Zizindikiro zovuta za ubongo zimayenera kuyesa ndikumeza
Mbali za ubongo zomwe zimayambitsa kulankhula ndi kuyendetsa minofu ya pakamwa ndi pamtima zingakhoze kuonongeka panthawi yachisokonezo cha mutu . Kuwonongeka kumeneku kumakhudza momwe minofu ndi mitsempha yawo yothandizira imayankhira mauthenga ochokera mu ubongo kapena kupsinjika ndi zovuta zomwe zimayambitsa mmero. Pamene kutafuna ndi kumeza sikugwira ntchito bwino, kungayambitse mavuto ambiri kuphatikizapo chibayo.
Kudya ndi kumeza mavuto kungakhale kusagwirizana pakati pa ubongo ndi minofu, ngakhale kuti pangakhale kuwonongeka kwa minofu komwe kumayambitsa vuto.
Ubongo ndi Kuyala
Pali mitsempha 26 yosiyana pakamwa, pakhosi, mmero ndi phokoso kuti ubongo umalamulira pamene chakudya kapena madzi amatha. Mitsempha yomwe imalamulira minofu imeneyi imalandira chizindikiro kuchokera mu ubongo kotero kuti ikhonza kugwira ntchito mogwirizana. Ubongo ukapwetekedwa ndi kupsinjika kwa mutu, zizindikiro za minofu 26 zingakhale zosagwirizana.
Kugwiritsa ntchito MRI ndi PET kuunika kwa ubongo kumasonyeza kuti kumeza ndi kovuta komanso kuti pali kusiyana pakati pa kumeza ndi cholinga chowongolera ngati kugwedeza kumbuyo kwa mmero kumachokera ku madzi kapena chakudya. Kulumikiza molondola sikumangokhala mbali imodzi ya ubongo koma kumakhala mbali zambiri za ubongo.
Kuwonongeka kwa ubongo kuchokera ku matenda aakulu ndi kuikidwa magazi, kutupa ndi mitsempha ya mitsempha imfa kumatha kulepheretsa zizindikiro zowononga kuti zisachoke ku ubongo kupita pakamwa ndi mmero, ndi mmbuyo.
Dysphagia pa Kuvulaza Ubongo
Mawu otsatirawa amagwiritsidwa ntchito pofotokoza zovuta zomwe zimabwera chifukwa cholephera kulamulira lilime, pakamwa, mmero ndi phokoso.
- Dysphagia: zovuta kumeza
- Dysarthria : zovuta kulankhula mawu
Pali masitepe anai, kapena magawo, omwe amafunika kutsatiridwa pamene akumeza. Iwo amatchedwa gawo lokonzekera pakamwa, gawo la pakamwa, gawo lokhalitsa ndi kuchepa. Kulephera kugwira ntchito kumatha kuchitika kumodzi mwa izi malinga ndi malo a kuvulala kwa ubongo
- Gawo lokonzekera pakamwa: chakudya chimayambitsidwa pakamwa, koma palivuta kuliyesa molondola, kusakaniza ndi saliva ndikupanga mpira wa chakudya chokonzekera kumeza. Izi zimawoneka ngati pali kuvulala kwa ubongo .
- Mlomo wa dysphagia : zovuta kulamulira mpirawo pokhapokha atapangidwa, ndipo sitingathe kufika pamalo abwino oti amame. Ochita kafukufuku amakhulupirira kuti phokoso la trigeminal ndi mapangidwe othandizira amatha kudziletsa.
- Pharyngeal phase dysphagia : mpira wa chakudya wapanga kumbuyo kwa kamwa ndi pamwamba pa pharynx. Mbalame yoyenera sizimachitika kotero chakudya chimangoyenda kumbuyo kwa mmero. Izi zingachititse kuti chakudya chifike m'mapapo. Kuwonongeka kwa khungu kakang'ono kamene kalikonse kameneka kungakhale kovuta mu nkhani yovutayi.
- Gawo la Esophageal dysphagia : chakudya chadutsa pammero ndi m'kati, koma chimagwira. Chakudyacho chimatha kupita kumbuyo ndikulowa m'mapapo. Zizindikiro ku malo omwe zimayambitsa kukankhira chakudya m'mimba zimayenera nthawi imeneyi, ndipo kachiwiri kachigawo kakang'ono kamene kalikonse kamakhala koyambitsa , kuphatikizapo phokoso lamakono ndi mpweya wamoto.
Ochita kafukufuku akuphunziranso njira zovuta zowonetsera kumeza.
Zimene Muyenera Kuziyang'ana
Zina mwa zizindikiro zoyambirira za vuto loyipa ndizo:
- Kudya kapena kumwa kumayambitsa kutsokomola mwamsanga
- Akungoyamba atangomva
- Kusankha pamene kuyesera kumeza
- Kusuta kapena kumeza
- Kudya chakudya pakati pa tsaya kapena chingamu
- Kutaya kwa chakudya kapena madzi kudzera m'mphuno
- Kutaya / kutaya madzi kapena chakudya kuchokera mkamwa pamene mukudya kapena kumwa
- Kudya pang'onopang'ono
- Zovuta zooneka kapena zovuta kumeza
- Osadya kapena kumwa mokwanira
- Kutsetsereka kwamadzi ozizira
- Zikakamizo kuti ngati akuwona kuti chakudya chikukwera mmero
- Ululu pambuyo pa sternum mutatha kudya
Popeza ndi kofunikira kuti ndiyankhule, kukhwima ndi kumeza, aliyense amene ali ndi vuto m'maderawa ayenera kuwona olankhula chinenero chamalankhula. Kuyesera kwachindunji kungathandize kuzindikira vuto lalikulu lomwe likulepheretsa kutaya ulamuliro pa ntchito yofunikayi.
Udindo Wa Kulankhulana Kwachiyankhulo Wopereka Opaleshoni Pambuyo Pakuzunzika kwa Mutu
Mwina simungaganize kuti wodwala kulankhula chinenero angathandize munthu amene akuvutika kumeza. Komabe, mtundu uwu wa mankhwala umayankhula nkhani zingapo zomwe zimayenda pamodzi monga kulamulira milomo, lirime ndi chilakolako, zomwe ndizofunikira kuyankhula ndi kumeza.
Wodwala wodwalayo angayambe ndi kuyankhulana, kenaka fufuzani pakamwa ndikupereka chakudya ndi madzi pazigawo zosiyanasiyana kuti mudziwe momwe munthu amachitira.
Pali zowonongeka zambiri zomwe zingagwiritsidwe ntchito pakakhala koyenera kumvetsetsa nthawi yomwe ikumeza sikugwira ntchito bwino.
Mayesero Odziwika Amodzi
- Barium: Barium ndi mtundu wosiyana womwe umaonetsa pa x-ray. Wodwala amapatsidwa madzi kapena mapiritsi ovekedwa ndi barium ndiyeno x-ray amagwiritsidwa ntchito powona mmene ntchitoyo ikugwiritsidwira ntchito, ndipo ngati mapiritsi angadutse pakamwa mpaka mmimba.
- Phunziro Lowonjezera Mphamvu : Chakudya chimaphimbidwa ndi kusiyana kwa barium ndikudya. Njira ya kutafuna imawonetsedwa pa x-ray, kuphatikizapo kutha kupanga chakudya mu mpira, kusunthira kumbuyo kwa mmero ndi kumeza. Ndizotheka kuona ngati chakudya chikulowa m'mapapo.
- Kujambula kwapopopi / Fiber-Optic Swallow Kuwunika : Phukusi limagwedezeka mpaka kummero ndipo mapiko a mitsempha ndi amphongo amatengedwa pamene akumeza.
- Manometry : Tiyi yaing'ono imayikidwa mu mmero kuti tiyese kupanikizika pamene tikumeza. Izi zikhoza kukhala njira imodzi yodziwira ngati mphamvu zofooka za minofu zikuthandizira kuti pasakhale kuyenda bwino kwa zakudya.
Kubwezeretsa Zinthu Zofunikira Pambuyo Pambuyo la Mutu
Zochitika zazikuluzikuluzikulu ziyenera kukumana ndi vuto la ubongo pozindikira momwe munthu angathe kumeza ndipo ndizotheka kuti kubwezeretsedwa kumabweretsanso ntchitoyi.
- Pamafunika kukhazikika mosalekeza pa mlingo wa chidziwitso. Mayankho oyenerera pa zochitika zosiyanasiyana, zolimbitsa thupi ndi zooneka ndizofunikira. Pamene ufulu wochulukirapo ukuwonjezeka komanso mayankho amakhala oyenerera, ndibwino kuti ubongo udzayankhire moyenera kuyambika kwa chakudya ndi madzi.
- Kukhoza kuika maganizo pazochita ndi kuchepetsa kusokonezeka n'kofunikanso. Kuchita nawo mankhwala opatsirana, ndi kudya chakudya chonse popanda mavuto, kumafuna kuika maganizo.
Pali zochitika zosiyanasiyana zomwe odwala amachititsa odwala omwe akudwala matenda aakulu, komanso kuti mabanja angathandizenso munthu amene akudwala matendawa.
Zizindikiro Zowatumiza Zidzabwereranso Pambuyo pa Chisautso Chakumutu
Zisonyezo zina zomwe gulu la rehab likuyang'ana kuti liwonetsetse kulamulira pa kumeza ikubweranso ndi:
- Khalani maso ndi kumvetsetsa zomwe zikuchitika m'deralo
- Kukonza zolakwa poyesa kuchita mtundu uliwonse wa ntchito
- Mavuto ndi kumeza makamaka makamaka mukutafuna ndi kulenga mpira wa chakudya, osati kulamulira minofu ya mmero
- Ngati chakudya chikuyenda molakwika, pali chifuwa cholimba kuti chiteteze mlengalenga
- Kukhoza kupuma mpweya ndikupuma bwino kulipo
- Kukhoza kudya zakudya zokwanira komanso zakudya zokwanira mwa kudya
Kodi Mungadye Chiyani?
Pachiyambi pangakhale kofunikira kuti chakudya ndi madzi azikhala ndi mawonekedwe osagwirizana. Wodwala wodwalayo amadziŵa mtundu wa mawonekedwe amene amagwira ntchito bwino kwambiri kuti wodwalayo azivutika kwambiri. Textures ndi awa:
- Kuyeretsedwa: Kusankhidwa pamene pali zofooka za pakamwa ndi m'zinenero, ndi zovuta zowutafuna ndi kutsuka pakamwa pakamwa. Chakudya choyera chimachepetsa mwayi woti chakudya chokwanira chidzakanikizidwira ndi kutsekereza pamsewu
- Mankhwala amafewa: zakudya izi zimadulidwa kapena kudulidwa mzidutswa ting'onoting'ono. Iwo ali ndi anthu omwe apindula nawo chakudya choyera, koma akadali pangozi yokakwera zidutswa zazikulu.
- Zowonongeka : chakudya chimenechi ndi anthu omwe ali ndi zofooka za pakamwa zomwe zimavuta kuti azifunafuna zakudya zokhazikika. Zakudya monga bagels kapena steak zomwe zimafuna kutafuna mwamphamvu ndi kukonzekera kumeza zimapewa.
- Kudulidwa kofewa : kawirikawiri amagwiritsidwa ntchito kwa opulumuka odwala omwe ali ndi mavuto ena monga kudziŵa mbali yoyenera ya chakudya choyikidwa pakamwa, kapena omwe ali ndi zofooka kwambiri zomwe zimapangitsa kuti zikhale zovuta kuti adzidye chakudya chawo.
- Nthawi zonse: Zakudya zamakono zilibe malamulo.
Kudyetsa Kwambiri
Nthawi zina thupi limatha kubwerera osati kubwerera. Pazochitikazi, zimakhala zoyenera kuyamba kuyambitsa zopatsa.
- Kudyetsa kwa IV : Yankho laling'ono labwino lingakhale kupereka chakudya kudzera mwa IV. Izi zikhoza kugwiritsidwa ntchito ngati pangakhale kuwonongeka kwa dongosolo la zakudya zomwe zimalepheretsa kudya zakudya mwa njira yoyenera.
- Tizilombo toyambitsa matenda : Ichi ndi chakudya cha kanthawi kochepa. Chubu imalowa mkati mwa mphuno mpaka kumimba. Ikhoza kugwiritsidwa ntchito pokhapokha mutatha kupwetekedwa mtima pamene wina ali pa mpweya wabwino, kapena ali ndi zolepheretsa zina zomwe zimawalepheretsa kumeza chakudya chokhazikika.
- PEG Tube: PEG imaimira Percutaneous Endoscopic Gastrostomy. Tizilombo toyambitsa matenda amaikidwa opaleshoni kudzera m'mimba mwa m'mimba m'mimba. Imeneyi ndi njira yodalirika yopatsa chakudya.
Kubwezeretsa Mutu Wopweteka ndi Kuwongolera
Kuchokera kuchisokonezo cha mutu kungakhale pang'onopang'ono. Pakhoza kukhala zovuta zambiri zomwe zingagonjetse, ndi kumeza ngati kukhala mmodzi wa iwo. Popeza chakudya choyenera ndi chofunikira kwambiri kwa minofu, mitsempha ndi matenda kuchiritsa, kumeza kumakhala nkhani yoyamba yomwe ikugwiritsidwa ntchito ndi timu yoyipa.
> Zosowa
> Chilankhulo cha American, Language ndi Kumvetsera (2016) Kuopsa kwa ubongo wa ubongo. http://www.asha.org/public/speech/disorders/TBI/
> Hamdy, S. (2006) Udindo wa ubongo wa chiberekero mu ulamuliro wa kumeza, GI Motility online doi: 10.1038 / gimo8
> Lang, I. (2009) Kugonjetsedwa kwa ubongo wa magawo a kumeza. Dysphagia. 24 (3): 333-48. lembani: 10.1007 / s00455-009-9211-6