Kudyetsa Ziphuphu ndi Vuto pa Mapeto a Moyo
Zimakhala zachilendo komanso zachilendo kwa odwala omwe akudwala matenda othetsera matenda kuti asadye njala ndi kuchepa kwa chakudya kapena zakumwa ndi kuchepa. Pamene matendawa akupita, odwala sangathe kudya kapena kumwa madzi pakamwa kapena sadzakana kudya kapena kumwa. Mwina mwinamwake wodwalayo wakhala akudwala kwa nthawi ndithu ndipo wakhala akulandira zakudya zopangira zakudya koma sakupeza bwino.
Mulimonsemo, funso loti sizingalephereke kapena kuchotsa zakudya zowonongeka. Izi zikhoza kukhala chifukwa chokhazika mtima pansi ndi zowawa kwa okondedwa a wodwalayo ndi osamalira.
Chakudya chopatsa thanzi ndiko kupereka kwa wodwala zakudya zothandizira zakudya zomwe sizikufuna kuti wodwala asake. Izi zingaperekedwe ndi zakudya zopatsa thanzi (TPN) kapena kudzera mu chubu la nasogastric (NG tube) kapena gastrostomy tube (G-tube kapena PEG tube).
Pali zinthu zambiri zomwe zingayambitse kusowa kwa njala ndikuchepetsa kuchepa kwa chakudya ndi madzi kumapeto kwa moyo. Zina zimayambitsa kusinthika, monga kudzimbidwa, kunyowa , ndi ululu . Zina zimayambitsa matendawa, monga khansa zina, kusintha kwa chidziwitso, ndi kufooka kwa minofu yoyenera kudya. Zotsatira zowonongeka ziyenera kudziwika ndi dokotala wa wodwalayo. Ngati chifukwa chake sichikudziwika kapena chosachiritsidwa, chisankho chomwe chingakhale choletsa kapena kuchotsa chithandizo chingapangidwe.
Kupanga chisankho choletsera kapena kuchotsa zakudya zakuthupi ndikumangirira kumapangitsa kuti anthu ambiri asamvetsetse bwino. Nthawi zambiri zimakhala zothandiza kuti anthu adziwe chisankho chovuta kumvetsetsa zomwe asayansi ndi mankhwala adapeza pokhudzana ndi zakudya zopangira zakudya komanso kumapeto kwa moyo.
Ubwino ndi Zowopsa za Zakudya Zakudya Zopangira Zakudya ndi Hydration
M'dziko lathu ndi chikhalidwe, chakudya ndi madzi amadziwoneka kuti ndi ofunikira kuti pakhale moyo ndikufulumizitsa machiritso ndi kuchiza matenda. Zimatsutsana ndi miyezo ya anthu ambiri kuti asiye chakudya ndi madzi kuchokera kwa wodwala wodwalayo kapena wakufa . Komabe ife tonse tikudziwa kuti kudziwa ndi mphamvu. Mofanana ndi chisankho chilichonse chamankhwala chomwe mukukumana nazo, nkofunika kumvetsa ubwino wa zoopsa. Kodi zakudya zakuthupi zimapindulitsa wodwalayo? Tiyeni tione zomwe kafukufuku wamankhwala angatiuze:
- Nthendayi ya Nthenda ya Parenteral - TPN ndi mtundu wopanda ungwiro wa zakudya zomwe zimagwiritsidwa ntchito kanthawi kochepa. Amaperekedwa kudzera mu mzere wapakati, omwe nthawi zambiri amaikidwa mu khosi kapena pamphuno ndi kutsekedwa kudzera mu mitsempha yomwe imatha pafupi ndi mtima. Nthaŵi ina ankaganiza kuti odwala ali ndi khansa angapindule ndi TPN. Chiyembekezo chinali chakuti chingathetseretu kusowa kwa njala ndi kuwonongeka kolemera kwambiri komwe odwala matenda a khansa amavutika ndikuwongolera. Komabe, kafukufuku wambiri anapeza kuti sizinathandizenso odwala khansa kulemera kapena kusintha moyo wawo. M'malo mwake, izi zowonjezera chiopsezo cha matenda ndi mavuto ndi chigawo chapakati chimene chinali choopsa kwa odwala.
- Nkhono (NG) Mipope - Kwa odwala omwe sangathe kumeza, kaya ndi chifukwa cha zotupa, zofooka, kapena matenda a mitsempha, kudyetsa kudzera mu chubu ndikumapereka chakudya choyenera. The nasogastric tube ndi njira yophweka yokwaniritsira izi. Phukusi imayikidwa kupyolera m'mphuno ndi pansi mpaka mmimba. Mankhwala amadzimadzi amaperekedwa kudzera mu chubu nthawi zonse pang'onopang'ono kapena kangapo patsiku ndi mlingo waukulu. Komabe, monga TPN, kafukufuku wambiri wa zachipatala wasonyeza kuti chiwerengero cha anthu omwe akudwala matenda odwala sichikusiyana ngati akudyetsedwa m'malo moperewera. Apanso, zoopsazo ndizoopsa. Odwala omwe ali ndi ma TB amakhala ndi chiopsezo chachikulu cha chibayo chomwe chingachepe kwambiri. Mankhwala a NG angathenso kuchotsedwa, kuchititsa kuti odwala komanso okondedwa awo azivutika.
- Gastrostomy (G) Mavayira - Gastrostomy chubu ndi imodzi yomwe imalowetsa m'mimba mwachithandizo mwa opaleshoni. Gastrostomy yokhayokha, kapena PEG tube, yatha kumapeto kwake ndipo imakhala yochepa kwambiri. Pamodzi mwa ma tubes, mulibe chiopsezo chochepa cha wodwala akukoka chubu. Pali chiopsezo cha chibayo, komabe. Mofanana ndi chubu la nasogastric, pali umboni wochepa wosonyeza kuti kudyetsa kudzera mu gastrostomy chubu kudzawonjezera thanzi kapena moyo wa odwala odwala.
- Kusakanikirana (IV) Kutentha - Ngati wodwalayo sangathe kumwa zakumwa kapena osamwa zomwe omusamalira ake amaganiza kuti ndizokwanira, wothandizira akhoza kuyesedwa kuti apemphe IV. Madzi amatha kuperekedwa kudzera mu singano yaing'ono yomwe imayikidwa mu mitsempha ndipo imagwiritsidwa ntchito poyikira. Kafukufuku wasonyeza kuti kupereka madzi kwa wodwala wodwalayo kumapeto kwa moyo kumapatsa pang'ono, ngati kulikonse, kupindula. Mavuto amaphatikizapo matenda pa tsamba lolowetsa kapena m'magazi, ndipo kutaya kwa madzi kumawopsa chifukwa cha kutupa kapena ngakhale kupuma m'mabvuto ovuta kwambiri.
Zambiri pa Njala ndi Wachisanu Pamapeto a Moyo
Zotsatira:
Mavuto Omwe Amatha Mapeto a Moyo Wosamalira. B. Kinzbrunner, N.Weinreb, J. Policzer
HPNA Policy Statement Zakudya Zopangira Zodzoladzola ndi Kutentha kwa Mapeto a Moyo Wosamalira