Kodi kudyetsa wodwalayo mu nthawi isanayambe kapena itatha opaleshoni?

Zomwe zatsimikiziridwa

Opaleshoni ndi katundu wolemetsa kwa thupi. Zinganenedwe kuti cholinga chake ndi kuvulaza mwadala thupi kuti lipindule kwambiri ndi wodwalayo. Koma kumbukirani kuti momwe thupi lanu limayankhira kuvulala kochitidwa opaleshoni limatha kusintha kagayidwe kanu kukhala catabolism - njira yomwe thupi lanu limayamba kutenga ndikugwiritsa ntchito mapuloteni. Ngati sanapatsidwe chakudya, thupi limawafikira kuminofu.

Nkhaniyi idapangidwa mogwirizana ndi Nutramil Complex.

Njira yochira idapangidwa kuti isinthe ma catabolism omwe amayambitsa zoopsa kupita ku anabolism. Kudya koyenera, mphamvu ndi mapuloteni ndi gawo lofunikira la chithandizo cha perioperative.

Thandizo lopatsa thanzi limafulumizitsa kuchira. Odwala ambiri amatha kudya ndipo ayenera kuloledwa kutero. Cholinga cha chithandizo chamankhwala chiyenera kukhala kukhathamiritsa kudya kwamadzimadzi, kuonetsetsa kuti pali mphamvu zokwanira komanso zomanga thupi.

Kodi mankhwala opatsa thanzi ndi chiyani?

Chithandizo chamankhwala chamankhwala - ndikuwongolera ndikukhalabe ndi thanzi labwino. Zimakhudzanso momwe chithandizo chimakhalira komanso zotsatira zake.

Zakudya zachipatala zimachokera pakupanga zakudya za wodwalayo m'njira yoti amupatse zonse zofunikira zomanga ndi zowonjezera mphamvu (mapuloteni, shuga, mafuta, mchere ndi mavitamini). Pazakudya zopatsa thanzi, zakudya zopangidwa kale zamakampani (mwachitsanzo Nutramil Complex) kapena madzi am'mitsempha amagwiritsidwa ntchito, zomwe zimatsimikiziridwa mosalekeza kutengera zosowa za wodwalayo.

Chakudya musanachite opaleshoni

Pakali pano, tikulimbikitsidwa kuti anthu omwe ali ndi zakudya zopatsa thanzi adye chakudya chawo chanthawi zonse mpaka usiku woti achite opaleshoni. Mpaka maola 2 - 3 musanayambe opaleshoni, mutha kumwa madzi aliwonse oyera, omwe amathandiza kuti musayambe kutaya madzi m'thupi.

Zasonyezedwanso posachedwapa kuti kupereka chakumwa chochuluka cha carbohydrate kwa wodwala yemwe asanayambe opaleshoni kumasowa msanga m'mimba, ndipo kuwonjezera kwa chakudya kumachepetsa njala ndi nkhawa isanayambe. Kupereka kwa chakudya cham'thupi musanachite opaleshoni kumachepetsanso kukana kwa insulin pambuyo pa opaleshoni.

Zakudya zopatsa thanzi musanachite opaleshoni ndizofunikira kwambiri kwa odwala omwe ali ndi vuto loperewera zakudya m'thupi. Zasonyezedwa kuti mu gulu la odwala, cholowa ndi ngakhale parenteral zakudya ntchito 1-2 milungu pamaso opaleshoni kwambiri bwino zotsatira za mankhwala opaleshoni.

Malangizo a European Society of Anaesthesiology pa kusala kudya kwapang'onopang'ono kwa akulu ndi ana

Zakudya zamafuta amkamwa:

1. Kumwa zakumwa zokhala ndi ma carbohydrate mpaka maola a 2 opaleshoni yomwe akukonzekera ndi yabwino kwa odwala (komanso odwala matenda ashuga),
2. Kumwa zamadzimadzi zokhala ndi ma carbohydrate musanachitike opaleshoni yosankha kumathandizira kukhala ndi moyo wabwino, kumachepetsa kumva njala komanso kumachepetsa kukana kwa insulin pambuyo pa opaleshoni.

Zakudya zabwino pambuyo pa opaleshoni

Chofunika kwambiri kwa wodwala aliyense ndi kubwerera kuntchito mwamsanga pambuyo pa opaleshoni kuti akhale ndi zovuta zochepa momwe angathere ndikutulutsidwa kunyumba mwamsanga. Kuti izi zitheke, ndikofunikira kuchepetsa catabolism ndikulola kuti thupi la wodwalayo libwerere ku chikhalidwe cha anabolism. Zakudya zopatsa thanzi zimakhala ndi gawo lalikulu munjira izi. Zakudya zamadzimadzi zitha kukhala gawo lofunikira pazakudya zopatsa thanzi pano. Pazovuta kwambiri, zakudya zopatsa thanzi komanso zopatsa thanzi zimathandizanso.

Kaya njira ya zakudya akulimbikitsidwa ndi dokotala (kulowa kudzera chubu kapena stoma, parenteral), ayenera kugwiritsidwa ntchito mpaka wodwalayo athe kudya osachepera 70% ya mphamvu ndi mapuloteni zofunika kudzera pakamwa njira.

Kuchuluka kwa mphamvu zomwe wodwalayo amafunikira ziyenera kusankhidwa payekha, koma pafupifupi zimayambira 25 mpaka 35 kcal / kg bw. Pambuyo pa njirayi, wodwalayo amafunikiranso mapuloteni ambiri kuposa munthu wathanzi kuti amangenso minofu yowonongeka ndikuonetsetsa kuti chitetezo cha mthupi chikugwira ntchito bwino. Kuchuluka kwa mapuloteni omwe wodwala ayenera kudya ndi 1,2 mpaka 1,5 g / kg bw, bola ngati impso zikugwira ntchito bwino.

Wytyczne ESPEN - European Society for Clinical Nutrition and Metabolism

1. Odwala ambiri safunikira kusala kudya asanachite opaleshoni usiku. Anthu omwe alibe chiwopsezo chochulukirachulukira amatha kumwa zamadzimadzi mpaka maola awiri asanayambe opaleshoni. Kugwiritsa ntchito chakudya cholimba kumaloledwa mpaka maola 2 isanayambe opaleshoni.
2. Njira yokondeka yazakudya ndi kudzera m'mimba, kupatula ngati ikutsutsana.
3. Kusakwanira kwa chakudya cham'kamwa kwa masiku opitilira 14 kumalumikizidwa ndi kuchuluka kwa kufa. Ngati kuyembekezera nthawi ya kusala kudya mu perioperative nthawi yaitali kuposa 7 masiku, enteral zakudya tikulimbikitsidwa komanso odwala popanda zizindikiro za kuperewera kwa zakudya m'thupi.
4. Zakudya zam'mimba zimawonetsedwanso mwa odwala omwe amayembekeza chakudya cham'kamwa sichidzapitilira 10% ya zomwe zimafunikira masiku opitilira 60.
5. Kudyetsa chubu kuyenera kuyambika mkati mwa maola 24 pambuyo pa ndondomekoyi, tikulimbikitsidwa kwa odwala: pambuyo pochita maopaleshoni ambiri chifukwa cha khansa ya mutu, khosi ndi m'mimba, pambuyo pa kuvulala kwakukulu, kuperewera kwa zakudya m'thupi pa tsiku la opaleshoni, amene amayembekezera chakudya. adzakhala <60% ya kufunika kwa masiku oposa 10.
6. Zakudya zokhazikika zomwe zili ndi mapuloteni athunthu ndizokwanira kwa odwala ambiri.
7. Cholinga cha chithandizo cha perioperative ndi kuchepetsa kusakwanira kwa nayitrogeni, kupewa kuperewera kwa zakudya m'thupi, kusunga minofu, kusunga chitetezo chokwanira, ndikufulumizitsa kuchira pambuyo pa opaleshoni.
8. Odwala omwe amadyetsedwa bwino samapindula ndi zakudya zopangira, zomwe zingakhale gwero la zovuta kwa iwo.
9. Postoperative parenteral zakudya tikulimbikitsidwa kwa odwala amene sangathe kukwaniritsa zosowa zawo ndi m`kamwa kapena lolowera njira 7-10 masiku opaleshoni. Kuphatikizika kwa parenteral-enteral zakudya ziyenera kuganiziridwa apa.
10. Nthawi zambiri, tikulimbikitsidwa kupereka 25 kcal / kg kulemera kwa thupi. Odwala omwe ali ndi nkhawa kwambiri, chakudyacho chikhoza kuwonjezeka kufika 30 kcal / kg ya kulemera kwa thupi.
11. Odwala amene sangathe kudyetsedwa kudzera m`mimba thirakiti, parenteral zakudya ayenera wathunthu.

Zakudya zopatsa thanzi musanachite opaleshoni zimathandizira zotsatira za chithandizo chamankhwala kwa odwala omwe ali ndi vuto loperewera zakudya m'thupi, ndipo makonzedwe amthupi a preoperative amachepetsa kukana kwa insulini ndi protein catabolism pambuyo pa opaleshoni yosankha. Kuonjezera apo, zimakhala ndi zotsatira zabwino pa umoyo wa wodwalayo ndipo zimachepetsa nkhawa zomwe zimagwirizanitsidwa ndi ndondomeko yokonzekera.

Anthu ambiri omwe akuchitidwa opaleshoni alibe zotsutsana kuti abwerere msanga ku zakudya zapakamwa ndipo ayenera kubwereranso mwamsanga. Chakudya cham'mimba cha postoperative chimachepetsa kuchuluka kwa zovuta zomwe zimachitika pambuyo pa opaleshoni. Chakudya chiyenera kukhala mbali ya kasamalidwe kophatikizana panthawi yonse ya chithandizo cha wodwalayo.

Malemba:

1. Szczygieł B., Matenda osowa zakudya m’thupi, Warsaw 2012, PZWL, pp. 157-160

2. Sobotka L. et al., Zofunikira pazakudya zachipatala, Warsaw 2008, PZWL, pp. 296-300

Nkhaniyi idapangidwa mogwirizana ndi Nutramil Complex.