Muva nje kube nombiko wokuthi inkampani yaseMelika i-Gl Dynamics isungule indlela entsha yokwelapha ukukhuluphala, okungaba enye indlela eshibhile futhi ephephile ezindleleni zokuhlinza ezikhona manje zokwehlisa isisindo. Idalwe yi-Gl Dynamics, idivayisi ye-EndoBarrier iyishubhu elingenalutho elenziwe nge-polymer enwebekayo, elinamathiselwe kusisekelo esenziwe nge-nitinol (ingxubevange ye-titanium ne-nickel). Isisekelo se-EndoBarrier sigxilile esiswini, futhi "umkhono" we-polymer cishe ubude obungamasentimitha angu-60 uvuleka emathunjini amancane, ukuvimbela ukumuncwa kwezakhi. Ukuhlolwa kwamavolontiya angaphezu kuka-150 kubonise ukuthi ukufakwa kwe-EndoBarrier akuphumelelanga kangako kunokwehliswa kokuhlinzwa kwevolumu yesisu ngokuhlanganisa. Ngesikhathi esifanayo, idivayisi ifakwe futhi ikhishwe ngomlomo, isebenzisa inqubo ye-endoscopic elula futhi ephephile esigulini, uma kunesidingo, isusiwe, futhi izindleko zayo ziphansi kakhulu kunezokwelashwa kokuhlinzwa. Ukukhuluphala ngokweqile yisimo lapho ukwanda kwezicubu ze-adipose emzimbeni kubangela usongo empilweni yomuntu. I-Body mass index (BMI) isetshenziswa njengesilinganiso somgomo wokuba ukhuluphele noma ungaphansi kwesisindo somzimba. Ibalwa ngokuhlukanisa isisindo somzimba ngamakhilogremu ngesikwele sobude ngamamitha; isibonelo, umuntu onesisindo esingamakhilogremu angu-70 namamitha angu-1,75 ubude une-BMI engu-70/1,752 = 22,86 kg/m2. I-BMI ye-18,5 kuya ku-25 kg/m2 ithathwa njengejwayelekile. Inkomba engaphansi kwe-18,5 ibonisa ukuntuleka kwesisindo, i-25-30 ibonisa ukweqisa kwayo, futhi ngaphezu kwe-30 ibonisa ukukhuluphala. Njengamanje, ukudla nokuzivocavoca kusetshenziselwa ikakhulukazi ukwelapha ukukhuluphala. Kuphela uma zingasebenzi, ziphendukela ekwelashweni kwezidakamizwa noma ngokuhlinzwa. Izidlo zokunciphisa umzimba ziwela ezigabeni ezine: amafutha aphansi, i-low-carb, i-low-calorie, ne-calorie ephansi kakhulu. Ukudla okunamafutha aphansi kunganciphisa isisindo ngamakhilogremu amathathu phakathi nezinyanga ezi-2-12. I-Low-carb, njengoba ucwaningo luye lwabonisa, lusebenza kuphela uma okuqukethwe kwekhalori ekudleni kuncishisiwe, okungukuthi, akuholeli ekulahlekelweni kwesisindo ngokwabo. Ukudla okunekhalori ephansi kusho ukwehla kwenani lamandla okudla okudliwa ama-kilocalories angama-500-1000 ngosuku, okwenza kube lula ukulahlekelwa isisindo esingamakhilogremu angama-0,5 ngeviki futhi uzuze ukwehla kwesisindo esimaphakathi ngamaphesenti ayisishiyagalombili ngaphakathi kwe-3- Izinyanga ezingu-12. Ukudla okunekhalori ephansi kakhulu kuqukethe ama-kilocalories angu-200 kuya kwangu-800 kuphela ngosuku (ngesilinganiso se-2-2,5 ayizinkulungwane), okungukuthi, empeleni balambile umzimba. Ngosizo lwabo, ungalahlekelwa kusuka ku-1,5 kuya ku-2,5 kilograms ngesonto, kodwa azibekezelelwa kahle futhi zigcwele izinkinga ezihlukahlukene, njengokulahlekelwa kwemisipha, i-gout noma ukungalingani kwe-electrolyte. Ukudla kukuvumela ukuba unciphise isisindo ngokushesha, kodwa ukugcinwa kwabo kanye nokugcinwa okulandelayo kwesisindo esitholiwe kudinga imizamo yokuthi akuwona wonke umuntu olahlekelwa isisindo okwaziyo - ngokuyinhloko, sikhuluma ngokushintsha kwendlela yokuphila. Ngokuvamile, amaphesenti angamashumi amabili kuphela abantu abakwazi ukulahlekelwa ngempumelelo nokugcina isisindo ngosizo lwabo. Ukusebenza kahle kokudla kuyanda uma kuhlanganiswa nokuzivocavoca. Ukwanda kwezicubu ze-adipose kwandisa kakhulu ingozi yokuthuthukisa izifo eziningi: thayipha i-2 yesifo sikashukela, izifo zesimiso senhliziyo, i-obstructive sleep apnea (ukuphazamiseka kokuphefumula ngesikhathi sokulala), ukukhubazeka kwamathambo, izinhlobo ezithile zomdlavuza nezinye. Ngakho-ke, ukukhuluphala kunciphisa kakhulu isikhathi sokuphila komuntu futhi kungenye yezimbangela zokufa ezingavinjelwa futhi enye yezinkinga ezinkulu kakhulu zezempilo zomphakathi. Ngokwalo, ukuzivocavoca, okutholakala kubantu abaningi, kuholela ekulahlekelweni kwesisindo esincane kuphela, kodwa uma kuhlanganiswa nokudla okunekhalori ephansi, imiphumela yanda kakhulu. Ngaphezu kwalokho, ukuvivinya umzimba kuyadingeka ukuze kugcinwe isisindo esivamile. Izinga eliphezulu lemithwalo yokuqeqesha liqinisekisa ukulahlekelwa kwesisindo esikhulu ngisho nangaphandle kokuvinjelwa kwekhalori. Olunye ucwaningo eSingapore lwabonisa ukuthi ngaphezu kwamasonto angu-20 okuqeqeshwa kwezempi, amasosha akhuluphele alahlekelwa isilinganiso samakhilogremu angu-12,5 esisindo somzimba, kuyilapho edla ukudla okunenani elivamile lamandla. Ukudla nokuzivocavoca, nakuba kuyizindlela zokwelapha eziyinhloko futhi zokuqala zokukhuluphala, kungase kungazisizi zonke iziguli.
Umuthi wesimanje osemthethweni unezidakamizwa ezintathu eziyinhloko zokwehlisa isisindo ngezindlela ezihlukene zokwenza. Lezi yi-sibutramine, i-orlistat ne-rimonabant. I-Sibutramine (“i-Meridia”) isebenza ezikhungweni zendlala nokusutha njengama-amphetamine, kodwa ngesikhathi esifanayo ayinawo umphumela onjalo wokuvuselela ingqondo futhi ayibangeli ukuncika emithini. Imiphumela emibi ngokusetshenziswa kwayo ingase ihlanganise umlomo owomile, ukuqwasha nokuqunjelwa, futhi iphikisana nabantu abanezifo ezinzima zenhliziyo. I-Orlistat (“Xenical”) iphazamisa ukugaya futhi, ngenxa yalokho, ukumuncwa kwamafutha emathunjini. Enqatshelwe ukungena kwamafutha, umzimba uqala ukusebenzisa izinqolobane zawo, okuholela ekulahlekelweni kwesisindo. Kodwa-ke, amafutha angagayeki angabangela i-flatulence, isifo sohudo kanye ne-stool incontinence, okuyinto ezimweni eziningi edinga ukuyeka ukwelashwa. I-Rimonabant (i-Acomplia, okwamanje egunyazwe kuphela e-EU) umuthi omusha wokwehlisa isisindo. Ilawula isifiso sokudla ngokuvimbela ama-cannabinoid receptors ebuchosheni, okuphambene nesithako esisebenzayo ku-cannabis. Futhi uma ukusetshenziswa kwensangu kwandisa isifiso sokudla, i-rimonabant, ngokuphambene nalokho, iyayinciphisa. Ngisho nangemva kokwethulwa komuthi emakethe kutholakale ukuthi unciphisa nokulangazelela ugwayi kwababhemayo. Ububi be-rimonabant, njengoba kuboniswa izifundo zangemuva kokumaketha, ukuthi ukusetshenziswa kwayo kwandisa amathuba okuba nokucindezeleka, futhi kwezinye iziguli kungavusa imicabango yokuzibulala. Ukuphumelela kwalezi zidakamizwa kulinganiselwe kakhulu: isilinganiso sokulahlekelwa isisindo nge-course yesikhathi eside sokuphathwa kwe-olistat yi-2,9, i-sibutramine - i-4,2, ne-rimonabant - i-4,7 kilogram. Njengamanje, izinkampani eziningi ezithaka imithi zenza imithi emisha yokwelapha ukukhuluphala, ezinye zazo ezisebenza ngendlela efanayo naleyo ekhona kakade, kanti ezinye zinendlela yokusebenza ehlukile. Isibonelo, kubonakala sengathi kuthembisa ukudala umuthi osebenza kuma-receptors we-leptin, i-hormone elawula umzimba namandla. Izindlela eziphumelela kakhulu neziqinile zokwelapha ukukhuluphala ziwukuhlinzwa. Sekunemisebenzi eminingi eyenziwe, kodwa yonke ihlukaniswe yaba amaqembu amabili ahlukene ngokwendlela yawo: ukususwa kwezicubu ze-adipose ngokwayo kanye nokuguqulwa komgudu wamathumbu ukuze kuncishiswe ukudla noma ukumuncwa kwezakhi. Iqembu lokuqala lihlanganisa i-liposuction kanye ne-abdominoplasty. I-Liposuction iwukukhipha (“ukumunca”) kwezicubu ezinamafutha amaningi ngokusikwa okuncane esikhumbeni kusetshenziswa ipompo yevacuum. Awekho ngaphezu kwamakhilogremu amahlanu amafutha akhishwa ngesikhathi, njengoba ubunzima bezinkinga buxhomeke ngokuqondile kumthamo wezicubu ezisusiwe. I-liposuction eyenziwe ngokungaphumeleli igcwele ukuguqulwa kwengxenye yomzimba ehambisanayo neminye imiphumela engathandeki. I-Abdominoplasty iwukukhipha (ukusikwa) kwesikhumba esiningi kanye nezicubu ezinamafutha zodonga lwangaphambili lwesisu ukuze kuqiniswe. Lokhu kuhlinzwa kungasiza kuphela abantu abanamafutha amaningi esiswini. Ibuye ibe nesikhathi eside sokululama - kusukela ezinyangeni ezintathu kuya kweziyisithupha. Ukuhlinzwa kokulungiswa kwepheshana lamathumbu kungase kuhloselwe ukunciphisa umthamo wesisu ukuze kusheshe kuqale ukusutha. Le ndlela ingahlanganiswa nokuncipha kokumuncwa kwezakhi. Kunezindlela eziningana zokunciphisa umthamo wesisu. Ku-vertical Mason gastroplasty, ingxenye yesisu ihlukaniswa nomthamo wayo omkhulu ngezisekelo zokuhlinzwa, kwakheka isikhwama esincane lapho kungena khona ukudla. Ngeshwa, lesi "isisu esincane" sinwebeka ngokushesha, futhi ukungenelela ngokwayo kuhlotshaniswa nengozi enkulu yezinkinga. Indlela entsha - i-gastric banding - ihilela ukunciphisa ivolumu yayo ngosizo lwe-bandage ehambayo ezungeza isisu. Ibhandeshi elingenalutho lixhunywe ku-reservoir egxilwe ngaphansi kwesikhumba sodonga lwesisu sangaphambili, okwenza kube lula ukulawula izinga lokuvinjelwa kwesisu ngokugcwalisa nokuthulula ichibi ngesisombululo se-physiological sodium chloride usebenzisa inaliti evamile ye-hypodermic. Kukholakala ukuthi i-bandaging inconywa ukuthi isetshenziswe kuphela lapho isiguli sishukumiseleka kakhulu ukuba sehlise isisindo. Ngaphezu kwalokho, kungenzeka ukunciphisa umthamo wesisu ngokususa ngokuhlinzwa iningi lalo (ngokuvamile cishe ngamaphesenti angu-85). Lokhu kuhlinzwa kubizwa nge-sleeve gastrectomy. Kungaba yinkimbinkimbi ngokwelula kwesisu esisele, ukucindezeleka kwama-seams, njll. Ezinye izindlela ezimbili zihlanganisa ukwehlisa umthamo wesisu nokucindezelwa kokumuncwa kwezakhi. Lapho usebenzisa i-gastric bypass anastomosis, kwakhiwa isikhwama esiswini, njengaku-gastroplasty eqondile. Ijejunum ithungelwa kulesi sikhwama, lapho kungena khona ukudla. I-duodenum, ehlukanisiwe ne-jejunum, ixhunywe endaweni enciphile "ezansi nomfula". Ngakho-ke, iningi lesisu ne-duodenum licishiwe enqubweni yokugaya. Ku-gastroplasty ngokukhishwa kwe-duodenal, kuze kufike kumaphesenti angu-85 wesisu ayasuswa. Okusele kuxhuma ngqo engxenyeni engezansi yamathumbu amancane amamitha amaningana ubude, okuba yilokho okubizwa ngokuthi. iluphu yokugaya ukudla. Ingxenye enkulu yamathumbu amancane, kuhlanganise ne-duodenum, evaliwe ekugayweni kokudla, ithungwe ngokungaboni ukusuka phezulu, futhi ingxenye engezansi ithungelwa kule loop ebangeni elingaba imitha ngaphambi kokuba igelezele emathunjini amakhulu. Izinqubo zokugaya nokumuncwa ngemuva kwalokho zizokwenzeka ikakhulukazi kulesi sigaba samamitha, ngoba ama-enzyme okugaya angena kulume lomgudu wokugaya ukudla esuka kumanyikwe ngokusebenzisa i-duodenum. Ukuguqulwa okunjalo okuyinkimbinkimbi nokungenakulungiseka kwesimiso sokugaya ngokuvamile kuholela ekuphazamisekeni okukhulu emsebenzini walo, futhi, ngenxa yalokho, kuwo wonke umzimba. Kodwa-ke, le misebenzi iphumelela ngokungenakuqhathaniswa kunezinye izindlela ezikhona, futhi isiza abantu abanamazinga anzima kakhulu okukhuluphala. Ithuthukiswe e-USA, i-EndoBarrier, ngendlela elandelayo kusukela ekuhlolweni kokuqala, iphumelela njengokwelashwa kokuhlinzwa, futhi ngesikhathi esifanayo ayidingi ukuhlinzwa emgudwini wamathumbu futhi ingasuswa nganoma yisiphi isikhathi.
Isihloko esivela ku-kazanlife.ru