupa ofooka (Osteoporosis). |
| Mavuto a ndulu | Popeza njira yogayira chakudya sikugwira ntchito bwino, ndulu mu ndulu imatha kudziunjikira ndikupanga miyala. |
Kodi mumazolowera bwanji kudya pakamwa?
Matumbo akayamba kugwira ntchito, madokotala amayesa kubwezeretsa wodwalayo pakumwa mwamsanga, chifukwa matumbo amatha kukhala "aulesi" ngati sagwiritsidwa ntchito nthawi zonse.
Izi zachitika bwino kwambiri.
Sayamba kudya mpunga nthawi yomweyo. Amayamba ndi 'zakudya zamadzimadzi zoyera'. Mwachitsanzo, zinthu monga madzi owiritsa, phala la mchere, ndi madzi. Ngati thupi lingathe kupirira, ndiye kuti amapitiliza kudya zakudya zamadzimadzi zodzaza. Pamenepo ndi pomwe amaphunzitsidwa kudya zakudya zolimba.
Panthawi yonseyi, gulu lachipatala likuyang'anira mosamala kuchuluka kwa zakudya m'thupi lanu.
Uthenga Wopita Nawo Kunyumba
- Zakudya zopatsa thanzi ndi njira yofunika kwambiri yopulumutsira moyo kwa iwo omwe sangathe kudya ndi pakamwa.
- Mu izi, zakudya zonse zomwe thupi limafunikira zimaperekedwa mwachindunji mumtsempha wamagazi.
- Pali mitundu iwiri ikuluikulu: TPN (zakudya zonse za parenteral) ndi PPN (zakudya zochepa za parenteral).
- Popeza njira imeneyi ili ndi zoopsa monga matenda, magazi kuundana, ndi mavuto a chiwindi, imachitika pokhapokha ngati madokotala akuyang'anira bwino.
- Ngati inu kapena munthu amene mumamudziwa wapatsidwa mankhwala awa, musachite mantha. Funsani dokotala wanu za izi ndipo mumvetse bwino. Tsatirani malangizo ake molondola.
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