Joang ho fepa mokuli nakong ea pele le ka mor'a ho buuoa?

Likahare tse netefalitsoeng

Ho buuoa ke moroalo o boima bakeng sa 'mele. Ho ka boleloa hore morero oa eona ke ho ntša ’mele kotsi ka boomo molemong oa kakaretso oa mokuli. Empa hopola hore tsela eo 'mele oa hau o arabelang ka eona nakong ea ts'oaetso e ka fetola metabolism ea hau ho catabolism - mokhoa oo' mele oa hau o qalang ho nka le ho sebelisa liprotheine. Haeba li sa fepeloe ka lijo, 'mele o tla li fihlela ka har'a mesifa.

Boitsebiso bo entsoe ka tšebelisano 'moho le Nutramil Complex.

Mokhoa oa ho hlaphoheloa o etselitsoe ho khutlisa catabolism e bakiloeng ke khatello ea maikutlo ho ea ho anabolism. Phepo e nepahetseng, phepelo ea matla le liprotheine ke karolo ea bohlokoa ea kalafo ea perioperative.

Kalafo ea phepo e nepahetseng e potlakisa ho hlaphoheloa. Palo e kholo ea bakuli e ka ja 'me e lokela ho lumelloa ho etsa joalo. Sepheo sa phekolo ea phepo e nepahetseng e lokela ho ba ho matlafatsa ho noa metsi, ho netefatsa phepelo e lekaneng ea matla le protheine.

Phekolo ea phepo e nepahetseng ke eng?

Phekolo ea phepo ea meriana - ke ho ntlafatsa le ho boloka boemo ba phepo e nepahetseng. E boetse e susumetsa tsoelo-pele le liphello tsa phekolo.

Phepo ea meriana e itšetlehile ka ho qapa lijo tsa mokuli ka tsela ea ho mo fa limatlafatsi tsohle tse hlokahalang tsa mohaho le matla (liprotheine, tsoekere, mafura, liminerale le livithamine). Ka kalafo ea phepo e nepahetseng, ho sebelisoa lijo tsa indasteri tse lokiselitsoeng (mohlala, Nutramil Complex) kapa maro a kenang methapong, e leng sebopeho sa eona se ikemiselitseng ho latela litlhoko tsa hajoale tsa mokuli.

Phepo e nepahetseng pele ho opereishene

Hona joale, ho khothalletsoa hore batho ba nang le phepo e nepahetseng ba je lijo tsa bona tse tloaelehileng ho fihlela bosiung ba pele ho opereishene. Ho fihlela lihora tse 2 - 3 pele ho anesthesia, o ka nka metsi leha e le afe a hloekileng, a thusang ho qoba ho felloa ke metsi pele ho ts'ebetso.

Hape morao tjena ho bontšitsoe hore ho fana ka seno se nang le lik'habohaedreite ho mokuli oa pele ho ts'ebetso ho nyamela kapele ka mpeng, 'me ho eketsoa ha lik'habohaedreite ho fokotsa tlala le matšoenyeho pele ho ts'ebetso. Phepelo ea lik'habohaedreite pele ho opereishene e boetse e fokotsa ho hanyetsa insulin ka mor'a ho buuoa.

Phepo ea pele ho opereishene e bohlokoa haholo ho bakuli ba haelloang ke phepo e nepahetseng. Ho 'nile ha bontšoa hore sehlopheng sena sa bakuli, enteral esita le phepo ea batsoali e sebelisoa libeke tse 1-2 pele ho buuoa ho ntlafatsa haholo liphello tsa phekolo ea ho buuoa.

Tataiso ea Mokhatlo oa Europe oa Anaesthesiology mabapi le ho itima lijo ka nako e telele ho batho ba baholo le bana

Li-carbohydrate tsa molomo:

1. Ho noa lino tse nang le lik'habohaedreite tse ngata ho fihlela lihora tse 2 pele ho ts'ebetso e reriloeng e bolokehile ho bakuli (le bakeng sa batho ba nang le lefu la tsoekere),
2. Ho noa metsi a nang le lik'habohaedreite pele ho opereishene e khethehileng ho ntlafatsa boiketlo ba motho, ho fokotsa maikutlo a tlala le ho fokotsa ho hanyetsa insulin ka mor'a ho buuoa.

Phepo e nepahetseng ka mor'a ho buuoa

Ntho ea bohlokoa ka ho fetisisa bakeng sa mokuli e mong le e mong ke ho khutlela mosebetsing o tloaelehileng kapele ka mor'a ho buuoa e le hore ho be le mathata a seng makae kamoo ho ka khonehang le ho lokolloa hae kapele. Ho finyella sena, hoa hlokahala ho fokotsa catabolism le ho lumella 'mele oa mokuli hore o khutlele boemong ba anabolism. Phepo e na le karolo e kholo lits'ebetsong tsena. Lijo tsa metsi e ka ba karolo ea bohlokoa ea phekolo ea phepo e nepahetseng mona. Maemong a boima le ho feta, phepo e nepahetseng le ea botsoali le eona e phetha karolo ea bohlokoa.

Ho sa tsotellehe mokhoa oa phepo o khothalletsoang ke ngaka (ho kena ka tube kapa stoma, parenteral), e tlameha ho sebelisoa ho fihlela mokuli a khona ho ja bonyane 70% ea litlhoko tsa matla le protheine ka tsela ea molomo.

Palo ea matla eo mokuli a e hlokang e lokela ho khethoa ka bomong, empa ka karolelano e tloha ho 25 ho isa ho 35 kcal / kg bw. Ka mor'a ts'ebetso, mokuli o boetse o hloka liprotheine tse ngata ho feta motho ea phetseng hantle ho tsosolosa lisele tse senyehileng le ho netefatsa hore tsamaiso ea 'mele ea ho itšireletsa mafung e sebetsa hantle. Palo ea protheine eo mokuli a lokelang ho e ja ke 1,2 ho isa ho 1,5 g / kg bw, ha feela liphio li ntse li sebetsa hantle.

Wytyczne ESPEN - European Society for Clinical Nutrition le Metabolism

1. Bakuli ba bangata ha ba hloke ho itima lijo pele ho buuoa bosiu. Batho ba se nang kotsi e eketsehileng ea ho ba le takatso e matla ba ka noa metsi ho fihlela lihora tse 2 pele ho qala ts'oaetso. Ho sebelisoa ha lijo tse tiileng ho lumelloa ho fihlela lihora tse 6 pele ho qala ha anesthesia.
2. Mokhoa o ratoang oa phepo ke ka pampitšana ea gastrointestinal, ntle le ha e le hantle ha e hanyetsanoa.
3. Ho ja lijo tse sa lekaneng tsa molomo bakeng sa matsatsi a fetang 14 ho amahanngoa le ho eketseha ha lefu. Haeba nako e lebelletsoeng ea ho itima lijo nakong ea perioperative e telele ho feta matsatsi a 7, phepo e nepahetseng e khothalletsoa hape ho bakuli ba se nang matšoao a khaello ea phepo e nepahetseng.
4. Phepo ea 'mele e boetse e bontšoa ho bakuli bao phepelo ea lijo tsa molomo e lebelletsoeng e ke keng ea feta 10% ea tlhoko ea matsatsi a fetang 60.
5. Ho fepa ka li-tube ho lokela ho qala ka mor'a lihora tse 24 ka mor'a ts'ebetso, ho kgothaletswa ho bakuli: ka mor'a ts'ebetso e kholo ka lebaka la kankere ea hlooho, molala le mala, ka mor'a ho sithabela ho matla, ho haelloa ke phepo e nepahetseng letsatsing la ho buuoa, eo ho eona ho lebelletsoeng phepelo ea lijo. e tla ba <60% ea tlhoko ea matsatsi a fetang 10.
6. Lijo tse tloaelehileng tse nang le protheine e feletseng li lekane bakeng sa bakuli ba bangata.
7. Sepheo sa phekolo ea perioperative ke ho fokotsa tekanyo e mpe ea naetrojene, ho thibela khaello ea phepo e nepahetseng, ho boloka mesifa ea mesifa, ho boloka tšireletso e tloaelehileng, le ho potlakisa ho hlaphoheloa ka mor'a ho buuoa.
8. Bakuli ba feptjoang hantle ha ba rue molemo phepong ea maiketsetso, e ka bang mohloli oa mathata ho bona.
9. Ho khothalletsoa ho ja ka mor'a ts'ebetso ea botsoali bakeng sa bakuli ba sa khoneng ho fihlela litlhoko tsa bona ka molomo kapa ka tsela e kenang ka hare ho matsatsi a 7-10 ka mor'a ho buuoa. Phepo e kopantsoeng ea parenteral-enteral e lokela ho nkoa mona.
10. Hangata, ho kgothaletswa ho fana ka 25 kcal / kg ea boima ba 'mele bo loketseng. Ho bakuli ba tlas'a khatello e matla, phepelo e ka eketsoa ho 30 kcal / kg ea boima ba 'mele bo loketseng.
11. Ho bakuli ba ke keng ba feptjoa ka pampitšana ea gastrointestinal, phepo ea batsoali e tlameha ho ba e feletseng.

Phepo e nepahetseng pele ho opereishene e ntlafatsa liphello tsa phekolo ea opereishene ho bakuli ba haelloang ke phepo e nepahetseng haholo, 'me tsamaiso ea lik'habohaedreite pele ho ts'ebetso e fokotsa ho hanyetsa insulin le protheine catabolism ka mor'a ho buuoa ka boithatelo. Ho phaella moo, e na le phello e ntle ho boiketlo ba mokuli 'me e fokotsa khatello ea kelello e amanang le mokhoa o reriloeng.

Batho ba bangata ba etsoang opereishene ha ba na li-contraindications bakeng sa ho khutlela kapele lijong tse tloaelehileng tsa molomo 'me ba lokela ho khutlela ho eona kapele kamoo ho ka khonehang. Phepo ea ka mor'a ho sebetsa ka mpeng e fokotsa palo ea mathata a ka morao. Phepo e lokela ho ba karolo ea tsamaiso e kopanetsoeng ho pholletsa le phekolo ea mokuli.

Libuka tsa Bibele:

1. Szczygieł B., Khaello ea phepo e nepahetseng e amanang le mafu, Warsaw 2012, PZWL, maq. 157-160

2. Sobotka L. et al., Metheo ea phepo e nepahetseng ea kliniki, Warsaw 2008, PZWL, maq. 296-300

Boitsebiso bo entsoe ka tšebelisano 'moho le Nutramil Complex.