Chimwe chezvinhu zvakakosha zvekudzikinura kubva kune chirwere chekudya ndiko kuyananisa kwekudya . Izvozvo zvinoreva kudya zvinokwana makirogiramu nguva nenguva kuti uwane zvido zvemuviri uye uzvibvumira kuporesa. Vanhu vevamwe varume, mazera, maumbirwo, uye hukuru zvinogona kuva nekutambudzika kwekudya uye kusagadzikana kudya ; iwe haugone kuziva kana mumwe munhu ane hutano kana anorwara kubva pakuvatarisa.
Muchikamu chino, tichakurukura basa rekuwedzera kwekudya mukurapa kwekushushikana kwekudya, kubva pamuromo kunowedzera kudya kunoenderana nekugutsikana kana kusimbisa kushandiswa kwemhando dzakasiyana-siyana dzokudyisa tubate.
Vamwe Key Concepts of Rutral Rehabilitation
Kutanga pane zvose, chii chinonyatsogadziriswa kwekudya, zvakare chinonzi refeeding, chinosanganisira? Sezvo varwere vane zvinetso zvekudya vanowanzoshaya nzara- pasinei nehutano hwemuviri -ndeye nzira yakasiyana-siyana iyo inotanga kuitika pasi peanyanzvi hwevadzidzisi vakanyoreswa , zvakakodzera kune uyo ane unyanzvi mukudya kwekudya. Chirongwa chekudya chinowedzera zvishoma nezvishoma chinosimbiswa, kazhinji chinoumbwa chikafu uye zvokudya zvinonaka zvinenge zvakanyatsoenzaniswa. Kana mumwe munhu asingakwanisi kudya zvokudya nekuda kwekudzivirira kwekoriki (kuvharwa kwemakori, kuchenesa, kana kunyange kudya kwakanyanya), simba ravo rekugadzirisa muviri rinonyanya kunonoka kuchengetedza makirori uye kudzivirira kuyerwa kwemuviri.
Iyi ndiyo nzira yatakaponesa nayo nzara semhuka.
Apo vanhu vane zvinetso zvekudya vanotanga kuita basa rekugadzirisa, zvinogona kuva zvinotyisa kufungidzira kudya zvakasara kudarika zvishoma zvisinganzwisisiki kuti chirwere chekudya chakabvumira. Mushure mezvose, kuti kudya dambudziko rezwi rinogona kuve rakanyanya, rinoreva, uye rinokumbira zvikuru. Zvisinei, miviri yedu inoshamisa uye inonzwisisa kupfuura isu tinovapa chikwereti nokuda.
Kutanga kudya mamwe makorikori-anoti, 1600 kana kupfuura pazuva-chinhu chimwe chete chemapenzi: Inokurudzira muviri wemunhu pasina kuunza kuwedzera. Iwe unoverenga izvozvo zvakarurama. Izvozvo zvinoreva kuti kana mumwe munhu ave achivhara makoriyumu, uye akaora mwoyo kuti uremu hwavo hahuzogoni kuderera (uye zvichida uchinzwa uine simba uye wakaneta uye wakaneta), unotanga kudya kadha dzinenge 1600 pazuva, uremu hwavo hunogona kuramba hwakasimba, nepo simba ravo rekugadzirisa muviri rinokurumidza kusvika.
Zvinoshamisa kuti, apo vanhu vasati vashanyirwa kudya vanopfuurira kuburikidza nehutano hwekugadzirisa utano, vanova hypermetabolic . Iko kuti, vangave vachida kudya 3000 kana kupfuura maoriri pazuva kuti vadzorere 1-2 mapaundi emuviri wevhiki vhiki. Kune zvipingamupinyi zvekudzorera, kusanganisira donho muropa re phosphorus, rinonzi hypophosphatemia. Munguva yakapfuura, kukurudzirwa kwaiva kuti makorikori anofanira kutanga akatanga zvishoma nezvishoma, kudzivisa hypophosphatemia. Zvisinei, zvidzidzo zvitsva zvakaratidza kuti zviri nani zvakanyanya kuwana zviratidzo zvekugadzirisa muviri, kufudza muviri nemafungiro, uye kwete kutanga zvishoma-uye phosphorus mazinga anoita zvakanaka.
Mawaniro Aungawana Iko Maoriro Muna
Mubvunzo ndeyekuti: Tingawana sei makorikoni? Vanhu vazhinji vane zvinetso zvekudya vanogona kudya kudya nguva dzose , uye kudya nguva dzose nguva dzose ndiyo nzira yakanakisisa yekupinda mumakirori uye micronutrients.
Zvisinei, pane dzimwe nguva kana chikafu chekudya chikafu chakanaka, zvakaoma kudya zvose sezvokudya. Muzviitiko izvi, kuwedzera kwakanyanya kune zvakadai seInsure Plus (pa355 kcal / bottle) kana Magic Cup (pa 290 makoriki muma 4 ounces) zviri nyore pane muviri wose zvakakwana kune imwechete makori muzvokudya zvakasimba.
Vamwe vezvokudya zvinosarudza kugadzira zvirongwa zvekudya uko kudya kwekudya (kudya kwemanheru, masikati, uye kudya kwemanheru) kunoramba kuripo nguva dzose mukudzokorora, asi kunotswa kunowedzera kudarika nguva, dzimwe nguva nekushandiswa kwekuwedzera. Nenzira iyi, apo chinangwa chinorema chave chave chichigadziriswa, zvinowedzera uye huwandu hwezvokudya zvinotapira zvinoshanduka, asi kudya kukuru kunogara zvakafanana pane chirongwa chekuchengetedza, zvichikonzera kushungurudzika kuderera kuzhinji kuchinja.
Uyewo, vamwe varwere vanoda "kuisa mishonga" yavo makoriyori pakutanga. Apo kudya nyama yakasiyana-siyana yakasimba inotyisa zvikuru kune chirwere chekudya, kungowana kuwana makirimu ari nekuwedzera kunogamuchirwa zvakakwana. Icho chinangwa, chokwadi, nguva dzose kudzokera kunodya zvakasiyana-siyana zvekudya. Kuna avo vanounza dambudziko rekuwedzera kune zvokudya zvisingasviki "zvechokwadi" kana kuti zvichishandiswawo, tinogona kuti: Hapana chinhu chinotyisa kudarika kuregererwa. Saka kana kuwedzera kunobatsira mumwe munhu kufamba mumazuva ekutanga ekugadzirisa kudya kwezvokudya, izvo zvakanyanya kukunda kudarika kunze nekuzara kunokonzera mudumbu.
Kudyisa Tubes
Dzimwe nguva, varwere vane zvinetso zvekudya vanoda zviduku, zvinogadziriswa zvinopinza zvinowanikwa kuburikidza nemhuno, kupera mukati mudumbu kana mudiki mudumbu. Aya nasogastric (NG) kana nasojejunal (NJ) mabhuti anogona kupa mishonga yakakwana ivo pachavo kana kuti inogona kuwedzera kudya kwemazuva masikati nemafuta ekusiku. Kuzvipatara varwere, kusanganiswa kweNF uye kudya kwemasikati kunodya kunogona kubatsira varwere kutora makorikiti akakwana kuti vafambire nekudzorerwa kwekureruka, uye zvinopfuurira zvokudya zvinoderedza njodzi yezvinetso zvakadai seshuga yepasi shoma.
NG kudya kunogona kubatsirawo "kurapa" makoriyori kare apo varwere vanoda kuenderera mberi asi havagoni kudya. Kazhinji, varwere vangashandisa NG tubes kumba. Izvi hazviwanzokurudzirwe, sezvo kune ngozi yakawanda yevarwere kusanganisa kutarisira kuburikidza nekudzima tube feeds, kusashandisa zvakanaka, kana kubvisa kunze kwehutu. Kana murwere ari iye anorwara mune chirwere chavo, kazhinji ivo vari mumatunhu akakwirira ekutarisira kwakanyanyisa . An NG tube inogona kugara munzvimbo inenge kusvika masvondo matanhatu nekutarisira kwakanaka, asi njodzi dzekushandisa dzinosanganisira sinusitis (utachiona hwe sinus), reflux, aspiration pneumonia (apo mudumbu zviri mumvura zvinoyerera zvichidzokorora sopu uye kusvika mumapapu), uye rwonzi kutsamwa kana kukuvara.
Iko kune zvimwe zvirwere zvinogara zvisingagumi kune avo vane zvinetso zvekudya, zvakadai sehutachiona hwegastrostomy (PEG) yega-percutaneous kana pejjusstomy percutaneous (PEJ) tube. Izvi zvinogona kuiswa nechiremba chiremba, chiremba weGI, kana kuti chirwere chinonzi interventional radiologist. Pfungwa inonyanya kukosha yekuita apa ndeyokuti hutachiona hwe PEG hahufaniri kuiswa nekuda kwekuti mumwe munhu ari kudzivirira kudya kwavo. Kazhinji, vanachiremba vasina ruzivo vachati kune mumwe munhu ane anorexia nervosa, "Ingoisa muPGG." Kana mumwe munhu achidzivirira makirori nemuromo, ivo vachadzivirira zvikamu nezvikamu!
MaPGG anofanirwa kuchengetwa mamiriro ezvinhu apo NOKUTI nzira imwe cheteyo munhu angawana kudya kwakakwana ndeye PEG. Mamiriro ezvinhu akadaro anosanganisira kurutsa kusingagumi kushanduka, apo PEJ inobvumira kuderedza mvura mudumbu uko iyo isingagoni kurutsirwa kunze. Uyewo, mumusorosita wemesiteric artery syndrome, umo hutumbu huchibatanidza pakati pemariti maviri mumamiriro ekukurumidza kana kuwedzerwa kuora muviri, mutemo wekutarisira ndewekupa zvakakwana zvinodhaka kusvikira muviri uchingodzorerwa. Chero bedzi kuvharwa kwakanyanya kwazvo kunofanira kuiswa pej.
Zvakakosha kucherechedza kuti idzi tubhu zvinokuvadza zvikuru pakutanga, uye kuiswa kwavo kunowanzoomeswa nekurwadziwa, kushungurudzika, kufema kunorwadza, uye matambudziko anotanga kugadzira tube. Kubvisa tubhu pamberi pemavhiki masere kunogona kukonzera zvirwere zvakashata zvepamuviri. Kushandiswa kwavo kunofanira kuchengetwa kune avo vane unyanzvi.
> Sources
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> Gaudiani JL, Mehler PS. Zviratidzo zvekurapa nguva refu zvekudzivirira zvakanyanya uye kuchenesa: "Zebra," akashaya zvirwere, uye zvakanakisisa maitiro. Int J Eat Disord. 2016 Mar; 49 (3): 331-44
> Madden S, Miskovic-Wheatley J, Clarke S, Touyz S, Hay P, Kohn MR. Migumisiro yekukurumidza kugadzirisa protocol muAdolescent Anorexia Nervosa. J Idya Matambudziko. 2015 Mar 25; 3: 8
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