Ngaba wakha waya esibhedlele ukuze ubone isigulana esingakwaziyo ukutya ngomlomo, kwaye sinikwa ulwelo ngebhegi enkulu ngemithambo yegazi? Sihlala sicinga ngalo njengetyuwa. Kodwa ayisoloko ityuwa kuphela. Ngamanye amaxesha lulwelo olukhethekileyo oluqulathe zonke izondlo umntu azidingayo ukuze aphile. Yiloo nto siyibiza ngokuba 'yisondlo esifakwa ngaphakathi', okanye ngokwezonyango, iSondlo seParenteral .
Ngamafutshane, yintoni iParenteral Nutrition?
Ngamafutshane, oku kwenzeka xa udlula kwinkqubo yakho yokwetyisa (yonke inkqubo ukusuka emlonyeni wakho ukuya kwi-anus yakho) ngokupheleleyo uze uhambise izondlo ngqo emzimbeni wakho ngemithambo yegazi. Igama elithi "parenteral" lithetha "ngaphandle kwenkqubo yokwetyisa."
Usenokuba ukhe weva ngesondlo sangaphakathi. Oku kuquka ukunika ukutya okumanzi ngqo esiswini okanye emathunjini amancinci ngetyhubhu efakwe ngempumlo okanye ngomngxuma omncinci esiswini. Kodwa ngesondlo sangaphakathi, le nkqubo yonke ayisebenzi kwaye izondlo zongezwa ngqo egazini. Kwezinye iimeko zonyango, le ndlela inokufuneka ixesha elifutshane okanye elide. Abanye abantu banikwa oku ukongeza ekutyeni abakutya ngomlomo. Abanye kufuneka bafumane zonke iikhalori zabo ngesi sondlo semithambo yegazi.
Ziziphi iintlobo eziphambili zale ndlela?
Le ndlela yokondla ngokwe-parenteral inokwahlulwa ibe ziintlobo ezimbini eziphambili. Enye isekelwe kubungakanani besondlo esinikiweyo, kwaye enye isekelwe kuhlobo lomthambo osetyenziselwa ukunika isondlo. Masiziqonde zombini ezi zinto ngokucacileyo.
1. Ukwahlulahlula ngokwesixa sesondlo esibonelelwayo
Kukho iintlobo ezimbini eziphambili zale nto.
| Inkqubo yesondlo | Kalula nje... |
|---|---|
| Isondlo Esingenamkhethe Somzali (PPN) | Oku kunikwa ukongeza kwezinye iindlela zokutya. Khawuthelekelele ukuba umntu angatya kancinci ngomlomo, kodwa akwanelanga ukunika umzimba izondlo ozifunayo, kwaye unesifo sokungondleki. Kwiimeko ezinjalo, le ndlela isetyenziselwa ukubonelela ngezinye zezondlo ezingekhoyo okanye iikhalori ezongezelelweyo. |
| Isondlo Esipheleleyo Somzali (TPN) | Le yindlela yokunika ukutya okunesondlo esipheleleyo ngomthambo. Oku kuyimfuneko kubantu abangakwaziyo ukusebenzisa inkqubo yabo yokugaya ukutya konke konke. Ngenxa yeemeko ezithile zonyango, abakwazi ukugaya ukutya nokufunxa izondlo. Ngamanye amaxesha, kuyimfuneko ukunika inkqubo yokugaya ukutya ukuphumla okupheleleyo kwaye uyivumele ukuba iphile. Kwiimeko ezinjalo, kusetyenziswa i-TPN. |
2. Uhlu ngokwendlela yomthambo osetyenzisiweyo
| Uhlobo lomthambo | Inkcazo |
|---|---|
| Ngokusebenzisa umthambo oyintloko (iCentral Parenteral Nutrition - CPN) | Oku kuquka ukondla umthambo omkhulu, oyintloko emzimbeni. Lo uhlala uyiSuperior Vena Cava, umthambo omkhulu ongaphantsi kwethambo lentamo oya ngqo entliziyweni. Ngenxa yokuba lo mthambo mkhulu, unokubonelela ngesondlo solwelo esiqinileyo nesineekhalori eziphezulu ngokukhawuleza. Yiyo loo nto isetyenziselwa ukubonelela ngesondlo esipheleleyo se-parenteral (TPN). |
| Ngokusebenzisa umthambo omncinci, ongaphandle (iPeripheral Parenteral Nutrition - PPN) | Oku kuquka ukondla ngemithambo emincinci engalweni, emlenzeni, okanye entanyeni. Ngenxa yokuba kulula ukuyenza, le ndlela isetyenziselwa ukubonelela ngesondlo esingesosigxina (PPN). |
Luqulathe ntoni olu lwelo lwesondlo?
Le yifomyula yeekhemikhali. Kodwa le ayiyonto enikwa wonke umntu ngendlela efanayo. Ngokweemfuno zomzimba wakho, ngokusekelwe kwiziphumo zovavanyo lwakho lwegazi, unikwa isisombululo sesondlo esilungiselelwe wena .
Ingaqulatha zonke izondlo ezintandathu ezibalulekileyo emzimbeni ngobuninzi obahlukeneyo:
- Amanzi
- Iicarbohydrate (zamandla)
- Iiproteni (zokukhulisa nokulungisa umzimba)
- Amafutha (amandla kunye nee-fatty acids ezibalulekileyo)
- Iivithamini
- Iityuwa zeminerali
Le fomula yesondlo iphelele kangangokuba, ukuba kuyimfuneko, umntu angaphila kule nkqubo ubomi bakhe bonke ngaphandle kokuthatha nantoni na ngomlomo.
Zeziphi iimeko ezisetyenziswa kwezi ndlela?
Ifuneka nini i-partial nutrition (PPN)?
I-PPN idla ngokusetyenziswa okwethutyana. Umzekelo, isetyenziselwa ukunika umntu amandla ngokukhawuleza ngaphambi kokuba atshintshele kancinci kancinci ekutyiseni ngetyhubhu okanye ekutyeni ngomlomo. Kwakhona, izigulana ezilaliswe esibhedlele ixesha elide zinokondleka ngenxa yezizathu ezahlukeneyo. I-PPN ikwasetyenziswa rhoqo ukubanika ukutya okongezelelweyo.
Ifuneka nini isondlo esipheleleyo se-parenteral (TPN)?
Ukuba inkqubo yakho yokugaya ukutya ayisebenzi konke konke, okanye ukuba unesifo sesisu esifuna ukuphumla ngokupheleleyo kuloo nkqubo, unokufuna i-TPN.
Nazi ezinye iimeko ezithile apho i-TPN inokufuneka khona:
- Utyando olukhulu lwesisu
- I-Chemotherapy yomhlaza
- Ukuncipha kokuhamba kwegazi ukuya emathunjini (i-intestinal ischemia)
- Ukuvaleka kwamathumbu emathunjini amancinci okanye amakhulu
- Ukungasebenzi kakuhle kwamathumbu (i-ileus ende)
- Ukopha kwamathumbu
- Ukonakala kwamathumbu ngenxa yonyango lwemitha (i-radiation enteritis)
- Ukuzalwa ngaphambi kwexesha kakhulu
- I-necrotizing enterocolitis kwiintsana
- Urhudo oluhlala ixesha elide
- Izifo zamathumbu ezivuthayo ezifana nesifo sikaCrohn
- Isifo samathumbu amafutshane (imeko eyenzeka emva kokuba inxalenye yamathumbu isusiwe ngotyando)
- Isifo samathumbu esibangelwa yi-graft-versus
Ukulungiswa nokuphunyezwa kolu nyango kwenziwa njani?
Lo ngumzamo ocwangcisiweyo kakhulu nowentsebenziswano weqela loogqirha.
Ukulungiselela unyango
Iqela lakho lezonyango (oogqirha, abahlengikazi, kunye neengcali zesondlo) liza kuhlola ngononophelo imbali yakho yempilo, i-body mass index (BMI), kunye neziphumo zovavanyo lwegazi ukuze kuchongwe ifomula yesondlo oyifunayo. Olu lwelo lwesondlo lulungiswa yingcali kwiidosi ezaneleyo iiyure ezingama-24. Lufanele lugcinwe efrijini kude kube yimini oluyidingayo. Lukhutshwa iiyure ezimbalwa ngaphambi kokusetyenziswa kwaye luvunyelwe ukuba lufike kubushushu begumbi.
Indlela yokufaka i-catheter emzimbeni
Ukufaka ityhubhu, ebizwa ngokuba yi-catheter, emzimbeni wakho yinkqubo encinci yotyando. Ngaphambi kokuba oku kwenziwe, uza kunikwa amayeza okunciphisa iintlungu nokuthomalalisa umsindo. Emva koko, indawo apho i-catheter iza kufakwa khona iya kucocwa kakuhle kwaye ibulawe iintsholongwane.
Ugqirha ufaka ucingo olukhokelayo emthanjeni esebenzisa inaliti, aze asuse inaliti aze afake i-catheter ngentambo aye emthanjeni. I-ultrasound okanye i-X-ray zingasetyenziswa ukujonga ukuba zikwindawo efanelekileyo.
Kusetyenziswa iintlobo ezintathu eziphambili zee-catheters:
- I-catheter yangaphandle "eneetyhuna": Le yenzelwe ukuhamba umgama omfutshane phantsi kolusu kwaye iphume kwindawo eyahlukileyo.
- I-catheter efakwe ngokupheleleyo: Le ingaphantsi kwesikhumba ngokupheleleyo. Xa kufuneka ukondliwa, inaliti ifakwa kwindawo ekhethekileyo phantsi kwesikhumba ize iqhagamshelwe kuyo.
- I-catheter ephakathi efakwe ngasemva (PICC): Le ifakwa ngomthambo ongakwingalo engasentla ize ifakwe kwi-venous venture ekufutshane nentliziyo. Le idla ngokusetyenziswa kubantu abafuna ukutya okunesondlo ngaphantsi kweeveki ezi-6.
Eyona nto ibalulekileyo kukwenza yonke le nkqubo phantsi kweemeko ezicocekileyo nezingenazintsholongwane, kuba kukho umngcipheko wokosuleleka.
Isondlo sinikezelwa kwaye sijongwa njani?
Ukondla kudla ngokuba yinkqubo yeeyure ezili-10-12, ngoko ke abantu abaninzi bakwenza ebusuku xa besiya kulala. Olu nyango lunokwenziwa esibhedlele, kwiziko lokhathalelo lwexesha elide, okanye nasekhaya .
Ukuba ukwenza oku ekhaya, iqela lezonyango liza kunika wena okanye umnakekeli wakho uqeqesho olupheleleyo, kuquka indlela yokubona iimpawu zosulelo, indlela yokugcina izixhobo zicocekile, kunye nendlela yokutshintsha iityhubhu.
Iqela lezonyango liza kuhlala likujongile ngexesha lonyango.
- Ilinganisa ubungakanani bolwelo olungena noluphuma emzimbeni wakho.
- Ubunzima nobude bujongwa rhoqo.
- Uvavanyo lwegazi lwenziwa rhoqo ukuze kubonwe ukuba kufuneka utshintsho kwifomyula yesondlo.
Ngokukodwa, bagxila kwezi zinto:
- Ii-electrolytes kunye nomsebenzi wezintso (BUN/Creatinine)
- Amanqanaba eswekile egazini (thintela i-hyperglycemia okanye i-hypoglycemia)
- Amanqanaba eeminerali
- Iimpawu zokusebenza kwesibindi (ii-Aminotransferases, iBilirubin)
Ziziphi iingenelo kunye neengozi eziyingozi zale ndlela?
Njengalo naluphi na unyango lwezonyango, olu lunezibonelelo kunye neengozi.
Iinzuzo
Eyona nzuzo iphambili yale ndlela kukuba inika inkqubo yakho yokugaya ukutya ukutya okuseleyo ekudingayo ukuze iphiliswe emva kokugula okanye utyando olunzima.. Ikwanceda ukuqinisa umzimba ngokubonelela ngesondlo esifunekayo kwizigulana ezilaliswe esibhedlele ixesha elide, ingakumbi abantu abadala. Lunyango olusindisa ubomi kwabo baneenkqubo zokugaya ukutya ezihlala zonakele ngokusisigxina kunye neentsana ezizelwe ngaphambi kwexesha ezingenakutya ngendlela eqhelekileyo.
Iingozi kunye neengxaki
Le ndlela inomngcipheko ophezulu weengxaki kunokondla ngokutya okungaphakathi. Iingxaki ezimbini eziphambili kumngcipheko weentsholongwane zokungena egazini nge-catheter kunye nokuba buthathaka kwenkqubo yokugaya ukutya ngenxa yokungasetyenziswa ixesha elide.
| Ingxaki eqhelekileyo | Ingcaciso elula |
|---|---|
| Usulelo | Iintsholongwane zingangena egazini nge-catheter. Ukuba olu sulelo lusasazeka emzimbeni wonke, lunokubangela imeko esongela ubomi ebizwa ngokuba yi-sepsis . |
| Amahlwili egazi | Amahlwili egazi anokwenzeka apho i-catheter iqhagamshela khona nomthambo. |
| Ubuthathaka benkqubo yokugaya ukutya (i-GI atrophy) | Emva kweeveki ezimbini ingasasebenzisi le nkqubo, ukusebenza kwayo kuyaqala ukwehla. Nangona kunjalo, ibuyela esiqhelweni kancinci kancinci xa uqala ukutya kwakhona. |
| Ukungalingani kwamanqanaba eswekile | I-Hyperglycemia okanye i-hypoglycemia ziqhelekile kwaye zinokulawulwa ngokulungelelanisa i-insulin kunye neendlela zokutya. |
| Iingxaki zesibindi | Malunga nama-50% abantu abasebenzisa olu nyango ixesha elide banokufumana isifo sesibindi (i-PNALD) kwiminyaka emi-5-7. Isizathu esichanekileyo soku asaziwa. |
| Iingxaki zenyongo | Ngenxa yokuba inkqubo yokugaya ukutya ayisebenzi, inyongo ekwinyongo ayinakukhululwa kwaye inokuqokelelana, yenze amatye. |
| Ukususwa kweeminerali kwithambo | Abantu abafumana olu nyango ixesha elide banokufumana izifo zokuncitshiswa kwamathambo ezifana ne -osteoporosis ngenxa yokunqongophala kweevithamini kunye neeminerali (i-calcium, i-magnesium, i-vitamin D). |
Ukongeza, kukho ezinye iingozi ezifana nokwenzakala ngexesha lokufakwa kwe-catheter, ulwelo oluninzi, kunye nokuziva ulambile.
Uqala njani ukutya ngomlomo kwakhona?
Nangona ukondla umntwana ngexesha lokukhulelwa kunokwenziwa ixesha elide, oogqirha basoloko bezama ukukubuyisela ekutyeni ngetyhubhu okanye ekutyeni ngomlomo ngokukhawuleza. Isizathu soku kukuphepha iingxaki ezihlala ixesha elide.
Olu tshintsho lwenziwa kancinci kancinci kuba, njengemeko yakho yempilo engaphantsi, inkqubo yokwetyisa ebikade "ingasebenzi" okwethutyana ayizukuqala ukusebenza ngequbuliso.
1. Qala ngokutya okucacileyo okuneziselo .
2. Ukuba umzimba usabela kakuhle kuyo, tshintshela kwisidlo esipheleleyo esilulwelo .
3. Ekugqibeleni, kancinci kancinci wazise ukutya okuqinileyo .
Kwanasemva kokuba uyekile olu nyango, iqela lezonyango liza kuqhubeka nokujonga ubunzima bakho kunye namanqanaba esondlo sakho okwethutyana.
Isondlo seParenteral lunyango olusetyenziswa kwiimeko ezinzima kakhulu, kodwa ngamanye amaxesha kuyimfuneko ukusindisa ubomi. Ukuba oku kuyimfuneko kuwe okanye kumntu omthandayo, kunokuba ngamava anzima nantsha. Kodwa emva kwexesha elithile, kuya kuba yinxalenye yenkqubo yakho yemihla ngemihla. Eyona nto ibalulekileyo kukulandela imiyalelo enikwe liqela lezonyango ngokuchanekileyo kwaye ubazise ngazo naziphi na iingxaki.
Umyalezo Wokuya Ekhaya
- Isondlo seParenteral yindlela yokuhambisa isondlo ngqo egazini ngomthambo xa inkqubo yokugaya ukutya ingasetyenziswa.
- Kukho iintlobo ezimbini eziphambili: i-PPN, enikwa njengesondlo esongezelelweyo, kunye ne-TPN, enika isondlo esipheleleyo.
- Nangona olu nyango lusindisa ubomi, kukho iingozi ezinkulu, ezinje ngezifo, amahlwili egazi, kunye neengxaki zesibindi.
- Olu nyango kufuneka luhlale lwenziwa phantsi kweliso elibukhali leqela loogqirha, abahlengikazi kunye neengcali zesondlo.
- Ukuba wena okanye umntu omthandayo kufuneka nifumane olu nyango ekhaya, kubalulekile ukufumana uqeqesho olufanelekileyo kwaye nizinyamekele ngococeko. Ukuba unemibuzo okanye iingxaki, thetha nogqirha wakho ngokukhawuleza.
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