Tizilombo toyambitsa matenda ndi mankhwala omwe amagwiritsidwa ntchito kudyetsa munthu amene sangathe kudya chakudya moyenera. Vutoli likhoza kukhala chifukwa cha vuto lomeza , kusintha kwa chidziwitso, vuto la kudya, kapena zina zomwe zimapangitsa kudya kukhala kovuta. Pali mitundu yambiri ya kudyetsa timachubu komanso zifukwa zambiri zomwe zimapangidwira kugwiritsira ntchito chubu.
Mkhalidwe uliwonse ndi wosiyana, ndipo chisankho chokhala ndi chubu chodyetsa chosungidwa ndi chinthu chosiyana kwambiri kuposa kulola chubu yamakono kuti ikhalepo.
Kuti mudziwe zambiri zokhudza kudyetsa timachubu, m'pofunika kumvetsetsa kuti tizilombo toyambitsa matenda ndi kusiyana kotani pakati pa mitundu yodyetsera zida, pamene phukusi likufunika kutsutsana ndi momwe mungapangidwire.
Kudyetsa Mitambo Yabwino
Tizilombo toyamwa ndi kapulasitiki yomwe imagwiritsidwa ntchito kudula ndi kummeza wodwala yemwe sangathe kudya kapena kumwa moyenera. Ma tubes angagwiritsidwe ntchito popereka chakudya ndi madzi, ndipo angagwiritsidwe ntchito popereka mankhwala pakufunika. Tizilombo toyambitsa matenda tingagwiritsirenso ntchito kuchotsa madzi m'mimba ngati thupi silikukonza m'mimba bwino.
Ntchito
Kudyetsa timachubu ndi zabwino koposa kupatsa chakudya, zimathandizanso kuchepetsa mpweya ndi kupweteka, komanso kuchepetsa kunyowa ndi kusanza.
Kugwiritsidwa ntchito kwagwiritsiridwa ntchito ndi:
- Kupereka Chakudya: Chakudya, mu mawonekedwe a madzi, chingaperekedwe kudzera mu chubu chodyetsa. Kupatsa tizilombo, kapena chakudya chamagulu, kungaperekedwe kudzera mu chubu kuti mupereke chakudya, mapuloteni, ndi mafuta kwa thupi popanda kufunika kuti wodwala azimeza kapena kusaka.
- Kupereka Zamadzimadzi: Madzi akhoza kuperekedwa pogwiritsa ntchito chubu kuti amuthandize wodwalayo kuti asazidwe popanda kuwapatsa madzi.
- Kupereka Mankhwala: Mankhwala, kuphatikizapo mapiritsi ambiri ndi mapiritsi, angaperekedwe pogwiritsa ntchito chubu. Mapiritsi angafunike kugaya ndipo makapulisi ena amafunika kutsegulidwa, koma ngati ma particles ali ochepa mankhwala ambiri akhoza kuphatikizidwa ndi madzi ndipo amaperekedwa kudzera mu chubu.
- Kusokoneza m'mimba: Mitundu ina ya chubu imatha kugwiritsidwa ntchito kuchotsa mpweya kuchokera m'mimba. Mitundu ina ya kudyetsa timachubu, nthawi yaying'ono, makamaka, ingagwirizanitsidwe ndi kuyamwa kuchotsa mpweya kuchokera m'mimba kuchepetsa kutsekedwa ndi kuphulika.
- Kuchotsa m'mimba Zamkatimu: Ngati simukukonza chakudya kapena madzi, mutha kukhala ndi chakudya chokhala m'mimba chomwe chimayambitsa mavuto, kunyoza, kusanza kapena kupweteka m'mimba. Kusamwa pang'ono kungagwiritsidwe ntchito kuchotsa madzi ndi zakudya zing'onozing'ono za m'mimba mwako.
Pamene Kudyetsa Tube N'kofunika
Tizilombo toyambitsa matenda ndi kofunikira pamene simungatenge chakudya kapena madzi mwachangu. Ngakhale kuti n'zotheka kupereka madzi ndi zakudya kudzera mu IV , thupi limachita bwino ndi chakudya chomwe chimaperekedwa m'matumbo kusiyana ndi mitsempha ya m'magazi. Ngati n'kotheka, ndibwino kuti thupi lilandire chakudya ndi zakumwa m'mimba kuti zikhale bwino, koma ngati muli ndi vuto lomeza, izi sizikhala zotetezeka.
Kugwidwa ndi vuto kungatanthauze wodwala kugwedeza pa chakudya ndi madzi, kapena "amatsitsa chitoliro cholakwika" ndipo zinthu zimaphatikizidwa m'mapapo m'malo momeza. Izi zingayambitse matenda aakulu, kuphatikizapo chibayo , kuchokera ku chakudya chomwe chimalowa m'mapapu.
Ena akhoza kudwala kwambiri kuti asamame, kapena ali pa mpweya wokhala ndi chubu yomwe imalowetsedwera mumsewu womwe umalepheretsa kumeza. Odwala ena ali ochenjera komanso otsogolera koma sangathe kumeza bwino. Komabe, ena ali ndi matenda kapena matenda omwe amachititsa kuti zikhale zovuta kuzimeza, monga khansa ya m'kamwa.
Chisankho Choyika Kudyetsa Tube
Chigamulo choyika tizilombo toyambitsa matenda ndi chovuta ndipo chimakhala chovuta kwambiri ngati wodwala sangathe kutenga mbali pazokambirana kapena sanakambirane zofuna zawo pokhudzana ndi chisamaliro chawo.
Nthaŵi zambiri, wodwala amene akusowa chubu amatha kukhala pansi kapena kusadziwa kanthu ndipo satha kugawana zofuna zawo ndi abwenzi ndi okondedwa awo.
Funso la zomwe wodwala angafunire, ndipo ngati chubuyo ikhoza kukhala yachanthawi, nthawi yayitali kapena yosatha imayenera kulingalira. Mabanja ena amathera masiku akukambirana za chisankho pakati pawo kapena amakhala ndi abambo akukumana ndi odwala kuti akambirane za chisankhocho.
Nthawi zambiri, chigamulo choyika tizilombo toyambitsa matenda chikugwirizana ndi chisankho choyika tracheostomy, phokoso pammero pomwe mpweya umatha kupuma. Izi zimakhala chifukwa cha mpweya , njira yomwe chubu imalowetsamo m'kamwa ndikupita kumtunda kuti mpweya uzigwiritsidwa ntchito, ingagwiritsidwe ntchito kwa masabata pang'ono mpaka kuwonongeka kungachitike pammero. Popeza zinthu zonsezi zili mkati mwa mphindi ziwiri, kugwiritsidwa ntchito kwa tracheostomy ndi chapamimba chubu nthawi zambiri zimagwira nthawi imodzi kapena masiku angapo.
Mitundu
Pali mitundu yambiri ya kudyetsa makapu, ndipo amagwiritsidwa ntchito pazinthu zosiyanasiyana. Mkhalidwe wa vuto lomwe limayambitsa kumeza , lotchedwanso dysphagia, lidzathandiza kudziwa mtundu wa chubu yomwe imagwiritsidwa ntchito. Zina zimakhala zosakhalitsa, ndipo zina zimayenera kukhala zanthawi yaitali kapena zosatha.
Tizilombo toyambitsa kanthawi kochepa, kamene kamalowetsedwa m'mphuno kapena pakamwa, pammero, mmimba, kapena m'mimba (J-tube), ikhoza kukhalabe pamalo okwana pafupifupi khumi ndi anai masiku. Kuyika pa khosi yaitali kuposa masabata awiri kumawonjezera chiopsezo cha kuwonongeka kwa matenda osakanikirana a mmero ndi mmimba. Izi zingayambitse nkhani zamuyaya monga kuwonongeka kwa bokosi la mawu ndi mmero.
Tizilombo toyambitsa matenda nthawi yayitali kapena yodalirika ndi imodzi yomwe ikuyenera kugwiritsidwa ntchito kwa miyezi, zaka kapena malo osatha. Mofanana ndi chubu yamakono, ma tubes angachotsedwe ngati sakufunikanso koma akhoza kukhalapo kwa nthawi yaitali popanda chiopsezo kwa pakamwa, pakhosi, ndi m'mimba chifukwa chakudya chimalowa m'mimba.
Kudyetsa kwa nthawi yayitali
Thupi la Nasogastric (NG): Mtundu uwu wa chubu umayikidwa mu mphuno, pansi mpaka pammero, mpaka kudutsa m'mimba mpaka m'mimba. Ikhoza kukhala m'malo kwa milungu iwiri isanayambe kuchotsedwa kapena kusinthidwa ndi tizilombo toyamwa nthawi yaitali.
Tizilombo toyambitsa matenda (OG): Thumba lofanana ndi chubu, chubu imalowetsedwa m'kamwa, pansi pammero mpaka kumapeto ndi kumapeto kwa m'mimba. Thubuyi ikhoza kukhalabe m'malo kwa milungu iwiri pamene iyenera kuchotsedwa kapena kusinthidwa ndi chubu chosatha.
Kudyetsa Kwadongosolo Nthawi Zonse
Tizilombo toyambitsa kanthawi kameneka timalowetsamo m'kamwa kapena mphuno, kummero, kummimba ndipo kenako mapeto amakhala m'mimba (J-tube) kapena pakatikati mwa katumbo. Mitundu ya ma tubes ili ndi nsonga yofiira, yomwe imatanthawuza kuti pali zinthu zambiri zomwe zimawalola kuti zidziwike pa x-ray pamapeto a chubu. Pambuyo poika malo, x-ray yachitidwa, ndipo izi zimalola kuti malo oyenera atsimikizidwe kuti chubu isagwiritsidwe ntchito.
Mitundu ya Kudyetsa Kwanthawi Zonse / Kwanthawi Yaitali Mitengo
Tizilombo toyambitsa matenda (G chubu): Mankhwalawa amathandiza kuti munthu apite m'mimba mwachindunji kudzera m'mimba yomwe ili kumapeto kwa mimba. Phukusili limadutsa pakamwa ndi pammero ndipo limapatsa chakudya, madzi, ndi mankhwala popanda kumeza.
Thupi la Jejunostomy (J tube): Mtundu uwu wa chubu umakhala wofanana ndi chubu cha m'mimba, poikidwa kudzera m'kati mwa mimba yomwe ili yochepa kuposa G-tube placement, ndipo amalola kulumikiza mwachindunji ku jejunum yomwe ili pakati pa magawo atatu a matumbo aang'ono. Phukusili limakhala laling'ono kwambiri kuposa G-tube, zomwe zingathe kuchepetsa zomwe zingapangidwe kuti zikhale zochepa komanso zamadzimadzi.
Gulurostomy (Percutaneous Endoscopic Gastrostomy) (PEG): Liwu limeneli limagwiritsidwa ntchito mosiyana ndi G-tube, koma izi zikutanthauza njira yogwiritsira ntchito G-tube. Pogwiritsa ntchito khungu (endoscopic) (gastrostomy) (kugwiritsira ntchito mimba m'mimba) imalongosola njira yomwe amagwiritsa ntchito poika G-tube, osati G-tube yokha.
Momwe Tingagwiritsire Ntchito Tiyi ya Gastric
Ndondomeko yowonjezeramo chapakiteriya yamatumbo imakhala yofulumira, ndipo imatha kapena siidzafuna anesthesia malingana ndi matenda anu. Odwala omwe ali odwala kwambiri mu chithandizo chamankhwala, palibe choonjezera choonjezera chomwe chiyenera kuyika chubu pambali pa bedi.
Endoscope ndi chida chochepa chaching'ono chokhala ndi kuwala ndi kamera kumapeto komwe kumalola woperekayo kuti ayang'ane njirayo pa kufufuza. Chiwerengerocho chimayikidwa m'kamwa, pansi pammero, ndi m'mimba. Kamodzi m'mimba, n'zotheka kuwona kuwala komwe kumawonekera kupyolera pakhungu la mimba, kusonyeza gastroenterologist komwe angapangitse chikopacho. Kutengeka pang'ono kumapangidwa pafupifupi theka la inchi yaitali, kupyolera mwazimene zimapangidwira. Ma G-tubes akale angakhale ndi buluni yomwe imasunga chubu.
Gawo lakunja la chubu liri ndi kapu yomwe imalola kuti chubu ikhale yotsegulidwa, komanso kuti chakudya ndi madzi azitsitsimutsidwa mosamala kudzera mu chubu kupita mmimba. Pokhala ndi chithandizo chabwino cha chubu , chowomberacho chimayandikira kwambiri mozungulira chubu, ndipo chakudya chilichonse kapena kutuluka kwa madzi komwe kumachitika masiku omwe amatsatira chithandizochi chiyenera kuchepetsedwa ndi machiritso.
Pamene mankhwalawa akuchiritsidwa, bandage yomwe imagawanika imayikidwa kuzungulira chubu. Izi zimathandiza kuyamwa madzi alionse omwe angathenso kuchoka pa webusaitiyi. Ngati ngalande ilipo ndipo ikuwopsya khungu, mafuta oletsa angagwiritsidwe ntchito poteteza. Kusamba mosamala malowa ndi sopo ndi madzi ndi sopo wochapa zowonongeka m'deralo nthawi zambiri amasamalira malo.
Kwa nthawi yayitali, odwala ambiri samafuna mafuta onunkhira kapena malo ochezera, koma ena amasankha kuvala ngati pali madzi okwanira kuteteza khungu kapena zovala.
Kudyetsa Kwadongosolo Kuchotsedwa kwa Tube
Kutulutsidwa kwa tizilombo toyambitsa matenda omwe ndi kanthawi kochepa ndi kosavuta komanso kosavuta. Zingakhale zokwiyitsa ndi matenda osakhwima a pakamwa, mmero, ndi mphuno, koma izi sizing'onozing'ono. Pochotsa chubu, chubu imachotsedwa chakudya ndi madzi, ndi sirinji yaikulu yomwe imagwiritsidwa ntchito ndi chubu. Kenako amachotsedwa pang'onopang'ono, kutenga 3-5 masekondi kuti achoke mosavuta. Ngati nsonga ya chubu ili yosakanikirana, kusonyeza kuti chubu chonsecho chachotsedwa bwino, chimatayidwa kutali.
Kudyetsa Kwamuyaya Kuchotsa Mafuta
Ngati mungathenso kudya ndi kumwa bwino, n'zotheka kuchotsa chubu "chosatha". Chodabwitsa n'chakuti njirayi ifulumira, ndipo pamene pali ululu, nthawi zambiri imakhala yochepa komanso yochepa. Ogwira ntchito amasiyana malinga ndi zomwe akufuna kuti chubu chichotsedwe; zina zingafunike kuti mukhalebe wolemera kwa mwezi umodzi pamene mukudya chakudya chonse ndi madzi kudzera mu G-tube, pamene ena angafunike nthawi yaitali.
Mukasankha kuchotsa chubu, chubu ikhoza kutulutsidwa, koma izi zimafuna mphamvu zambiri kuti zigwiritsidwe ntchito. Nthawi zambiri wodwalayo ali ndi thaulo losungira malo pafupi ndi malowa, ndipo wothandizira amajambula chubuchi mwamphamvu ndipo amachotsa mwamphamvu koma molimba kuchotsa pa webusaitiyi. Ngati pali buluni mkatikati mwa m'mimba, imatetezedwa musanachotse chubu, koma mitundu yambiri ili ndi phula m'malo mwa buluni ndipo sitepeyi siidakali.
Njirayi imakhala ikubaya, ndipo nthawi zina mumakhala magazi pang'ono, koma ululu umapita mwamsanga. Mutha kuyembekezera kuti chovalacho chidzatsekedwa, koma izi sizofunika, ndipo kuvala koyera kumakhala kokwanira kuti zovala za wodwala zikhale zoyera m'masiku omwe akutsatira ngati pali ngalande iliyonse. Katemerawo amatseka mkati mwa sabata ya chubu ikuchotsedwa.
Mawu Ochokera
Chisankho choyika tizilombo toyambitsa matenda sikoyenera kuchepetsa, ndikofunika kukambirana za mtundu wautali womwe mungathe kuyembekezera inu kapena wokondedwa wanu. Kwa odwala ena, chubu amayenera kukhala ya kanthawi pamene akuchira matenda. Kwa odwala ena, tizilombo toyambitsa matenda tingayembekezere kukhalabe moyo wawo wonse.
Kaya izi ndi zoyenera kwa inu kapena wokondedwa wanu funso lalikulu. Ngati muli wothandizira pazifukwa zomwe zingafunike kugwiritsira ntchito tizilombo toyambitsa matenda, wokondedwa wanu akhoza kukhala ndi malingaliro olimba pa mutuwo, kapena iwo sanatchulepo zokhumba zawo za nthawi yaitali. Ngati simukudziwa zokhumba zawo, pogwiritsa ntchito malingaliro anu-pamodzi ndi malingaliro a gululo mutasamalira komanso mwakufunsani kwa okondedwa anu-zidzakuthandizani kupanga chisankho.
> Chitsime:
> Kumvetsetsa Endoscopic Gastrostomy (PEG). American Society Kwa Zachimake Endoscopy. https://www.asge.org/home/for-patients/patient-formation/understanding-peg