Pali mtundu wina wa chakudya, umene umatenga chakudya wamba monga zopangira ndipo ndi wosiyana ndi mawonekedwe a chakudya wamba. Lilipo mu mawonekedwe a ufa, madzi, etc. Mofanana ndi ufa wa mkaka ndi mapuloteni ufa, ukhoza kudyetsedwa pakamwa kapena m'mphuno ndipo ukhoza kugayidwa mosavuta kapena kutengeka popanda chimbudzi. Imatchedwa "chakudya champangidwe chamankhwala apadera", ndiko kuti, tsopano timagwiritsa ntchito zakudya zopatsa thanzi kwambiri.
1. Kodi zakudya zopatsa thanzi ndi chiyani?
Enteral nutrition (EN) ndi njira yothandizira zakudya zomwe zimapereka zakudya zosiyanasiyana m'thupi kudzera m'matumbo a m'mimba kuti akwaniritse zosowa za thupi ndi zamoyo. Ubwino wake ndikuti michere imalowetsedwa mwachindunji ndikugwiritsidwa ntchito kudzera m'matumbo, omwe amakhala okhudzana ndi thupi, osavuta kuwongolera, komanso otsika mtengo. Zimathandizanso kusunga umphumphu wa m'mimba mucosa kapangidwe ndi chotchinga ntchito.
2. Kodi ndi zinthu ziti zomwe zimafunikira zakudya zopatsa thanzi?
Odwala onse omwe ali ndi zizindikiro zothandizira zakudya ndi ntchito komanso kupezeka kwa m'mimba thirakiti amatha kulandira chithandizo chamankhwala, kuphatikizapo dysphagia ndi mastication; Kulephera kudya chifukwa cha kusokonezeka kwa chidziwitso kapena chikomokere; Nthawi yokhazikika ya matenda a m'mimba, monga fistula ya m'mimba, matenda a matumbo aang'ono, matenda otupa ndi kapamba; Hypercatabolic state, monga odwala omwe ali ndi matenda oopsa, opaleshoni, ovulala komanso amayaka kwambiri. Palinso matenda osokoneza bongo, monga chifuwa chachikulu, chotupa, etc; Chithandizo cha preoperative ndi postoperative zakudya; Adjuvant chithandizo cha chotupa chemotherapy ndi radiotherapy; Thandizo la zakudya kwa kutentha ndi kuvulala; Kulephera kwa chiwindi ndi impso; Matenda a mtima; Kobadwa nako chilema cha amino acid metabolism; Zowonjezera kapena kusintha kwa zakudya za parenteral.
3. Kodi zakudya zopatsa thanzi zimagawika bwanji?
Pamsonkhano woyamba pamaziko a gulu la kukonzekera enteral zakudya, Beijing Nthambi ya Chinese Medical Association anapempha gulu wololera wa Kukonzekera kudya zakudya, ndipo akufuna kugawaniza Kukonzekera kadyedwe kalowa mu mitundu itatu, kutanthauza amino asidi, mtundu wonse mapuloteni ndi chigawo chimodzi. Amino acid matrix ndi monomer, kuphatikizapo amino acid kapena peptide yochepa, shuga, mafuta, mchere ndi mavitamini osakaniza. Ndi oyenera odwala mkhutu m`mimba chimbudzi ndi mayamwidwe ntchito, koma ndi osauka kukoma ndi oyenera kudya m`mphuno. Mapuloteni amtundu wonse amagwiritsa ntchito mapuloteni athunthu kapena mapuloteni aulere monga gwero la nayitrogeni. Ndi oyenera odwala ndi yachibadwa kapena pafupi yachibadwa m`mimba ntchito. Ili ndi kukoma kwabwino, ndipo imatha kutengedwa pakamwa kapena kuperekedwa pamphuno. Mtundu wa chigawocho umaphatikizapo chigawo cha amino acid, chigawo chachifupi cha peptide, chigawo chonse cha mapuloteni, chigawo cha carbohydrate, chigawo chautali cha triglyceride (LCT), chigawo chapakati cha triglyceride (MCT), chigawo cha vitamini, ndi zina zotero, zomwe zimagwiritsidwa ntchito kwambiri monga zowonjezera kapena zolimbitsa thupi zolimbitsa thupi.
4. Kodi odwala amasankha bwanji zakudya zopatsa thanzi?
Odwala omwe ali ndi nephrotic amachulukitsa kuchuluka kwa mapuloteni ndipo amakhala ndi vuto la nayitrogeni, zomwe zimafunikira mapuloteni otsika komanso ma amino acid ambiri. Kukonzekera kwa zakudya zam'mimba za mtundu wa matenda a impso kumakhala ndi ma amino acid ofunikira, otsika kwambiri mu mapuloteni, otsika mu sodium ndi potaziyamu, omwe amatha kuchepetsa kupsinjika kwa impso.
Kagayidwe ka onunkhira amino zidulo, tryptophan, methionine, etc. odwala ndi mkhutu chiwindi ntchito watsekedwa, nthambi unyolo amino zidulo yafupika, ndi onunkhira amino zidulo akuwonjezeka. Komabe, unyolo nthambi unyolo amino zidulo zimapukusidwa ndi minofu, amene saonjezera katundu pa chiwindi, ndipo akhoza kupikisana ndi onunkhira amino zidulo kulowa magazi ubongo chotchinga, kusintha chiwindi ndi ubongo matenda. Chifukwa chake, ma amino acid okhala ndi nthambi amatha kuwerengera zoposa 35% ~ 40% ya ma amino acid onse muzakudya zamtundu wa matenda a chiwindi.
Pambuyo pa kutentha kwakukulu, kutentha kwa thupi la wodwalayo kumakwera, mahomoni ndi zinthu zotupa zimatulutsidwa mochuluka, ndipo thupi liri mumkhalidwe wa metabolism. Kupatula chilonda, matumbo ndi chimodzi mwa zikuluzikulu ziwalo ndi amkati mkulu kagayidwe. Chifukwa chake, zakudya zowotcha ziyenera kukhala ndi mapuloteni ambiri, mphamvu zambiri komanso mafuta osavuta kupukutika ndi madzi ochepa.
Kukonzekera kwa zakudya zam'mimba kwa odwala omwe ali ndi matenda a m'mapapo kuyenera kukhala ndi mafuta ambiri, otsika zama carbohydrate, komanso mapuloteni okha kuti akhalebe ndi minofu yowonda komanso anabolism, kuti apititse patsogolo kupuma.
Chifukwa cha mphamvu ya mankhwala amphamvu, thanzi labwino ndi chitetezo cha odwala omwe ali ndi zotupa zoipa ndi osauka, ndipo minofu yotupa imagwiritsa ntchito mafuta ochepa. Choncho, kukonzekera zakudya zokhala ndi mafuta ambiri, mapuloteni apamwamba, mphamvu zambiri komanso zakudya zochepa zama carbohydrate ziyenera kusankhidwa, momwe glutamine, arginine, MTC ndi zina zowonjezera chitetezo cha mthupi zimawonjezeredwa.
Zakudya zopatsa thanzi kwa odwala matenda ashuga ziyenera kukhala oligosaccharides kapena ma polysaccharides, kuphatikiza ulusi wokwanira wazakudya, womwe umathandizira kuchepetsa kuchuluka kwa shuga m'magazi.
Nthawi yotumiza: Sep-14-2022