Kupadera Kwambiri Kuchitira Kutsika Kwambiri ndi Kutaya Kwambiri
Bariatrics ndi ofesi ya mankhwala yomwe imakhudza kuphunzira, chithandizo, ndi kupewa kutaya kunenepa . Mawu akuti batiatrics amachokera ku chi Greek cha baro - chomwe chimatanthauza kulemera kapena kwakukulu. Munda wa bariatrics umaphatikizapo zakudya, zochita masewera olimbitsa thupi, mankhwala, mankhwala, ndi opaleshoni - zonse zokhudzana ndi kukwaniritsa zolemetsa.
Wopereka chithandizo chamankhwala akhoza kuchita mwapadera mu baratrics, koma sikuti ndi dokotala wa opaleshoni.
Wopereka zakudya zogwiritsira ntchito bwino kwambiri mankhwalawa akhoza kukhala wodalirika wothandiza odwala kupewa kapena kuthetsa kunenepa kwambiri, monga momwe wodwala wodziwika bwino wa mankhwalawa angapereke chithandizo kwa anthu omwewo. Madera ambiri a chithandizo chamankhwala akhoza kukhala ndi anthu omwe amadziwika bwino ndi mabungwe.
Kugwiritsidwa ntchito kofala kwambiri kwa mawu akuti "bariatrics" kumatchulidwa kumalo a mankhwala omwe amachititsa kunenepa kwambiri ndi njira zopangira opaleshoni. Opaleshoni ya bariat imaphatikizapo njira zothetsera kuchepa kwa msinkhu kapena kuchepetsa kukula kwa m'mimba kapena kuchepetsa kuchuluka kwa chakudya chomwe chingadye ndi kugwiritsidwa ntchito ngati ma calories m'thupi. Njira zina za bariatric zimapanga zonsezi, monga roux en y, njira yomwe imachepetsa kukula kwa m'mimba ndi kuchepetsa kuchuluka kwa mavitamini omwe thupi lingakhoze kulandira.
Opaleshoni ya Bariatric: Education ndi Certification
Madokotala akugwiritsa ntchito mankhwala ochiritsira ku America akhoza kukhala ndi bungwe lovomerezeka ndi American Board of Obesity Medicine (ABOM).
Kawirikawiri, dokotala adzatsiriza kumakhala mankhwala am'banja, mankhwala amkati, kapena opaleshoni yaikulu asanayambe maphunziro owonjezera kuti athandizidwe ndi ABOM.
Madokotala ochita opaleshoni ndi madokotala omwe amaphunzitsidwa opaleshoni kuphatikizapo opaleshoni ya opaleshoni. Ogwira ntchito opaleshoni omwe amadziwika kwambiri pochiza kunenepa amadziwika kuti ndi ana.
Kuwonjezera pa kuthana ndi kunenepa kwambiri, akatswiri a zabaatisti amadziŵa bwino matenda omwe amapezeka nawo nthawi zambiri ndi kunenepa kwambiri, kuphatikizapo shuga , nyamakazi, ndi matenda a mtima.
Njira Zopanda Opaleshoni Zochizira
Ngakhale kuti abambo a zaka zambiri amaganizira za njira zopanda opaleshoni mu mankhwala a mzere woyamba, kafukufuku amasonyeza kuti izi zimakhala ndi zochepa zochepa zomwe zimakhala zochepa komanso zimakhala zopanda phindu kwa nthawi yaitali. Zochitika zoyambirira zimaphatikizapo zakudya zowonongeka, mapulogalamu olimbitsa thupi, komanso njira zamakono zochizira pofuna kulingalira ndi kukonza zoyenera kudya.
Mankhwala angagwiritsidwe ntchito. Mwa iwo:
- Belviq (lorcaserin) amaletsa chilakolako chofuna kudya poyambitsa serotonin receptor yomwe imayendetsa matumbo.
- Byetta (exenatide) amagwiritsidwa ntchito pochiza mtundu wa shuga wa mtundu wa 2 koma amathandizanso kuchepetsa kuperewera kwa thupi pochepetsa kuchepa kwa mimba ndikupanga munthu kumverera mwamsanga.
- Glucophage (metformin) imagwiritsidwanso ntchito kwa odwala matenda a shuga koma imathandizanso kuchepetsa kulemera kwake kwa kuchepetsa kuchuluka kwa shuga komwe kamapangidwa ndi chiwindi pamene kuwonjezereka kwa shuga mu minofu.
- Qsymia (phentermine ndi topiramate) imaphatikiza chilakolako chokhudziritsa ndi anticonvulsant amakhulupirira kuti zimapangitsa kulemera.
- Xenical (orlistat) imachepetsanso m'mimba mafuta omwe amatulutsa mafuta.
Bariatric Surgery
Kuchita opaleshoni ya bariatric ndi imodzi mwa zinthu zofunika kwambiri mu mankhwala azaatric. Ochita opaleshoni a mabatire amafuna kuti azikhala ndi chiyanjano chaka chimodzi kapena kupitirira pakatha kumaliza chisamaliro chachikulu chokhala opaleshoni. Maphunziro apamwambawa amapereka mwayi wodziwa ntchito yopanga opaleshoni yolemetsa yosiyana.
Kuchita opaleshoni ya abatric kawirikawiri kumatengedwa kuti ndi anthu omwe ali ndi chiwerengero cha mthupi (BMI) cha makilogalamu 40 / m 2 kapena aakulu omwe opaleshoni yopanda opaleshoni alephera.
Zina mwazochita opaleshoni:
- Kugwiritsidwa ntchito kwagastric banding (komwe kumadziwika kuti lap band) kumachitidwa laparoscopically ndipo kumaphatikizapo kugwiritsa ntchito silicone yomwe siili yosatha yomwe imaletsa kukula kwa m'mimba.
- Kuchita opaleshoni yopitirira muyeso (yomwe imafala kwambiri ndi Roux-en-Y pozungulira) yapangidwa kuti ichepetse kuchuluka kwa chakudya chomwe munthu angathe kudya kudula gawo la m'mimba.
- Kaluni yamatumbo ndi njira yosakanikirana yomwe imapangidwira mkati mwa mmimba yomwe imakhala yotsekemera kuti ichepetse mpata.
- Mankhwala osakaniza (omwe amadziwikanso ngati msuzi wamkati) amachititsa kuchepetsa kuchepa kwa m'mimba mozungulira pafupifupi 15 peresenti pochotsa gawo lofanana ndi manja a chiwalo.
- Gulu lotchedwa banded gastroplasty (lomwe limatchulidwanso kuti mimba yosakanizidwa kapena njira ya Mason) imaphatikizapo kudumpha kwamuyaya kwa m'mimba kuti mupange thumba laling'ono.
Mawu Ochokera
Zapadera za bariatrics ndizokhalanso zatsopano, koma zikupita patsogolo pakupiritsa kunenepa kwambiri ndi opaleshoni komanso popanda. Kwa anthu omwe ali ochepa kwambiri, pali mitundu yambiri ya mankhwala yomwe ikupezeka kuchokera ku zakudya zowonjezereka kuti pakhale njira zothandizira kuchepetsa zakudya zomwe zimapezeka thupi. Kwa munthu yemwe ali wochuluka kwambiri ndipo akufuna kutaya mafuta owonjezera, pali zambiri zomwe mungapeze.
> Chitsime:
> Gloy, V .; Bhatt, D .; Kashyap, S. et al. "Kuchita opaleshoni yapamwamba poyerekeza ndi chithandizo chosagwiritsa ntchito opaleshoni cha kunenepa kwambiri: ndondomeko yowonongeka ndi kufotokozera mwachidule mayesero olamuliridwa mosavuta." BMJ . 2013; 347: f5934. DOI: 10.1136 / bmj.f5934.