Reka twige neza ibijyanye n'imirire y'ababyeyi, uburyo bwo guha umuntu udashobora kurya mu kanwa imirire binyuze mu mitsi.

Ese wigeze ujya kwa muganga kureba umurwayi udashobora kurya mu kanwa, kandi ahabwa ibinyobwa binyuze mu gafuka kanini binyuze mu mitsi? Akenshi tubifata nk'umunyu. Ariko si ko buri gihe uba ari umunyu gusa. Hari igihe uba ari umunyu udasanzwe urimo intungamubiri zose umuntu akeneye kugira ngo abeho. Ibyo ni byo twita 'indyo iterwa mu mitsi', cyangwa mu buryo bw'ubuvuzi, Parenteral Nutrition .

Mu magambo make, Parenteral Nutrition ni iki?

Mu magambo make, ibi bibaho iyo urenze uturemangingo tw’igogora (uturemangingo twose kuva mu kanwa kawe kugera mu kibuno) burundu hanyuma ugatanga intungamubiri mu mubiri wawe binyuze mu mitsi y’amaraso. Ijambo "parenteral" risobanura "hanze y’uturemangingo tw’igogora."

Ushobora kuba warumvise iby'imirire y'imbere. Ibi bikubiyemo gutanga ibiryo by'amazi mu gifu cyangwa mu mara mato binyuze mu muyoboro winjizwa mu mazuru cyangwa mu mwenge muto mu gifu. Ariko hamwe n'imirire y'imbere, iyi gahunda yose irarengerwa kandi intungamubiri zongerwa mu maraso. Mu ndwara zimwe na zimwe, ubu buryo bushobora gukenerwa igihe gito cyangwa kirekire. Hari abantu bahabwa ubu buryo kugira ngo burusheho kuryoherwa n'ibiryo barya mu kanwa. Abandi bakeneye kubona karori zabo zose binyuze muri iyi mirire yo mu mitsi.

Ni ubuhe bwoko bw'ingenzi bw'ubu buryo?

Ubu buryo bwo kugaburira abana bushobora kugabanywamo ubwoko bubiri bw'ingenzi. Bumwe bushingiye ku mubare w'indyo itangwa, ubundi bushingiye ku bwoko bw'imitsi ikoreshwa mu gutanga indyo. Reka tubisobanukirwe neza byombi.

1. Gutondekanya ingano y'indyo itangwa

Hari ubwoko bubiri bw'ingenzi bw'ibi.

2. Gushyira mu byiciro hakurikijwe ubwoko bw'imitsi ikoreshwa

Iyi ntungamubiri irimo iki?

Iyi ni formula y'imiti. Ariko iyi si ikintu gihabwa buri wese mu buryo bumwe. Ukurikije ibyo umubiri wawe ukeneye, hashingiwe ku bisubizo by'amaraso yawe, uhabwa umuti w'imirire wihariye .

Ishobora kuba irimo intungamubiri esheshatu z'ingenzi ku mubiri mu rugero rutandukanye:

• Amazi
• Karubohidrati (ku bijyanye n'ingufu)
• Poroteyine (zo gukura no gusana umubiri)
• Ibinure (bitanga ingufu n'aside irike y'ingenzi)
• Vitamine
• Umunyu w'amabuye y'agaciro

Iyi formula y'imirire yuzuye ku buryo, umuntu aramutse abyifuje, yashobora kubaho ubuzima bwe bwose adafashe ikintu icyo ari cyo cyose mu kanwa.

Ni mu bihe bihe ubu buryo bukoreshwa?

Ni ryari intungamubiri z'igice (PPN) ziba zikenewe?

PPN ikunze gukoreshwa by'agateganyo. Urugero, ikoreshwa mu guha umuntu imbaraga zihuse mbere yo kumuhindura buhoro buhoro akajya ku muyoboro w'imiyoboro cyangwa kumuha umunwa. Nanone, abarwayi bamara igihe kirekire mu bitaro bashobora kubura imirire myiza bitewe n'impamvu zitandukanye. PPN ikoreshwa kandi mu kumuha intungamubiri z'inyongera.

Ni ryari indyo yuzuye y'ababyeyi (TPN) ikenewe?

Niba uturemangingo tw’igogora tudakora neza na gato, cyangwa niba ufite indwara y’igifu isaba kuruhuka neza kuri urwo ruturemangingo, ushobora gukenera TPN.

Dore zimwe mu bihe byihariye aho TPN ishobora kuba ngombwa:

• Kubagwa mu nda gukomeye
• Kuvura kanseri hakoreshejwe imiti igabanya ubukana
• Kugabanuka kw'amaraso ajya mu mara (ischemia y'amara)
• Kuziba amara mu mara mato cyangwa manini
• Kudakora neza kw'amara (Ileus ihoraho)
• Kuva amaraso mu gifu
• Kwangirika kw'amara bitewe no kuvurwa hakoreshejwe imirasire (Radiation enteritis)
• Kubyara umwana utarageza igihe
• Enterocolitis itera indwara mu bana bato
• Impiswi igihe kirekire
• Indwara zo kubyimba amara nka Crohn's disease
• Indwara y'amara magufi (indwara ibaho nyuma yo kubagwa igice cy'amara)
• Indwara y'amara iterwa na graft-versus

Gutegura no gushyira mu bikorwa ubu buvuzi bikorwa bite?

Iki ni igikorwa cyateguwe neza kandi gihuriweho n'itsinda ry'abaganga.

Kwitegura kuvurwa

Itsinda ry'abaganga bawe (abaganga, abaforomo, n'inzobere mu by'imirire) bazasuzuma witonze amateka y'ubuzima bwawe, igipimo cy'uburemere bw'umubiri (BMI), n'ibisubizo by'amaraso kugira ngo bamenye formula y'imirire ukeneye. Iyi nutrition y'amazi itegurwa n'inzobere mu gutanga dose ihagije mu masaha 24. Igomba gushyirwa muri firigo kugeza umunsi uyikeneye. Ikurwamo amasaha make mbere yo kuyikoresha kandi ikareka ikagera ku bushyuhe bw'icyumba.

Uburyo bwo gushyiramo catheter mu mubiri

Gushyiramo umuyoboro witwa catheter mu mubiri wawe ni igikorwa cyo kubaga gito. Mbere yuko ibi bikorwa, uzahabwa umuti wo kugabanya ububabare no kugutuza. Hanyuma, aho catheter izashyirwa hasukurwa neza kandi hagashyirwamo imiti yica udukoko.

Muganga ashyira insinga iyobora umutsi mu mitsi akoresheje urushinge, hanyuma akuramo urushinge maze agashyira catheter mu mutsi mu mitsi. Hashobora gukoreshwa ultrasound cyangwa X-ray kugira ngo harebwe ko iri ahantu heza.

Ubwoko butatu bw'ingenzi bwa catheter bukoreshwa:

• Catheter yo hanze "ifite imiyoboro": Iyi yagenewe kujya munsi y'uruhu hafi y'aho umuntu atuye kandi ikava ahandi hantu.
• Katheteri yuzuye: Iyi iba iri munsi y'uruhu rwose. Iyo bikenewe kugaburira, urushinge rushyirwa mu mwanya wihariye munsi y'uruhu rugahuzwa narwo.
• Catheter yo hagati ishyirwa mu ruhande rw'umubiri (PICC): Iyi ishyirwa mu mutsi wo hejuru y'ukuboko hanyuma igashyirwa mu mutsi mukuru wegereye umutima. Ubusanzwe iyi ikoreshwa ku bantu bakeneye imirire mu gihe kitarenze ibyumweru 6.

Ni gute imirire itangwa kandi igakurikiranwa?

Ubusanzwe kugaburira umwana ni igikorwa kimara amasaha 10-12, bityo abantu benshi babikora nijoro iyo bagiye kuryama. Ubu buryo bwo kuvura bushobora gukorerwa mu bitaro, mu kigo cyita ku bana igihe kirekire, cyangwa se mu rugo .

Niba ubikora mu rugo, itsinda ry’abaganga rizaguha amahugurwa yuzuye wowe cyangwa umwitaho, harimo uburyo bwo kumenya ibimenyetso by’ubwandu, uburyo bwo kubungabunga ibikoresho bisukuye, n’uburyo bwo guhindura imiyoboro.

Itsinda ry'abaganga rizahora rigukurikirana mu gihe cyo kuvurwa.

• Ipima ingano y'amazi yinjira n'asohoka mu mubiri wawe.
• Uburemere n'uburebure bigenzurwa buri gihe.
• Ibizamini by'amaraso bikorwa buri gihe kugira ngo harebwe niba hari impinduka ku mirire.

By’umwihariko, bibanda kuri ibi bintu:

• Electrolyte n'imikorere y'impyiko (BUN/Creatinine)
• Igipimo cy'isukari mu maraso (wirinde hyperglycemia cyangwa hypoglycemia)
• Urugero rw'amabuye y'agaciro
• Ibipimo by'imikorere y'umwijima (Aminotransferases, Bilirubin)

Ni izihe nyungu n'ingaruka mbi z'ubu buryo?

Nk’uko bigenda ku buvuzi ubwo aribwo bwose, ubu buvuzi bufite ibyiza n’ibyago.

Ibyiza

Akamaro k'ingenzi k'ubu buryo ni uko buha uturemangingo tw'igogora ibiruhuko bikenewe kugira ngo ture nyuma y'indwara ikomeye cyangwa kubagwa.. Bifasha kandi gukomeza umubiri binyuze mu gutanga intungamubiri zikenewe ku barwayi barwariye mu bitaro igihe kirekire, cyane cyane abageze mu zabukuru. Ni uburyo bwo kuvura burokora ubuzima ku bafite imyanya ndangagitsina yangiritse burundu ndetse no ku bana bavutse igihe kitageze badashobora kurya neza.

Ingaruka n'ingorane

Ubu buryo bufite ibyago byinshi byo kugira ingorane kurusha kugaburira mu nda. Ibibazo bibiri by'ingenzi ni ibyago byo ko mikorobe zinjira mu maraso zinyuze muri catheter ndetse no gucika intege kw'igogora bitewe no kudakoreshwa igihe kirekire.

Byongeye kandi, hari izindi ngaruka nko gukomereka mu gihe cyo gushyiramo catheter, amazi menshi cyane, no kumva inzara.

Watangira gute kongera kurya ukoresheje umunwa?

Nubwo imirire y’abana ishobora gukorwa igihe kirekire, abaganga bahora bagerageza kugusubiza mu kugaburira abana mu miyoboro y’amazi cyangwa mu kanwa vuba bishoboka. Impamvu ni ukwirinda ingorane z’igihe kirekire.

Iri hinduka rikorwa buhoro buhoro kandi buhoro kuko, kimwe n'uburwayi bwawe, sisitemu y'igogora imaze igihe "itaramye" ntizatangira gukora mu buryo butunguranye.

1. Tangira urya indyo yuzuye amazi .

2. Niba umubiri ubyitabira neza, hindura ukoreshe indyo yuzuye y'amazi .

3. Amaherezo, shyiramo buhoro buhoro ibiryo bikomeye .

Nubwo bahagaritse ubu buryo bwo kuvura, itsinda ry’abaganga rizakomeza gukurikirana ibiro byawe n’ingano y’imirire yawe igihe runaka.

Indyo yuzuye ni uburyo bwo kuvura bukoreshwa mu gihe cy’uburwayi bukomeye cyane, ariko rimwe na rimwe ni ngombwa kugira ngo umuntu arokore ubuzima. Niba ari ngombwa kuri wowe cyangwa uwo ukunda, bishobora kugorana kandi bikaba bishya. Ariko nyuma y’igihe runaka, bizaba bimwe mu bikorwa byawe bya buri munsi. Ikintu cy’ingenzi ni ugukurikiza amabwiriza atangwa n’itsinda ry’abaganga neza no kubamenyesha ikibazo icyo ari cyo cyose.