Wakamboenda kuchipatara kunoona murwere asingakwanise kudya nemuromo here, uye ari kupihwa mvura kuburikidza nebhegi guru kuburikidza netsinga? Tinowanzoiona semunyu. Asi haisi mvura chete nguva dzose. Dzimwe nguva imunyu chaiwo une zvese zvinovaka muviri zvinodiwa nemunhu kuti ararame. Ndizvo zvatinodaidza kuti 'kudya kunovaka muviri mukati memutsinga', kana kuti mumashoko ekurapa, Parenteral Nutrition .
Zvichitaurwa zviri nyore, chii chinonzi Parenteral Nutrition?
Zvichitaurwa zviri nyore, apa ndipo paunopfuura nzira yako yekugaya chikafu (hurongwa hwese kubva mumuromo mako kuenda kuhuro) zvachose woendesa zvinovaka muviri zvakananga mumuviri wako kuburikidza netsinga yeropa. Izwi rekuti "parenteral" rinoreva "kunze kwenzira yekugaya chikafu."
Ungave wakambonzwa nezvekudya kwemukati. Izvi zvinosanganisira kupa chikafu chemvura zvakananga mudumbu kana muura hudiki kuburikidza nechubhu inopinzwa nemhino kana gomba diki mudumbu. Asi nekudya kweparenteral, iyi system yese inodziviswa uye zvinovaka muviri zvinowedzerwa zvakananga muropa. Mune mamwe mamiriro ehutano, nzira iyi inogona kudiwa kwenguva pfupi kana yakareba. Vamwe vanhu vanopihwa izvi kuti vawedzere chikafu chavanodya nemuromo. Vamwe vanoda kuwana macalorie avo ese kuburikidza nekudya uku kwemutsinga.
Ndedzipi mhando huru dzenzira iyi?
Nzira iyi yekudya kwevabereki inogona kukamurwa kuita mhando mbiri huru. Imwe inobva pahuwandu hwekudya kunopiwa, uye imwe inobva parudzi rwetsinga inoshandiswa kupa kudya. Ngatinzwisisei zvese izvi zvakajeka.
1. Kuronga nehukuru hwekudya kunopihwa
Kune mhando mbiri huru dzeizvi.
| Sisitimu yezvekudya | Zvichitaurwa zviri nyore... |
|---|---|
| Kudya Kwevana Vasina Kudya (PPN) | Izvi zvinopihwa pamwe chete nedzimwe nzira dzekudya. Fungidzira kuti munhu anogona kudya zvishoma nemuromo, asi hazvina kukwana kupa muviri zvinovaka muviri zvaunoda, uye ari kutambura nekushaya chikafu chakakwana. Muzviitiko zvakadaro, nzira iyi inoshandiswa kupa zvimwe zvezvinovaka muviri zvisipo kana macalorie ekuwedzera. |
| Kudya Kwakazara Kwevabereki (TPN) | Iyi inzira yekupa kudya kwakakwana kuburikidza netsinga. Izvi zvinodiwa kuvanhu vasingakwanise kushandisa sisitimu yavo yekugaya chikafu zvachose. Nekuda kwezvimwe zvirwere, havakwanise kugaya chikafu uye kunwa zvinovaka muviri. Dzimwe nguva, zvinodikanwa kupa sisitimu yekugaya chikafu zororo rakakwana uye kuibvumira kupora. Muzviitiko zvakadaro, TPN inoshandiswa. |
2. Kupatsanurwa zvichienderana nerudzi rwetsinga inoshandiswa
| Rudzi rwetsinga | Tsananguro |
|---|---|
| Kuburikidza nemutsinga mukuru (Central Parenteral Nutrition - CPN) | Izvi zvinosanganisira kudya mutsinga huru, huru mumuviri. Iyi inowanzova Superior Vena Cava, tsinga huru iri pasi pebhonzo rinoenda zvakananga kumoyo. Nekuti tsinga iyi yakakura, inogona kupa chikafu chakasimba, chine macalorie akawanda nekukurumidza. Ndokusaka ichishandiswa kupa hutano hwese hweparenteral (TPN). |
| Kuburikidza netsinga diki, inoyerera (Peripheral Parenteral Nutrition - PPN) | Izvi zvinosanganisira kudya tsinga diki muruoko, gumbo, kana mutsipa. Nekuti zviri nyore kuita, nzira iyi inoshandiswa kupa kudya kwepanguva pfupi (PPN). |
Chii chiri mumushonga uyu une zvinovaka muviri?
Iyi imhando yemakemikari. Asi iyi haisi chinhu chinopihwa munhu wese nenzira imwechete. Zvichienderana nezvinodiwa nemuviri wako, zvichibva pane zvabuda pakuongororwa kweropa rako, unopihwa mushonga wekudya wakagadzirirwa iwe .
Inogona kuva nezvinovaka muviri zvitanhatu zvakakosha mumuviri muhuwandu hwakasiyana:
- Mvura
- Makabhohaidhiretsi (esimba)
- Mapuroteni (ekukura nekugadzira muviri)
- Mafuta (esimba uye mafuta anokosha)
- Mavhitamini
- Munyu wemineral
Iyi fomura yekudya yakakwana zvekuti, kana zvichidikanwa, munhu anogona kurarama nehurongwa uhwu kweupenyu hwake hwese asingatore chero chinhu nemuromo.
Nzira idzi dzinoshandiswa mumamiriro api ezvinhu?
Kudya zvishoma (PPN) kunodiwa rini?
PPN inowanzoshandiswa kwenguva pfupi. Semuenzaniso, inoshandiswa kupa munhu simba nekukurumidza asati achinja zvishoma nezvishoma kuenda kukudya nechubhu kana kunwa. Uyewo, varwere vanogara muchipatara kwenguva yakareba vanogona kushaya chikafu chakakwana nekuda kwezvikonzero zvakasiyana-siyana. PPN inowanzoshandiswawo kuvapa kudya kwekuwedzera.
Zvinodiwa rini kuti pave nekudya kwakakwana kwevabereki (TPN)?
Kana kugaya kwako kusiri kushanda zvachose, kana kuti kana uine chirwere chemudumbu chinoda kuzorora zvakakwana kwemuviri iwoyo, ungangoda TPN.
Heano mamwe mamiriro chaiwo apo TPN ingangodiwa:
- Kuvhiyiwa kukuru kwedumbu
- Kurapa kenza nemakemikari
- Kuyerera kweropa kushoma muura (intestinal ischemia)
- Kuvharika kwedumbu muura hudiki kana hukuru
- Kusashanda zvakanaka kwemudumbu (Ileus yakareba)
- Kubuda ropa mudumbu
- Kukuvadzwa kweura nekuda kwekurapwa nemwaranzi (radiation enteritis)
- Kuzvara nguva isati yakwana zvakanyanya
- Kubvisa enterocolitis muvana vacheche
- Manyoka kwenguva refu
- Zvirwere zvemudumbu zvakaita sechirwere cheCrohn
- Chirwere chemudumbu mupfupi (chirwere chinoitika mushure mekunge chikamu chemudumbu chabviswa nekuvhiyiwa)
- Chirwere chemudumbu chinonzi graft-versus-host
Kugadzirira nekushandisa mushonga uyu kunoitwa sei?
Iri ibasa rakarongwa uye rakabatana nechikwata chevanachiremba.
Kugadzirira kurapwa
Chikwata chenyu chezvekurapa (vanachiremba, vanamukoti, uye nyanzvi dzezvekudya) vachanyatsoongorora nhoroondo yenyu yehutano, body mass index (BMI), uye mhedzisiro yekuongororwa kweropa kuti vaone fomura yezvekudya yamunoda. Mvura iyi inogadzirwa nenyanzvi muhuwandu hwakakwana kwemaawa makumi maviri nemana. Inofanira kuiswa mufiriji kusvika pazuva raunoda. Inobviswa maawa mashoma usati washandisa uye inobvumirwa kusvika patembiricha yemukamuri.
Maitiro ekuisa catheter mumuviri
Kuisa chubhu, inonzi catheter, mumuviri wako inzira diki yekuvhiya. Izvi zvisati zvaitika, uchapihwa mushonga wekuderedza kurwadziwa uye kudzikamisa pfungwa dzako. Zvadaro, nzvimbo ichaiswa catheter ichacheneswa zvakanaka uye ichapiswa nehutachiona.
Chiremba anoisa waya yekufambisa mutsinga achishandisa tsono, obva abvisa tsono yacho obva apinza catheter newaya yacho mutsinga. Ultrasound kana X-ray zvinogona kushandiswa kuona kuti iri panzvimbo chaiyo.
Mhando nhatu huru dzemacatheter dzinoshandiswa:
- Catheter yekunze "yakaganhurirwa": Iyi yakagadzirirwa kufamba chinhambwe chipfupi pasi peganda uye kubuda kubva kune imwe nzvimbo.
- Katheta yakaisirwa zvizere: Iyi iri pasi peganda rose. Kana uchida kudyiswa, tsono inopinzwa muchikamu chakakosha pasi peganda yobatanidzwa nayo.
- Catheter yepakati inopinzwa panze (PICC): Iyi inopinzwa nepatsinga iri pamusoro peruoko uye inopinzwa mutsinga huru iri pedyo nemoyo. Iyi inowanzo shandiswa kune vanhu vanoda kudya kunovaka muviri kwemavhiki asingasviki matanhatu.
Chinhu chinonyanya kukosha ndechekuita zvese izvi mumamiriro akachena uye asina utachiona, sezvo paine mukana wekutapukirwa.
Kudya kunopihwa uye kunotariswa sei?
Kudyisa mwana kunowanzoitwa kwemaawa gumi kusvika gumi nemaviri, saka vanhu vazhinji vanozviita husiku pavanoenda kunorara. Kurapa uku kunogona kuitwa muchipatara, kunzvimbo inochengeterwa vana kwenguva refu, kana kunyangwe kumba .
Kana muchiita izvi kumba, timu yezvekurapa ichakupai dzidziso yakakwana iwe kana muchengeti wenyu, kusanganisira maziviro ekuziva zviratidzo zvehutachiona, mashandisiro ekuchengetedza michina yakachena, uye mashandisiro ekuchinja machubhu.
Chikwata chekurapa chichagara chichikutarisa panguva yekurapwa.
- Inoyera huwandu hwemvura inopinda neinobuda mumuviri wako.
- Huremu nekukwirira zvinoongororwa nguva nenguva.
- Kuongororwa kweropa kunoitwa nguva nenguva kuti vaone kana kuchinjwa kwemushonga wekudya kuchidikanwa.
Zvikuru sei, vanonyanya kutarisa pazvinhu izvi:
- Maelectrolyte uye mashandiro eitsvo (BUN/Creatinine)
- Mazinga eshuga muropa (kudzivirira hyperglycemia kana hypoglycemia)
- Mazinga emaminerari
- Zviratidzo zvekushanda kwechiropa (Aminotransferases, Bilirubin)
Ndezvipi zvakanakira uye njodzi dzine njodzi dzenzira iyi?
Kufanana nechero nzira yekurapa, iyi ine zvakanakira uye njodzi.
Mabhenefiti
Chinhu chikuru chinobatsira pakuita izvi ndechekuti inopa muviri wako zvese zvinodiwa kuti upore mushure mekurwara zvakanyanya kana kuvhiyiwa.. Zvinobatsirawo kusimbisa muviri nekupa chikafu chinodiwa kuvarwere vanogara muchipatara kwenguva yakareba, kunyanya vakwegura. Inzira inoponesa hupenyu kune avo vane masisitimu ekugaya anokuvadzwa zvachose uye kune vacheche vanozvarwa nguva isati yakwana vasingagoni kudya zvakanaka.
Njodzi Nematambudziko
Nzira iyi ine njodzi huru yekusangana nematambudziko kupfuura kudya kwemwana ari mudumbu. Matambudziko maviri makuru injodzi yekuti utachiona hupinde muropa kuburikidza necatheter uye kushaya simba kwegadziriro yekugaya chikafu nekuda kwekusashandiswa kwenguva refu.
| Dambudziko rinowanzoitika | Tsananguro iri nyore |
|---|---|
| Utachiona | Mabhakitiriya anogona kupinda muropa kuburikidza necatheter. Kana hutachiona uhu hukapararira mumuviri wese, hunogona kukonzera chirwere chinouraya chinonzi sepsis . |
| Kugwamba kweropa | Magwamba eropa anogona kuumbwa apo catheter inosangana netsinga. |
| Kushaya simba kwegadziriro yekugaya chikafu (GI atrophy) | Mushure memavhiki maviri ekusashandisa sisitimu iyi, mashandiro ayo anotanga kudzikira. Zvisinei, zvishoma nezvishoma anodzoka pamaitiro ayo chaiwo paunotanga kudya zvakare. |
| Kusawirirana kwehuwandu hweshuga | Kuwanda kweshuga yeropa mumuviri kana hypoglycemia zvakajairika uye zvinogona kudzorwa nekugadzirisa insulin uye kudya kunovaka muviri. |
| Matambudziko echiropa | Vanhu vanosvika 50% vanotora mushonga uyu kwenguva refu vanogona kurwara nechiropa (PNALD) mukati memakore mashanu kusvika manomwe. Chikonzero chaicho cheizvi hachizivikanwe. |
| Matambudziko enduru | Nekuti kugaya chikafu hakusi kushanda, bile riri munduru harigone kuburitswa uye rinogona kuungana, richigadzira matombo. |
| Kubviswa kwemamineral mumapfupa | Vanhu vanorapwa kwenguva yakareba vanogona kubatwa nezvirwere zvekuonda kwemapfupa zvakaita se osteoporosis nekuda kwekushomeka kwemavhitamini nemaminerari (calcium, magnesium, vitamin D). |
Pamusoro pezvo, kune dzimwe njodzi dzakadai sekukuvara panguva yekuiswa catheter, mvura yakawanda, uye kunzwa nzara.
Ungatanga sei kudya nemuromo zvakare?
Kunyange zvazvo kudya kunovaka muviri kunogona kuitwa kwenguva refu, vanachiremba vanogara vachiedza kukudzosera kumwana kuti adye nechubhu kana nemuromo nekukurumidza. Chikonzero cheizvi ndechekudzivirira matambudziko anoitika kwenguva refu.
Kuchinja uku kunoitwa zvishoma nezvishoma uye zvishoma nezvishoma nekuti, sezvakaita chirwere chako, gadziriro yekugaya yagara "isina kurara" kwenguva yakati haizongoerekana yatanga kushanda.
1. Tanga nekudya zvine mvura yakachena .
2. Kana muviri ukapindura zvakanaka, chinja wotanga kudya zvine mvura yakakwana .
3. Pakupedzisira, zvishoma nezvishoma tanga kudya zvekudya zvakasimba .
Kunyangwe mushure mekumira kurapwa uku, timu yezvekurapa icharamba ichitarisa huremu hwako uye huwandu hwekudya kwako kwenguva yakati.
Parenteral Nutrition mushonga unoshandiswa muzviitiko zvakanyanya kuoma, asi dzimwe nguva zvakakosha kuponesa hupenyu. Kana izvi zvichidikanwa kwauri kana kune waunoda, zvinogona kuva chiitiko chakaoma uye chitsva. Asi mushure mechinguva, zvichava chikamu chehupenyu hwako hwezuva nezuva. Chinhu chakakosha kutevedzera mirairo yakapihwa nechikwata chekurapa nemazvo uye kuvazivisa nezvematambudziko ese.
Mharidzo Yekuenda Nayo Kumba
- Parenteral Nutrition inzira yekuendesa chikafu zvakananga muropa kuburikidza netsinga kana kugaya chikafu kusingakwanise kushandiswa.
- Kune mhando mbiri huru: PPN, iyo inopihwa sekudya kwekuwedzera, uye TPN, iyo inopa kudya kwakakwana.
- Kunyange zvazvo iyi iri nzira yekurapa inoponesa hupenyu, kune njodzi dzakakomba, dzakadai sekutapukirwa nehutachiona, kuumbwa kweropa, uye matambudziko echiropa.
- Kurapa uku kunofanira kuitwa nguva dzose pasi pekutarisirwa kwakasimba kwechikwata chevanachiremba, vanamukoti, uye nyanzvi dzezvekudya.
- Kana iwe kana mudiwa wako muchifanira kurapwa kumba, zvakakosha kuti muwane kudzidziswa kwakakodzera uye muchenjerere zvikuru nekuchenesa. Kana muine zvinokunetsai kana mibvunzo, taurai nachiremba wenyu nekukasika.
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