Zakudya mu matenda a impso

Kuchokera pakuwona kwachipatala, matenda a impso atha kukhala matenda otupa omwe akukula mwachangu komanso kufalikira komwe kumayambitsa kulephera kwaimpso, kapena kungakhale njira yopita patsogolo kuyambira pachiyambi monga kutupa kosatha pang'onopang'ono komanso kuwonongeka kosasinthika kwa impso.

Kuchokera pazakudya, ndikofunikira kupereka madzi, mchere, potaziyamu ndi mapuloteni mu matenda a impso. Pokonzekera zakudya, kulemera kwa thupi, kuchuluka kwa madzi ndi kuchuluka kwa ma electrolyte m'magazi ziyenera kuganiziridwa. Pakulephera kwaimpso, makamaka ndi kuchuluka kwa urea m'magazi, zakudya zopanda mapuloteni zimalimbikitsidwa, zopatsa mphamvu zokwanira 30-50 kcal / 1 kg ya kulemera kwa thupi, ngati matendawa alibe zovuta. Muyenera kusiya nyama, mabala ozizira, tchizi, mazira kuchokera ku zakudya, kuchepetsa mkaka ndi zakudya zokhala ndi potaziyamu ndi phosphorous. Zoletsa zimagwiranso ntchito pakupereka mchere ndi madzi. Kupatulapo ndi gawo loyamba la polyuria ndikulangizidwa kumwa madzi ambiri. Zakudya zopatsa thanzi ndikuwonjezera ma rusks, mpukutu wa tirigu wochepa wa mapuloteni, puree yophika zipatso, compotes yosenda, mbatata yosenda ndi batala. Mafuta akulimbikitsidwa kukhala 1g / 1 kg ya kulemera kwa thupi. Pachimake aimpso kulephera, odwala akhoza kuthandizidwa mosamala kapena dialysis. Pamene mukuchira, mumasintha ku zakudya zakuthupi, pang'onopang'ono kuwonjezera kuchuluka kwa madzi ndi mapuloteni.

Mu matenda aimpso kulephera, matenda chithunzi zimadalira kuopsa kwa aimpso kuwonongeka. Malingaliro azakudya munthawi imeneyi amatha kugawidwa m'magulu anayi: nthawi ya 4 - kulephera kobisika, komwe kulibe zoletsa zakudya, nthawi ya 0,6 - kuperewera kwamalipiro, kuchepa kwa mapuloteni 0,8-1 g / 0,4, 0,6 kg ya kulemera kwa thupi, phosphorous, mchere, Nyengo yachitatu - kuperewera kwapang'onopang'ono, komwe kumagwiritsidwa ntchito pazakudya zokhala ndi mapuloteni ochepa a 1-20 g / 25 kg, otsika-sodium, otsika potaziyamu zakudya. olemeretsedwa ndi mkulu-kalori, otsika-mapuloteni kukonzekera, nyengo IV - mapeto siteji kulephera, mmene mapuloteni okwanira 15-20 g / tsiku kapena dialysis, kuchepetsa sodium, potaziyamu, phosphorous ndi madzi, chofunika kuwonjezera zofunika amino. zidulo XNUMX-XNUMX g / tsiku ku mbale, mwachitsanzo Ketosteril.

Mfundo zazikuluzikulu zazakudya muzakudya zolimbitsa thupi: kufunikira kwa mphamvu kwa odwala omwe ali ndi thupi labwinobwino opitilira zaka 60 akuyenera kupereka 35 kcal / 1 kg ya kulemera kwa thupi / tsiku, komanso kwa odwala osakwana zaka 60. ayenera kupereka 30-35 kcal / 1 makilogalamu thupi / tsiku, mwachitsanzo za 2000-2500 kcal / tsiku. Odwala omwe sagwira ntchito mokwanira, kudya kokwanira ndi 1800-2000 kcal / tsiku. Kuchepa kwa mapuloteni kumachedwetsa chithandizo cha dialysis, kuchuluka kwa mapuloteni kumatsimikiziridwa ndi kuchuluka kwa urea ndi creatinine mu plasma yamagazi ndi creatine clearance (GFR). Mapuloteni ochepera pazakudya ndi 20 g / tsiku ndikuwonjezera ma amino acid ofunikira. Kuchepetsa kotereku kungapezeke pogwiritsa ntchito zakudya za mbatata mu kuchuluka kwa 1 kg ya mbatata + 300 g masamba ndi zipatso + 120 g batala watsopano ndi mafuta + 50 g shuga ndi kuwonjezera ufa wa mbatata kapena wowuma wochepa wama protein. ufa ndi zonunkhira zatsopano kapena zouma, popanda salting. Njira zopangira mbale za mbatata ndikuphika, kuphika, pomwe Frying imachotsedwa pamavuto a metabolism yamafuta. Zakudya zomwe zingathe kukonzedwa ndi Zakudyazi, dumplings, dumplings, casseroles, mbatata yodzaza, saladi. Kuchuluka kwa mapuloteni ndi 40-50 g / tsiku ndipo malire ang'onoang'ono ndi 60-70 g / tsiku. Mapuloteni ayenera kukhala abwino, kuchokera ku nyama: nyama yowonda, mkaka wosakanizidwa, kanyumba tchizi, dzira loyera, kefir, yoghurt. Kupereka mafuta sikufuna kuchepetsa 1 g / 1 kg ya kulemera kwa thupi. Ayenera kuchokera ku zomera, monga mafuta a azitona, mafuta a soya, mafuta a mpendadzuwa, mafuta a rapeseed. Contraindicated mafuta zinthu zochokera nyama ndi: mafuta anyama, tallow, margarines olimba, nyama yankhumba, komanso mafuta nyama monga nkhosa, nkhumba, offal, bakha, tsekwe, mafuta nsomba, yellow ndi kukonzedwa tchizi, nyama yankhumba, pates, soseji. Momwemonso, zopangira confectionery zomwe zimakhala ndi mafuta ambiri, monga zofukiza ndi makeke, sizoyenera. Kuletsa kwamadzimadzi kumatengera edema, kuthamanga kwa magazi komanso kuchuluka kwa mkodzo womwe umatulutsidwa masana. Muyenera kulabadira madzi zili mu mankhwala, mwachitsanzo sauces, masamba, zipatso, kupereka pafupifupi 400-500 ml. Kuchepetsa sodium pa nthawi yokwanira yolipiridwa sikofunikira, koma tikulimbikitsidwa kuti muchepetse 3 g (supuni imodzi) ya mchere patsiku ngati njira yodzitetezera, chifukwa chakumwa kwambiri. Ndikokwanira kuti musawonjezere mchere ku mbale, kusaphatikiza zinthu zamchere muukadaulo, monga: chakudya cham'chitini, pickles, nyama zozizira, nyama yophika, tchizi wosuta, tchizi wachikasu, silage, zokometsera za supu ndi sauces, zopangidwa okonzeka. zonunkhira, mwachitsanzo masamba, masamba, ma cubes a msuzi. kuchepetsa phosphorous kuchokera ku zinthu zomwe zili ndi phosphorous, monga: offal, phala, rennet ndi tchizi, nyemba, nsomba, dzira yolk, bowa, soseji, mkaka wonse wa ufa.

Ndi bwino kudya mankhwala amene amamanga phosphate mu m`mimba thirakiti chakudya. kufunikira kwa potaziyamu panthawi yakusakwanira kolipiridwa kuyenera kukulitsidwa, ndipo panthawi yakumapeto kuyenera kukhala 1500-2000 mg / tsiku, kupatula zinthu zomwe zili ndi mcherewu: nyemba zowuma, chinangwa, koko, chokoleti. , mtedza, zipatso zouma, nthochi , mapeyala, tomato, mbatata, masamba a masamba, bowa. Potaziyamu akhoza kuchepetsedwa mwa kuviika ndi kuphika chakudyacho, ndikusinthidwa madzi pophika. kufunika kwa mchere wina ayenera kuwonjezera kashiamu akusowa, chifukwa cha zofooka za mapuloteni mankhwala, supplementation wa chitsulo akusowa kumabweretsa magazi m`thupi. kusowa kwa mavitamini kumawonjezera kusowa kwa vitamini. kuchokera ku gulu B, kupatsidwa folic acid, vit. C ndi D chifukwa cha zakudya zochepa za potaziyamu.

Mfundo zambiri za zakudya pa nthawi ya dialysis: kufunikira kwa mphamvu chifukwa cha kusowa kwa zakudya m'thupi kwa odwala dialysed kuyenera kukhala 35-40 kcal / 1 kg ya kulemera kwa thupi, mwachitsanzo 2000-2500 kcal / tsiku. Gwero lalikulu lazakudya ziyenera kukhala zopangira phala: pasitala, groats, ufa wowuma, mkate wochepa wa protein wowuma. Odwala omwe amathandizidwa ndi peritoneal dialysis, chofunikira ichi chimaphimbidwa pang'ono ndi shuga mu dialysis fluid. Kufunika kwa mapuloteni chifukwa cha kutayika panthawi ya dialysis ndi 1,2-1,4 g / 1 kg kulemera kwa thupi mwa odwala hemodialysed, ndi 1,2-1,5 g / 1 kg kulemera kwa thupi mu peritoneal dialysis, ie 75-110 g / tsiku. Chakudyacho chikhoza kuwonjezeredwa ndi mapuloteni ochokera ku zakudya zowonjezera, monga Protifar. kufunikira kwa mafuta mu extracorporeal dialysis kuyenera kukhala 30-35% ya mphamvu, ndipo mu peritoneal dialysis 35-40%. mphamvu zochokera ku zomera, makamaka mafuta a azitona ndi mafuta. kufunikira kwa potaziyamu kuyenera kukhala 1500-2000 mg / tsiku, nyama ndi masamba siziyenera kugwiritsidwa ntchito. kufunika phosphorous ayenera kuchepetsa kumwa mankhwala wolemera mu chigawo ichi ndi kugwiritsa ntchito mankhwala amene amamanga phosphate mu m`mimba thirakiti. Kuletsa sodium kumagwira ntchito. kufunikira kwa mchere ndi mavitamini kumafuna kuwonjezereka kwa calcium, vit. D, A ndi C. Kuletsa kwamadzimadzi kumawerengedwa pa kuchuluka kwa mkodzo + 500 ml, kuchuluka kwachulukidwe kumasonyezedwa kokha nyengo yotentha, kutentha thupi, kusanza ndi kutsekula m'mimba.

Source: Mpando ndi Dipatimenti ya Nephrology, Hypertension ndi Internal Diseases, Collegium Medicum im. L. Rydygier ku Bydgoszcz

1. Nthawi - kulephera kobisika, komwe kulibe zoletsa zakudya,
2. Nthawi ya IV - kulephera kwakumapeto, komwe kupezeka kwa mapuloteni ndi 20-25 g / tsiku kapena dialysis, kuchepa kwa sodium, potaziyamu, phosphorous ndi madzi, ndikofunikira kuwonjezera ma amino acid 15-20 g / tsiku. mbale, mwachitsanzo Ketosteril.
3. Kuchepa kwa mapuloteni kumachedwetsa chithandizo cha dialysis, kuchuluka kwa mapuloteni kumatsimikiziridwa ndi kuchuluka kwa urea ndi creatinine mu plasma yamagazi ndi creatine clearance (GFR). Mapuloteni ochepera pazakudya ndi 20 g / tsiku ndikuwonjezera ma amino acid ofunikira. Kuchepetsa kotereku kungapezeke pogwiritsa ntchito zakudya za mbatata mu kuchuluka kwa 1 kg ya mbatata + 300 g masamba ndi zipatso + 120 g batala watsopano ndi mafuta + 50 g shuga ndi kuwonjezera ufa wa mbatata kapena wowuma wochepa wama protein. ufa ndi zonunkhira zatsopano kapena zouma, popanda salting. Njira zopangira mbale za mbatata ndikuphika, kuphika, pomwe Frying imachotsedwa pamavuto a metabolism yamafuta. Zakudya zomwe zingathe kukonzedwa ndi Zakudyazi, dumplings, dumplings, casseroles, mbatata yodzaza, saladi. Kuchuluka kwa mapuloteni ndi 40-50 g / tsiku ndipo malire ang'onoang'ono ndi 60-70 g / tsiku. Mapuloteni ayenera kukhala abwino, kuchokera ku nyama: nyama yowonda, mkaka wosakanizidwa, kanyumba tchizi, dzira loyera, kefir, yoghurt.
4. Kuletsa kwamadzimadzi kumatengera edema, kuthamanga kwa magazi komanso kuchuluka kwa mkodzo womwe umatulutsidwa masana. Muyenera kulabadira madzi okhutira mankhwala, mwachitsanzo sauces, masamba, zipatso, kupereka pafupifupi 400-500 ml.
5. Kuchepetsa sodium pa nthawi yokwanira yolipiridwa sikofunikira, koma tikulimbikitsidwa kuti muchepetse 3 g (supuni imodzi) ya mchere patsiku ngati njira yodzitetezera, chifukwa chakumwa kwambiri. Ndikokwanira kuti musawonjezere mchere ku mbale, kupatula zinthu zamchere muukadaulo, monga: chakudya cham'chitini, pickles, nyama, nyama yophika, kusuta, tchizi chachikasu, silage, zokometsera za supu ndi soseji, zonunkhira zopangidwa kale, mwachitsanzo masamba, masamba, msuzi cubes.
6. kuchepetsa phosphorous kuchokera ku zinthu zomwe zimakhala ndi phosphorous, monga: offal, phala, rennet ndi tchizi, nyemba, nsomba, mazira, bowa, mabala ozizira, ufa wa mkaka wonse. Ndi bwino kudya mankhwala amene amamanga phosphate mu m`mimba thirakiti chakudya.
7. kufunikira kwa potaziyamu panthawi yakusakwanira kolipiridwa kuyenera kukulitsidwa, ndipo panthawi yakumapeto kuyenera kukhala 1500-2000 mg / tsiku, kupatula zinthu zomwe zili ndi mcherewu: nyemba zowuma, chinangwa, koko, chokoleti. , mtedza, zipatso zouma, nthochi , mapeyala, tomato, mbatata, masamba a masamba, bowa. Potaziyamu akhoza kuchepetsedwa mwa kuviika ndi kuphika chakudyacho, ndikusinthidwa madzi pophika.
8. kufunika kwa mchere wina ayenera kuwonjezera kashiamu akusowa, chifukwa cha zofooka za mapuloteni mankhwala, supplementation wa chitsulo akusowa kumabweretsa magazi m`thupi.
9. kusowa kwa mavitamini kumawonjezera kusowa kwa vitamini. kuchokera ku gulu B, kupatsidwa folic acid, vit. C ndi D chifukwa cha zakudya zochepa za potaziyamu.
10. kufunikira kwa mafuta mu extracorporeal dialysis kuyenera kukhala 30-35% ya mphamvu, ndipo mu peritoneal dialysis 35-40%. mphamvu zochokera ku zomera, makamaka mafuta a azitona ndi mafuta.
11. kufunikira kwa potaziyamu kuyenera kukhala 1500-2000 mg / tsiku, nyama ndi masamba siziyenera kugwiritsidwa ntchito.
12. kufunika phosphorous ayenera kuchepetsa kumwa mankhwala wolemera mu chigawo ichi ndi kugwiritsa ntchito mankhwala amene amamanga phosphate mu m`mimba thirakiti.
13. Kuletsa sodium kumagwira ntchito.
14. kufunikira kwa mchere ndi mavitamini kumafuna kuwonjezereka kwa calcium, vit. D, A ndi C.
15. Kuletsa kwamadzimadzi kumawerengedwa kuchokera ku kuchuluka kwa mkodzo + 500 ml, kuchuluka kwachulukidwe kumawonetsedwa kokha nyengo yotentha, kutentha thupi, kusanza ndi kutsekula m'mimba.

Zitsamba zina zimathandiza kuchiza ndi kupewa matenda a impso. Pa Msika wa Medonet mutha kugula Herbal detox - tiyi wachilengedwe wachilengedwe wokhala ndi chimanga, pansy, yarrow ndi blackcurrant muzolemba.