Kodi kusagwirizana kwa zakudya m'matumbo kumatanthauza chiyani?

Kodi kusagwirizana kwa zakudya m'matumbo kumatanthauza chiyani?

Kodi kusagwirizana kwa zakudya m'matumbo kumatanthauza chiyani?

M'zaka zaposachedwapa, mawu akuti "kudyetsa tsankho" akhala akugwiritsidwa ntchito kwambiri pachipatala.Malingana ngati kutchulidwa kwa zakudya zowonongeka, ambiri ogwira ntchito zachipatala kapena odwala ndi mabanja awo adzagwirizanitsa vuto la kulolerana ndi kusalolera.Ndiye, kodi kulolerana kwa zakudya zopatsa thanzi kumatanthauza chiyani?Muzochita zachipatala, bwanji ngati wodwala ali ndi kusalolera kwa zakudya m'thupi?Pamsonkhano Wapachaka wa 2018 National Critical Care Medicine, mtolankhaniyo adafunsa Pulofesa Gao Lan wochokera ku dipatimenti ya Neurology ya Chipatala Choyamba cha Jilin University.

Muzochita zachipatala, odwala ambiri satha kupeza zakudya zokwanira kudzera muzakudya zabwinobwino chifukwa cha matenda.Kwa odwala awa, chithandizo cham'mimba chimafunika.Komabe, zakudya zopatsa thanzi sizophweka monga momwe timaganizira.Panthawi yodyetsa, odwala ayenera kuyang'anizana ndi funso ngati angathe kulekerera.

Pulofesa Gao Lan adanena kuti kulolerana ndi chizindikiro cha ntchito ya m'mimba.Kafukufuku wapeza kuti osachepera 50% odwala mkati mankhwala akhoza kulekerera okwana cholowa zakudya adakali aang'ono;Oposa 60% ya odwala omwe ali m'chipinda cha odwala kwambiri amayambitsa kusokonekera kwakanthawi kwa zakudya zam'mimba chifukwa chakusalolera m'mimba kapena kusayenda bwino kwa m'mimba.Pamene wodwala ayamba kudyetsa tsankho, zingakhudze chandamale kudyetsa kuchuluka, kumabweretsa zotsatira zovuta zachipatala.

Kotero, momwe mungaweruze ngati wodwalayo akulolera ku zakudya zamagulu?Pulofesa Gao Lan adanena kuti matumbo a wodwalayo amamveka, ngati pali kusanza kapena kupuma, ngati pali kutsekula m'mimba, ngati matumbo atuluka, ngati pali kuwonjezeka kwa zotsalira za m'mimba, komanso ngati voliyumu yomwe mukufuna imafika pambuyo pa masiku awiri kapena atatu. zakudya zopatsa thanzi, etc. Monga cholozera kuti aweruze ngati wodwalayo ali cholowa zakudya kulolerana.

Ngati wodwala sakumana ndi vuto lililonse pambuyo ntchito enteral zakudya, kapena ngati m`mimba kutsekula m`mimba, kutsegula m`mimba, ndi reflux kumachitika pambuyo ntchito enteral zakudya, koma kuchepetsa pambuyo mankhwala, wodwalayo akhoza kuonedwa kukhala wolekerera.Ngati wodwala akuvutika ndi kusanza, kutsekula m'mimba, ndi kutsegula m'mimba atalandira zakudya zopatsa thanzi, amapatsidwa chithandizo chofananira ndikuyimitsidwa kwa maola 12, ndipo zizindikiro zake sizikhala bwino pambuyo poti theka la chakudya cham'mimba chapatsidwanso, chomwe chimawonedwa ngati cholowa. kusalolera zakudya.Kusalolera kwa m'mimba kungathenso kugawidwa m'matumbo a m'mimba (kusunga m'mimba, kusanza, reflux, kukhumba, etc.) ndi kusalolera kwa m'mimba (kutsekula m'mimba, kutupa, kuwonjezeka kwa m'mimba).
Pulofesa Gao Lan adanenanso kuti odwala akayamba kusagwirizana ndi zakudya zopatsa thanzi, nthawi zambiri amakumana ndi zizindikiro malinga ndi zizindikiro zotsatirazi.
Chizindikiro 1: Kusanza.
Onani ngati chubu cha nasogastric chili pamalo oyenera;
Kuchepetsa kulowetsedwa kwa michere ndi 50%;
Gwiritsani ntchito mankhwala pakafunika kutero.
Chizindikiro 2: Kumveka kwamatumbo.
Lekani kulowetsedwa kwa zakudya;
Perekani mankhwala;
Yang'ananinso maola awiri aliwonse.
Chilolezo chachitatu: kuthamanga kwa m'mimba/m'mimba.
Kuthamanga kwapakati pamimba kumatha kuwonetsa bwino momwe matumbo ang'onoang'ono amasinthira komanso kusintha kwa mayamwidwe, ndipo ndi chizindikiro cha kulolerana kwazakudya kwa odwala omwe akudwala kwambiri.
Pakuthamanga kwa magazi m'mimba pang'ono, kuchuluka kwa kulowetsedwa kwa zakudya m'thupi kumatha kusungidwa, ndipo kuthamanga kwapakati pamimba kumatha kuyesedwanso maola 6 aliwonse;

Kuthamanga kwa m'mimba kukakwera pang'onopang'ono, chepetsani kulowetsedwa ndi 50%, tengani filimu ya m'mimba kuti musatseke matumbo, ndipo bwerezani kuyesa maola asanu ndi limodzi aliwonse.Ngati wodwalayo akupitilizabe kukhala ndi vuto la m'mimba, mankhwala a gastrodynamic angagwiritsidwe ntchito molingana ndi momwe alili.Ngati kuthamanga kwa m'mimba kukuchulukirachulukira, kulowetsedwa kwa zakudya zam'mimba kuyenera kuyimitsidwa, kenako kuwunika mwatsatanetsatane m'mimba kuyenera kuchitidwa.
Chizindikiro 4: Kutsekula m'mimba.
Pali zifukwa zambiri zomwe zimayambitsa matenda otsekula m'mimba, monga matumbo a m'mimba, kukhetsa, kukokoloka, kuchepa kwa michere ya m'mimba, mesenteric ischemia, edema ya m'mimba, ndi kusalinganika kwa zomera za m'mimba.
Njira yochizira ndikuchepetsa kuchuluka kwa chakudya, kuchepetsa chikhalidwe chazopatsa thanzi, kapena kusintha kadyedwe kameneka;perekani chithandizo chomwe mukufuna malinga ndi zomwe zimayambitsa kutsekula m'mimba, kapena kutengera kukula kwa m'mimba.Tikumbukenso kuti pamene kutsekula m'mimba kumachitika odwala ICU, ali osavomerezeka kusiya enteral zakudya supplementation, ndi kupitiriza kudyetsa, ndipo nthawi yomweyo kupeza chifukwa cha kutsekula m'mimba kudziwa njira yoyenera ya mankhwala.

Index 5: zotsalira m'mimba.
Pali zifukwa ziwiri zotsalira zam'mimba: zifukwa za matenda ndi zinthu zochizira.
Zomwe zimayambitsa matenda zimaphatikizapo ukalamba, kunenepa kwambiri, shuga kapena hyperglycemia, wodwalayo wachitidwa opaleshoni ya m'mimba, ndi zina zotero;

Zomwe zimapangidwira mankhwala zimaphatikizapo kugwiritsa ntchito mankhwala oletsa kupuma kapena opioid.
Njira zothetsera zotsalira za m'mimba zimaphatikizapo kuwunika mozama za wodwalayo musanagwiritse ntchito zakudya zopatsa thanzi, kugwiritsa ntchito mankhwala omwe amalimbikitsa kusuntha kwa m'mimba kapena kutulutsa acupuncture pakafunika, ndikusankha mankhwala omwe amachotsa mwachangu m'mimba;

Kudyetsa m'mimba ndi jejunal kumaperekedwa ngati pali zotsalira zamimba zambiri;mlingo wochepa umasankhidwa kuti udyetse koyamba.

Index 6: reflux/aspiration.
Pofuna kupewa kukhumba, ogwira ntchito zachipatala amatembenuza ndi kuyamwa zotsekemera za kupuma kwa odwala omwe ali ndi chidziwitso chofooka asanadyetse m'mphuno;Ngati mkhalidwewo ukuloleza, kwezani mutu ndi chifuwa cha wodwalayo ndi 30 ° kapena kupitilira apo panthawi yoyamwitsa m'mphuno, ndipo mukatha kuyamwitsa mphuno Khalani ndi malo ocheperako mkati mwa theka la ola.
Kuphatikiza apo, ndikofunikira kwambiri kuyang'anira kulolerana kwa zakudya za odwala tsiku ndi tsiku, komanso kusokoneza kosavuta kwa zakudya zopatsa thanzi kuyenera kupewedwa.


Nthawi yotumiza: Jul-16-2021