Ungasondla kanjani isiguli esikhathini ngaphambi nangemva kokuhlinzwa?

Okuqukethwe okuqinisekisiwe

Ukuhlinzwa kuwumthwalo osindayo emzimbeni. Kungashiwo ukuthi injongo yayo iwukulimaza umzimba ngamabomu ukuze kuzuze isiguli sonke. Kodwa khumbula ukuthi ukusabela komzimba wakho ekuhlukumezekeni kokuhlinzwa kungashintsha umzimba wakho ube yi-catabolism - inqubo lapho umzimba wakho uqala ukuthatha nokusebenzisa amaprotheni. Uma zingahlinzekwa ngokudla, umzimba uzofinyelela kuzo emisipheni.

Izinto ezisetshenziswayo zidalwe ngokubambisana neNutramil Complex.

Inqubo yokutakula iklanyelwe ukubuyisela emuva i-catabolism ebangelwa ukuhlukumezeka iye ku-anabolism. Ukondliwa okufanele, ukutholakala kwamandla kanye namaprotheni kuyingxenye ebalulekile yokwelashwa kwe-perioperative.

Ukwelashwa okunomsoco ngokuqinisekile kuyasheshisa ukululama. Inani elikhulu leziguli lingadla futhi kufanele livunyelwe ukwenza kanjalo. Umgomo wokwelashwa okunomsoco kufanele kube ukwandisa uketshezi oluthathwayo, uqinisekise ukutholakala kwamandla namaprotheni anele.

Kuyini ukwelashwa okunomsoco?

Ukwelashwa kokudla okunempilo - ukuthuthukisa kanye nokugcina isimo sokudla okwanele. Kuphinde kube nomthelela ekuqaguleni kanye nemiphumela yokwelapha.

Ukudla okunomsoco wezokwelapha kusekelwe ekuhlanganiseni ukudla kwesiguli ngendlela yokumnikeza zonke izakhi ezidingekayo zokwakha namandla (amaprotheni, ushukela, amafutha, amaminerali namavithamini). Ekwelashweni okunempilo, ukudla kwasezimbonini osekwenziwe kakade (isb. I-Nutramil Complex) noma uketshezi olufakwa emthanjeni, ukwakheka kwakho kunqunywa ngokuqhubekayo kuye ngezidingo zamanje zesiguli.

Ukudla okunomsoco ngaphambi kokuhlinzwa

Njengamanje, kunconywa ukuthi abantu abadla ukudla okunomsoco badle ukudla kwabo okujwayelekile kuze kube sebusuku bangaphambi kokuhlinzwa. Kuze kube amahora angu-2 - 3 ngaphambi kwe-anesthesia, ungathatha noma yiliphi inani loketshezi oluhlanzekile, okusiza ukugwema ukuphelelwa amandla kwamanzi ngaphambi kokusebenza.

Kusanda kuboniswa ukuthi ukunikeza isiguli esine-pre-operative isiphuzo esine-carbohydrate eningi kuyanyamalala ngokushesha esiswini, futhi ukufakwa kwama-carbohydrate kunciphisa indlala nokukhathazeka ngaphambi kokuhlinzwa. Ukunikezwa kwama-carbohydrate ngaphambi kokuhlinzwa nakho kunciphisa ukumelana ne-insulin ngemuva kokuhlinzwa.

Ukudla okunomsoco ngaphambi kokuhlinzwa kubaluleke kakhulu ezigulini ezingondlekile. Kuye kwaboniswa ukuthi kuleli qembu leziguli, ukondliwa kwe-enteral ngisho ne-parenteral kusetshenziswe amasonto angu-1-2 ngaphambi kokuhlinzwa kuthuthukisa kakhulu imiphumela yokwelashwa kokuhlinzwa.

Imihlahlandlela ye-European Society of Anaesthesiology mayelana nokuzila ukudla okungapheli kubantu abadala nasezinganeni

Ama-carbohydrate omlomo:

1. Ukusebenzisa iziphuzo ezigcwele ama-carbohydrate kuze kufike emahoreni ama-2 ngaphambi kokuhlinzwa okuhleliwe kuphephile ezigulini (nakwabanesifo sikashukela),
2. Ukuphuza uketshezi olunothe nge-carbohydrate ngaphambi kokuhlinzwa okukhethekile kuthuthukisa inhlalakahle yomuntu siqu, kunciphisa umuzwa wendlala futhi kunciphisa ukumelana ne-insulin ngemuva kokuhlinzwa.

Ukudla okunomsoco ngemuva kokuhlinzwa

Into ebaluleke kakhulu esigulini ngasinye ukuthi sibuyele ekusebenzeni okujwayelekile ngokushesha ngemva kokuhlinzwa ukuze sibe nezinkinga ezimbalwa ngangokunokwenzeka futhi sikhishwe ekhaya ngokushesha. Ukufeza lokhu, kuyadingeka ukunciphisa i-catabolism futhi uvumele umzimba wesiguli ukuthi ubuyele esimweni se-anabolism. Ukudla okunomsoco kudlala indima enkulu kulezi zinqubo. Ukudla okuwuketshezi kungaba yingxenye ebalulekile yokwelashwa okunomsoco lapha. Ezimweni ezinzima kakhulu, ukondliwa kwe-enteral kanye ne-parenteral nakho kudlala indima ebalulekile.

Kungakhathaliseki ukuthi iyiphi indlela yokudla okunconywe udokotela (ukungena ngeshubhu noma i-stoma, i-parenteral), kufanele isetshenziswe kuze kube yilapho isiguli sesikwazi ukudla okungenani amaphesenti angu-70 wamandla kanye nezidingo zamaprotheni ngomzila womlomo.

Inani lamandla isiguli esilidingayo kufanele likhethwe ngabanye, kodwa ngokwesilinganiso lisukela ku-25 kuya ku-35 kcal / kg bw. Ngemuva kwenqubo, isiguli sidinga amaprotheni amaningi kunomuntu onempilo ukuze akhe kabusha izicubu ezilimele futhi aqinisekise ukusebenza kahle kwamasosha omzimba. Inani lamaprotheni okufanele isiguli silidle ngu-1,2 kuya ku-1,5 g/kg bw, inqobo nje uma izinso zisebenza kahle.

I-Wytyczne ESPEN - I-European Society for Clinical Nutrition and Metabolism

1. Iziguli eziningi azidingi ukuzila ukudla ngaphambi kokuhlinzwa ebusuku. Abantu abangenayo ingozi eyengeziwe yokufisa bangaphuza uketshezi kuze kufike emahoreni ama-2 ngaphambi kokuqala kwe-anesthesia. Ukusetshenziswa kokudla okuqinile kuvunyelwe kuze kube amahora angu-6 ngaphambi kokuqala kwe-anesthesia.
2. Indlela ekhethwayo yokudla iwukusebenzisa umgudu wokugaya ukudla, ngaphandle kwalapho iphikisana khona.
3. Ukungena okwanele kokudla okuphuzwayo isikhathi esingaphezu kwezinsuku eziyi-14 kuhlotshaniswa nokwanda kokufa. Uma isikhathi esilindelekile sokuzila ngesikhathi sokusebenza isikhathi eside singaphezu kwezinsuku eziyi-7, ukudla okunomsoco kuyanconywa nasezigulini ezingenazo izimpawu zokungondleki.
4. Ukudla okunomsoco kwangaphakathi kukhonjisiwe ezigulini lapho ukudla okulindelekile ngomlomo kungeke kudlule u-10% wesidingo esingaphezu kwezinsuku ezingama-60.
5. Ukuphakelwa kwe-tube kufanele kuqalwe kungakapheli amahora angama-24 ngemuva kwenqubo, kunconyelwa ezigulini: ngemuva kokuhlinzwa okukhulu ngenxa yomdlavuza wekhanda, intamo kanye nomgudu wamathumbu, ngemuva kokulimala kanzima, ukungondleki ngosuku lokuhlinzwa, lapho ukudla okulindelekile. izoba ngu-<60% wesidingo izinsuku ezingaphezu kweziyi-10.
6. Izidlo ezijwayelekile eziqukethe amaprotheni aphelele zanele iziguli eziningi.
7. Umgomo wokwelashwa kwe-perioperative ukunciphisa ibhalansi ye-nitrogen engalungile, ukuvimbela ukungondleki, ukugcina imisipha yemisipha, ukugcina ukuzivikela okuvamile, nokusheshisa ukululama ngemva kokuhlinzwa.
8. Iziguli ezondlekile ngendlela efanele azizuzi ekudleni okwenziwayo, okungase kube umthombo wezinkinga kuzo.
9. Ukondleka kwabazali kwangemva kokuhlinzwa kunconywa ezigulini ezingakwazi ukuhlangabezana nezidingo zazo ngomlomo noma ngomzila wokungenisa izinsuku ezingu-7-10 ngemva kokuhlinzwa. Umsoco ohlanganisiwe we-parenteral-enteral kufanele ucatshangelwe lapha.
10. Ngokuvamile, kunconywa ukunikeza ama-25 kcal / kg wesisindo somzimba esifanele. Ezigulini ezingaphansi kokucindezeleka okukhulu, ukunikezwa kungakhushulwa ku-30 ​​kcal / kg yesisindo somzimba esifanele.
11. Ezigulini ezingakwazi ukondliwa ngepheshana lamathumbu, ukondliwa komzali kufanele kuphelele.

Ukudla okunomsoco ngaphambi kokuhlinzwa kuthuthukisa imiphumela yokwelashwa kokuhlinzwa ezigulini ezingondlekile kakhulu, futhi ukuphathwa kwe-carbohydrate ngaphambi kokuhlinzwa kunciphisa ukumelana ne-insulin kanye ne-protein catabolism ngemva kokuhlinzwa okukhethiwe. Ngaphezu kwalokho, kunomthelela omuhle enhlalakahleni yesiguli futhi kunciphisa ukucindezeleka okuhambisana nenqubo ehleliwe.

Iningi labantu abahlinzwayo alinakho ukungqubuzana kokubuyela ngokushesha ekudleni okujwayelekile komlomo futhi kufanele babuyele kukho ngokushesha ngangokunokwenzeka. Ukudla okunomsoco we-postoperative kunciphisa inani lezinkinga zangemva kokuhlinzwa. Ukudla okunomsoco kufanele kube yingxenye yokuphatha okudidiyelwe kukho konke ukwelashwa kwesiguli.

I-Bibliography:

1. Szczygieł B., Ukungondleki okuhlobene nezifo, i-Warsaw 2012, i-PZWL, amakhasi 157-160

2. Sobotka L. et al., Okuyisisekelo Kokudla Komtholampilo, Warsaw 2008, PZWL, pp. 296-300

Izinto ezisetshenziswayo zidalwe ngokubambisana neNutramil Complex.