Enteral kev noj haus - yog dab tsi? Nutrient sib tov rau cov neeg mob nyob rau hauv lub postoperative lub sij hawm

Nyob rau hauv lub neej muaj ntau yam teeb meem thaum ib tug neeg laus muaj peev xwm tsis tau khoom noj khoom haus nyob rau hauv ib tug paub txoj kev. Qhov no tshwm sim mas tom qab phais. Thaum lub sij hawm rov qab lub sij hawm tus neeg yog tsis tau ntxo thiab nce mus zom zaub mov. Tab sis kuj nyob rau ntawm lub sij hawm no ib tug neeg mob xav tau ib tug tas mus li mov ntawm cov as-ham rau lub cev rau cov hauj lwm ntawm tag nrho cov nruab nrog cev thiab es ua livelihoods. Nyob rau hauv cov ntaub ntawv no, tau txais daim ntawv xws zoo ntawm cov khoom noj nyob rau hauv lub cev raws li enteral noj.

Enteral kev noj haus - yog dab tsi?

Qhov no zoo ntawm tus neeg mob mob, nws yog ib tug feature uas cov zaub mov los ntawm ib tug raj los yog ib tug tshwj xeeb system. Feem ntau cov feem ntau nyob rau hauv xws li ib tug khoom noj khoom haus tshwj xeeb mixtures yog siv. Lawv txawv los ntawm ib txwm zaub mov rau cov neeg laus, raws li nyob rau hauv tej yam lub xeev ntawm tus neeg mob yuav tsis noj lwm yam khoom.

Qhov zoo ntawm cov xws hwj chim

Qhov no zoo ntawm cov zaub mov muaj nws zoo rau cov neeg mob:

1. Physiological - khoom noj khoom haus kis ncaj qha mus rau hauv lub digestive system, cia nws mus tau yooj yim assimilated thiab txhawb cov neeg mob tom qab phais.
2. Pheej Yig cov khoom noj - rau daim ntawv thov ntawm no txoj kev tsis xav tau ntau heev them tus nqi.
3. Tej yam yooj yim rau siv ntxiv txhais tau tias - yog tsis muaj yuav tsum tau nce sterility, raws li cia li txaus lis cov kev sojntsuam rau enteral kev noj haus los yog system rau qhov ncauj noj mixtures.
4. Nws tsis ua loj teeb meem - sojntsuam yog tso tsis muaj tej yam teeb meem, thiaj li muaj yog tsis muaj yuav ua rau muaj tshwm sim ntawm yus thiab lub neej-hem teeb meem rau tus neeg mob.
5. Tso cai rau kom muab tau lub cev nrog rau tag nrho cov tsim nyog cov ntaub ntawv, qhov no yog vim xaiv ntawm pom niam rau tib neeg.
6. Nws yuav pab tiv thaiv kom txhob cov tsos ntawm atrophic los nyob rau hauv txoj hnyuv ib ntsuj av.

Indications rau enteral kev noj haus

Txoj kev loj hlob ntawm cov tshuaj nyob rau hauv qhov kawg ob centuries nws tau los mus txiav txim yog dab tsi zoo tshaj plaws rau tus neeg tom qab phais cov tswv yim uas yuav pab tau nws rov qab sai thiab kom tau tus tsim nyog lub dag lub zog thiab tsis muaj qhov uas yuav muaj. Thiab cov zaub mov mixtures tom qab phais nrog ntxiv kev kho mob li nws muaj nws qhov zoo thiab qhov indications. Muaj tej yam indications hais rau mixtures tias ib tug neeg xav tau kev pab, raws li zoo raws li mus rau lub heev txoj kev ntawm kev noj mov. Dag noj haus yog muab thaum:

1. Tus Neeg Mob vim hais tias ntawm lawv cov mob no yuav tsis tau noj thaum nws tsis nco qab lawm los yog tsis tau nqos.
2. Tus neeg mob yuav tsis txhob noj cov khoom noj - ib lub xeev ntawm mob pancreatitis los yog los ntshav nyob rau hauv txoj hnyuv ib ntsuj av.
3. Ib tug neeg mob tsis kam zaub mov, yog siv ces yuam enteral kev noj haus. Yuav ua li cas yog nws thaum muaj xws li ib tug lub xeev? Nws tshwm sim nyob rau hauv anorexia nervosa, nyob rau hauv uas koj yuav tsis cia li thauj lub plab zoo tib yam zaub mov, raws li muaj ib tug raug tuag tom qab ib lub caij nyoog hwj chim tsis ua hauj lwm. Tsis tas li ntawd, ib tug ntau yam ntawm tus kab mob ib tug neeg mob yuav tsis kam noj mov, nyob rau hauv uas cov ntaub ntawv lub system yog siv rau enteral kev noj haus, sau lub cev nrog rau qhov tseem ceeb cov as-ham mus tua cov kab mob.
4. Lub hwj chim tsis tau raws li cov kev xav tau, nws tshwm sim nrog kev raug mob, catabolism, kub nyhiab.

Taw los ntawm no hom ntawm lub hwj chim thiab rau nram qab no pathological tej yam kev mob:

• tsis muaj protein nyob rau hauv lub cev thiab lub zog, yog tias koj tsis tau muab cov kom tsawg ntawm cov tshuaj nyob rau hauv ib tug tej yam ntuj tso txoj kev;
• nyob rau hauv cov kev tshwm sim los ntawm ntau yam hlav ntawm lub taub hau, caj dab thiab lub plab;
• yog hais tias muaj yog ib tug hnyav kab mob ntawm lub hauv paus poob siab system, xws li Parkinson tus kab mob, cerebrovascular stroke, tej lub xeev hnovqab;
• nyob rau hauv cancer lub xeev tom qab tawg thiab cov kws khomob;
• Khoom noj khoom haus yog feem ntau kws kho rau mob loj heev hnyuv kab mob: pancreatitis, pathological dab nyob rau hauv daim siab thiab biliary ib ntsuj av tau, malabsorption syndromes , thiab luv luv plob tsis so tswj, thiab Crohn tus kab mob;
• tam sim ntawd tom qab lub phais pab mus rau hauv lub cev;
• Burns thiab mob lom;
• thaum ib tug fistula, sepsis;
• Yog hais tias tsim txoj kis kab mob;
• nyob rau hauv kev mob loj depressions;
• txawv degrees ntawm hluav taws xob kev puas tsuaj ntawm tus txiv neej.

Txoj kev rau qhia as mixtures

Enteral kev noj haus cov neeg mob mas nws txawv raws li tus qauv ntawm kev noj mov:

1. Siv ib tug kev sojntsuam rau plaug sib tov rau hauv lub plab.
2. Fais fab txoj kev "Sipping" - tau txais tshwj xeeb cov khoom noj ntawm ncauj nyob rau hauv me me sips.

Cov kev no kuj hu ua passive thiab kom nquag plias. Keeb kwm - enteral raj noj, Txoj kev lis ntshav muaj tshwm sim nrog ib tug tshwj xeeb dispenser system. Qhov thib ob - active, phau ntawv, nqa tawm tsuas yog ntawm syringe. Rau kev siv cov qauv no nws yog tsim nyog los nce ib qhov nqi ntawm sib tov thiab txhaj maj mam muab mus rau hauv lub qhov ncauj ntawm tus neeg mob. Rau hnub tim, nyiam yog muab rau cov twj, ciliates, uas yog txiav noj mus rau lub sib tov.

Probes rau enteral kev noj haus

Muaj ntau cov txheeb ze ntawm cov neeg mob nug enteral kev noj haus - dab tsi yog nws thiab dab tsi cov cuab yeej uas yuav tsum tau rau qhov no? Tseeb, rau xws li ib tug qauv ntawm cov sau lub cev nrog rau khoom noj khoom haus yuav tsum tau sib txawv probes. Lawv muab faib ua:

• nasogastric (nazoenteralnye) - nyias yas probes uas muaj qhov ntawm ib tug tej theem, thiab weighting rau yooj yim ntawm kev saib xyuas;
• percutaneous - muab tom qab phais (pharyngoscope, gastrostomy, esophagostomy, eyunostomiya).

Hom ntawm mov lub cev

To taub qhov teeb meem no, enteral kev noj haus - dab tsi nws yog, yog tsis txaus los siv rau nws. Muaj ntau ntau nuances kev taw qhia ntawm cov zaub mov mus rau hauv lub cev nyob rau hauv no txoj kev, piv txwv li, tus pub tus nqi ntawm lub sib tov. Muaj ntau ntau hom kev muab ib tug neeg mob lub hwj chim.

1. Pub sib tov nrog rau qhov tshaj tawm. Gavage neeg mob tau txais zaub mov ntawm ib yam ceev, nws yog 40-60 ml / hr. Ces tus kws zoo rau ib tug cov tshuaj tiv thaiv ntawm tus neeg mob. Thaum lub sib tov twb zoo taus, tus ceev tau maj zog. Nyob rau nruab nrab nws tsub kom los ntawm 25 ml / hr rau 8-12 xuab moos, ces rau tib lub sij hawm yuav tau ntxiv ntau li ntau dua kom txog rau thaum yuav tsum tau ceev yog mus txog. Yog hais tias lub lag luam yog tsuas yog tuav thiab tus neeg mob yog nyob rau hauv loj mob, lub sib tov yuav tsum tau muab tsis muaj ntau tshaj li 20-30 ml / hr. Nws yog tsim nyog los ua tib zoo saib xyuas tus mob ntawm tus neeg. Xeev siab, raws plab, ntuav, tu-sauv los yog txo tus nqi ntawm cov kev taw qhia los yog mixtures ntawd, los yog nws cov concentration. Qhov no hloov ib co ib tug uas qhia hais tias yog tsis muaj kev nyuaj siab rau hauv lub cev.
2. Dag noj cov zaub mov yuav muab nyob rau hauv ib ncig. Qhov no cyclical cov zaub mov yog tias tus neeg mob tom qab tas mus li mov maj txo nws thaum hmo ntuj, ua ntej tus so, nqa nyob rau hmo ntuj. Qhov no txoj kev yog yooj yim rau tus neeg mob thiab yuav ua tau los ntawm ib tug gastrostomy raj.
3. Kev sib kho hwj chim (periodic) yog tsis nqa tawm rau tag nrho cov. Nws yog qhia rau cov neeg cov neeg mob uas raws plab los yog txoj hnyuv phais twb ua. Tej lub hwj chim yog hu ua ib tug periodic, raws li nqa lub sij hawm ntawm 4-6 teev.
4. Bolus txau. Qhov no hom yog zoo ib yam li ib txwm noj mov. Cov sib tov yog txhaj los ntawm koob txhaj los yog los ntawm ib tug raj, tab sis lub nkag teb chaws cov kev cai yog nruj me ntsis es. Thaum no ceev tsis pub tshaj 240 ml ib nrab teev. Number of noj mov ib hnub 3-5 lub sij hawm. Tab sis yuav pib muab cov sib tov sawv ntawm ib puas ml. Yog hais tias tus neeg mob suffers tsis muaj teeb meem, ces maj mam ntxiv nrog 50 ml. Tab sis qhov no tsoom fwv yog txaus ntshai lub heev tshwm sim los ntawm raws plab, yog li nws yuav tsum tau muab thiab saib xyuas los ntawm ib tug tshwj xeeb.

Lawm, cov hom yuav tsis tau siab customizable rau tag nrho cov neeg uas yuav tsum tau enteral kev noj haus. Xaiv tus qauv, ceev thiab ntim ntawm xws zaub mov tus me nyuam mus rau hauv lub cev yuav siv sij hawm qhov chaw nrog rau ib tug neeg tus yam ntxwv.

Properties mixtures xaiv

Sib tov sib xyaw rau enteral kev noj haus yuav tsum tau xaiv kom haum rau ib tug neeg xav tau kev pab ntawm cov neeg mob. Lawv xaiv nyob rau hauv ob peb yam tseem ceeb.

1. Zoo noj haus rau postoperative cov neeg mob yuav tsum tau muaj ib tug zoo zog ceev. Nws tsis yog tsawg tshaj li 1 kcal / ml.
2. Muaj pes tsawg leeg ntawm sib tov yuav tsum tsis mus kawm ntawv thiab lactose glyutein. Cov tshuaj yuav ua rau ua xua.
3. Nws yuav tsum tau tsis muaj ntau tshaj li qhov osmolarity ntawm 340 mOsm / l.
4. Kom tsis txhob muaj teeb meem nrog lub assimilation ntawm cov khoom noj nws yuav tsum tau uas tsis yog-khov.
5. Zoo sib tov tsis ua dhau heev lawm plab hnyuv kom.
6. Nws yog tsim nyog tias nyob rau nws nyob ntawm lub tuam txhab thiab lub xub ntiag ntawm lub caj kev hloov kho ntawm proteins.

Nws yuav tsum tau muab sau tseg tias mis rau me nyuam mos, raws li zoo raws li lub ntsiab uas tsim los ntawm tej yam ntuj tso khoom, yog tsis haum rau enteral kev noj haus. Lawv yog cov rau cov neeg laus tib neeg yog tsis tus balanced, thiab yog li ntawd yuav tsis coj tus yam tshwm sim. Rau cov neeg mob nyob rau hauv kev xav tau ntawm tej khoom noj khoom haus, lawv hom mixtures tau tsim, uas yuav tsum tau los sib tham li hauv qab no.

monomeric sib tov

Lub npe mixtures txiav txim lawv muaj nuj nqi. Lawv tsis muaj tag nrho cov tsim nyog ib txoj lw ntsiab, tab sis kuj siv nyob rau hauv lub postoperative lub sij hawm. Tej mixtures yog muaj li ntawm piam thaj thiab ntsev, yog li cia rau rov qab los ntawm cov hnyuv functionality tam sim ntawd tom qab kev phais. Nyob rau hauv lub xub ntiag ntawm ntuav los yog zawv plab yog ib tug zoo cov khoom noj kom txhawb lub dej electrolyte tshuav nyiaj li cas nyob rau hauv lub cev. Tej mixtures yog "touring", "Mafusol", "Regidron", "Tsitroglyukosolan", "Orasan" thiab ib txhia lwm leej lwm tus.

Lub elemental muaj pes tsawg leeg rau ib cov zaub mov

Qhov no fais fab mov rau cov neeg mob yog raws li nyob rau precisely xaiv tshuaj ntsiab. Lawv yog siv nyob rau hauv ib rooj plaub ntawm metabolic mob nyob rau hauv lub cev nyob rau hauv pathologies xws li daim siab thiab lub raum tsis ua hauj lwm, mob ntshav qab zib thiab pancreatitis. Nyob rau hauv cov ntaub ntawv no, tus txiav, lub siab thiab ob lub raum yuav tsis ua lawv cov kev khiav dej num, yog li no mixtures pab tus neeg kom tsawg kawg yog ib nrab los tseem ceeb heev functions. Faiv fab no hom xws li "Vivoneks", "Fleksikal", "Lofenalak" thiab lwm tus neeg.

ib nrab-elemental sib tov

Cov khoom noj khoom haus mixtures rau cov neeg mob ntau zaus siv tshaj yav dhau los sawv daws yuav. Qhov no yog vim lub fact tias lawv muaj ib tug ntau kuas thiab haum ib tug ntau yam ntawm cov neeg mob uas yuav tsum siv enteral kev noj haus. Ntawm no, cov nqaijrog yog nyob rau hauv daim ntawv ntawm cov amino acids thiab peptides, uas tso cai rau lawv mus rau ntau yooj yim absorbed rau hauv lub cev. Tej ntsiab yog thov tam sim ntawd tom qab kev phais ntawm kev cuam tshuam digestive zog. Cov no muaj xws "Nutrien Elemental", "Nutrilon Pepto TSC", "Peptisorb", "Peptamen".

Raug polymer niam

Qhov no hom yog siv nyob rau hauv ntau cov kab mob tom qab ua hauj lwm, thaum ib tug neeg nyob rau hauv ib tug coma. Lawv yog cov feem ntau haum rau ib tug neeg laus kab nyob rau hauv nws muaj pes tsawg leeg. Cov kev daws teeb meem muaj tag nrho cov tsim nyog minerals, muaj ib txoj lw ntsiab, cov nqaijrog, Sibhawm, carbohydrates. Lawv muab faib ua peb hom.

1. Qhuav yuav tsum tau diluted thiab yuav muab los ntawm gavage. Qhov no tom ntej no enteral kev noj haus: "Nutrizon", "Berlamin modular", "Nutrikomp Standard".
2. Kua, uas yuav tsum tau muab sai li sai tau. Lawv yog tsim rau lub sijhawm uas koj yuav tsis poob ib feeb, muab tseem ceeb heev rau tib neeg kev noj haus. Cov no muaj xws "Berlamin modular", "Nutrikomp Kua", "Nutrizon Standard" thiab ib txhia lwm leej lwm tus.
3. Mixtures yog siv lus. Qhov no "modular Berlamin", "Nutridrink", "Fortikrem" thiab thiaj on.

Ib tug sib tov ntawm directional

Qhov no hom ntawm lub hwj chim mov rau lub hom phiaj zoo ib yam li cov views ntawm elemental tebchaw. Lawv yog tsim los muab lub functionality ntawm lub cev ntawm ib tug pathology. Lawv kho metabolic pa tsis ua hauj lwm, raum thiab lub siab tiv thaiv.