Kushandiswa kwekufudza chigadzirwa chiremba chinoshandiswa kudyisa munhu asingakwanisi kutora zvokudya nemuromo zvakanaka. Iyi dambudziko ringangodaro nekuda kwekuoma kuedza , kuchinja kwehutano, chirwere chekudya, kana zvimwe nyaya dzinoita kuti kudya kuve kwakaoma. Kune marudzi akawanda ekudyisa tubes uye zvikonzero zvakawanda nei chikafu chekudya chingada kudiwa.
Mamiriro ose ega akasiyana, uye chisarudzo chekuita chikafu chekudya chakaiswa zvachose chinhu chakasiyana zvikuru pane kubvumira tube yenguva pfupi kuva panzvimbo.
Kuti uite chisarudzo chakanaka pamusoro pekudya mabhesi, zvinokosha kuti unzwisise kuti chii chinopisa kudya, iyo kusiyana pakati pemarudzi ekudyisa tubes, apo bhuti rinodikanwa rinopesana nechisarudzo, uye kuti aya mabheji akaiswa sei.
Kudyisa Tubhu Kunotsanangurwa
A tube tube ipurasitiki inoshandiswa kudarika kutsva uye kumedza mumurwere asingagoni kudya kana kunwa akachengeteka. Aya mazinga anogona kushandiswa kupa zvese zvokudya uye mvura, uye anogonawo kushandiswa pakupa mishonga kana zvichidiwa. Bhuku rekudya rinogonawo kushandiswa kubvisa mvura kubva mudumbu kana muviri usingashandisi mukati memazwi mukati.
Zvishandiso
Kudyisa mabhesi zvakanaka kune zvinopfuura kupa zvokudya, zvinogonawo kugadzirisa gesi uye kubvongodza, uye kuderedza kushushikana uye kurutsa.
Shanduro dzinowanzoshandiswa nehupfuti yekudya dzinosanganisira
- Kupa Chikafu: Zvokudya, mumvura yakasviba, zvinogona kupiwa kuburikidza nehutupa hwekudya. Kugadzira kudya, kana kudya kunovaka muviri, kunogona kupiwa kuburikidza ne tube kuti ipe marubhaidhirati, mapuroteni, uye mafuta kumutumbi pasina kudiwa murwere kuti amedze kana kudzora.
- Kupa Zvirwere: Mvura inogona kugoverwa kuburikidza nehutano hwekudya kuitira kuti murwere asvike asina kudikanwa kupa mvura inonaya.
- Kupa Mishonga: Mishonga, kusanganisira mapiritsi akawanda uye mahwendefa, inogona kupiwa kuburikidza nehutupa hwekudya. Matafura anogona kudika uye mamwe makirisiki angada kuzarurirwa, asi kana zvikamu zviduku zvakakwana mishonga yakawanda inogona kusanganiswa nemvura uye inotungamirirwa kuburikidza nehutupa hwekudya.
- Kudzvinyirira dumbu: Mamwe mavara ehututi yekudya anogona kushandiswa kubvisa mweya kubva mudumbu. Mamwe maitiro ekudyisa tubate, izvo zvenguva duku, kunyanya, zvinogona kubatana nekutsvaira kuti zvinyatsobvisa gasi kubva mudumbu kuti kuderedze kusagadzikana uye kuputika.
- Kubvisa Dumbu Mukati: Kana iwe usingashandisi zvokudya kana mvura, iwe unogona kuva nezvokudya zvakagara mumudumbu zvinokonzera kusagadzikana, kusuruvara, kusuruvara kana kurwadziwa kwepamuviri uye kuputika. Unyoro hunyoro hunogona kushandiswa kubvisa mvura uye zviduku zviduku zvekudya kubva mudumbu rako.
Apo Kudyisa Tube Kunokosha
Kushandiswa kwekudya kunokosha kana iwe usingagoni kuchengetedza kudya kana mvura inonzwika. Kunyange zvazvo zvichibvira kupa hutachiwana uye chikafu kuburikidza ne IV , muviri unoita zviri nani nechikafu ichiendeswa mumatumbo kupinda mumidziyo yeropa. Pese pazvinenge zvichibvira, zvakachengeteka uye zviri nani kuti muviri ugamuchire kudya uye mvura inonaya mumudumbu yekudya zvakakwana, asi kana uchinetseka kumedza, izvi zvingave zvisina kuchengeteka.
Dambudziko rinomedza rinogona kureva kuti murwere anotsvaira pazvokudya nemvura, kana kuti "inodonha pombi isina kunaka" uye zvinhu zvinoputirwa mumapapu panzvimbo pokumedzwa. Izvi zvinogona kukonzera kurwara kwakakomba, kusanganisira pneumonia , kubva pane zvinyorwa zvekudya zvinopinda mumapapu.
Vamwe vangave vachirwara zvikuru kuti vasaza, kana vari pane ventileri vane tube inowanikwa mumugwagwa unodzivirira kumedza. Vamwe varwere vakangwarira uye vane mazano asi havana kukwanisa kumedza zvakanaka. Kunyange zvakadaro, vamwe vane chirwere kana chirwere chinoita kuti zvive zvakaoma kumedza, zvakadai semukenza wemuromo.
Chisarudzo chekuisa Feeding Tube
Chisarudzo chekuisa tube yekudya chinhu chakaoma uye chinoitwa zvakaoma kana murwere asingakwanisi kutora chikamu muhurukuro kana kuti asati agovana zvavanoda maererano nehutano hwavo.
Mune zviitiko zvakawanda, murwere anoda chirwere chekudya chinogona kunge chichigadzikana kana kuti chisingazivi uye haakwanisi kugovana zvavanoda neshamwari nevanoda.
Mubvunzo wezvingadiwa nemurwere, uye kana iyo tube inogona kuva yenguva pfupi, nguva yakareba kana kusingaperi inoda kufunga. Dzimwe mhuri dzinopedza mazuva achikurukura nezvechisarudzo pakati pavo pachavo kana kuti inogona kuva nemhuri kusangana nevashandi vekurapa kuzokurukura chisarudzo.
Mune zviitiko zvakawanda, chisarudzo chekuisa chikwata chekudya chinosanganiswa nechisarudzo chekuisa tracheostomy, chirongo mumutsipa umo ventilator inogona kutsigira kufema kwako. Izvi ndezvekuti intubation , iyo nzira iyo tube inopinza mumuromo uye ichienda mumugwagwa kuitira kuti vhizimusi ishandiswe, inogona kushandiswa kwemasvondo mashomanana kusvikira kuipa kunogona kuitika mumutsipa. Sezvo zvinhu izvi zvose zviri mukati memavhiki maviri kwemazuva, kuiswa kwetracheostomy uye gastric tube inowanzoitwa panguva imwe chete kana mukati memazuva mashomanana.
Aina
Kune marudzi akawanda ekudyisa tubhu, uye anoshandiswa kune zvakasiyana-siyana. Chimiro chechinetso chiri kukonzera kuoma kukumedza , inozivikanwawo se dysphagia, chichabatsira kugona rudzi rwehuputi inoshandiswa. Zvimwe zvinotarisirwa kunge zvenguva pfupi, uye zvimwe zvinoreva kuti ndezvenguva refu kana kuti zvekare.
Chimbo chekudya kwenguva pfupi, iyo inowanikwa mumhino kana mumuromo, pasi pomutsipa, uye mukati mudumbu (G-tube) kana kupinda mukati mumatumbo (J-tube), inogona kungogara yakachengeteka panzvimbo inenge gumi nemana mazuva. Kuiswa pamutsipa kwenguva yakareba kupfuura vhiki mbiri kunowedzera mukana wekukanganiswa kwemasukisi asina kuchena emuhuro nepamusoro. Izvi zvinogona kutungamirira kune nyaya dzekusingaperi dzakadai sekukuvadza kwezwi inzwi nehuro.
Chimbo chekugara kwenguva refu kana chigarire chiya chinotarisirwa kushandiswa kwemwedzi, makore kana kunyange kugadziriswa kwekusingaperi. Kungofanana nehutapu yenguva duku, idzi tubhu dzinogona kubviswa kana dzisingachadiwi asi dzinogona kuramba dziri panzvimbo kwenguva yakawanda pasina ngozi kune muromo, huroti, uye sopu nokuti chikafu chinofamba zvakananga mudumbu.
Nguva Yenguva Pfupi Yokupa Tubes
Nasogastric (NG) Tube: Iri rudzi rwehuputi inowanikwa mumhino, pasi nepamusoro pehoro, ichidzika nepamuviri kusvika mudumbu. Inogona kuramba iri panzvimbo kwemavhiki maviri isati yafanirwa kubviswa kana kushandiswa nehupenyu hwekudya kwenguva refu.
Orogastric Tube (OG): Ida imwechete yehuputi seyasipastric tube, iyo tube inopindirwa mumuromo, pasi pasi nehuro uye kusvika pakupedzisira inogara mudumbu. Iyi tubhu inogonawo kuramba ichigara kwemavhiki maviri apo inofanira kubviswa kana kushandiswa nehupenyu husingaperi.
Kudyisa Zvenguva Pfupi Tubes
Chirwere chenguva pfupi chinoshandiswa mumuromo kana mumhino, pasi pemoti, kupinda mudumbu uye ipapo mugumo unosara mudumbu (G-tube) kana pakati pemukomana muduku (J-tube). Izvo zvipfeko zvine mavara ane redio-opaque, zvinoreva kuti pane zvishoma zvinyorwa zvinovabvumira kuti zvionekwe pa-x-ray pamugumo we tube. Mushure mekuiswa, x-ray yakaitwa, uye iyo inobvumira kuiswa kwakakodzera kuti kusimbiswe mberi iyo tube inoshandiswa.
Mhando dzePermanent / Long Term Feeding Tubes
Gastric Tube (G tube): Rudzi urwu rwehuputi runobvumirana nekuwana zvakakwana kumudumbu kuburikidza nekukanganiswa kuruboshwe rwekumusoro kwemuviri. Iyi tube inopedzisira yakanyanyisa muromo nehuro uye inobvumira kudya, mvura, uye mishonga kunopiwa pasina kumedza.
Jejunostomy Tube (J tube): Rudzi urwu rwebhubhu yakafanana nehutachiva, iyo inowanikwa kuburikidza nekuputika mumimba inenge yakaderera pane G-tube yekuiswa, uye inobvumidza kupinda zvakananga ku jejunum iyo iri pakati pechitatu utumbo muduku. Iyi tube inoita seyiduku kudarika G-tube, iyo inokwanisa kuderedza izvo zvingave zvichisanganiswa kuti zvidye zvakasviba uye zvakanakisa pasi zvinodhaka mishonga.
Percutaneous Endoscopic Gastrostomy (PEG): Iri izwi rinowanzoshandiswa pamwe chete neG-tube, asi izvi chaizvo zvinoreva nzira inoshandiswa kuisa G-tube. Percutaneous (kuburikidza neganda) endoscopic (achishandisa endoscope yakagadziriswa) gastrostomy (kuisa chirongo mukati mudumbu) inotsanangura nzira inoshandiswa kuisa G-tube, kwete G-tube pachayo.
Maitiro eTachi Gastric Akaiswa
Nzira yekuisa gastric tube ndiyo inowanzokurumidza, uye inogona kana inogona kusada anesthesia zvichienderana nemamiriro ako. Muvarwere vanorwara zvikuru mukuchengetedza kwakanyanya, hapana rimwezve rinogona kunge rinenge richidikanwa kuti riise tube iri pamubhedha.
Iko endoscope isimbi yakareba yakareba ine chiedza uye kamera pamagumo inobvumira mupiro kutarisa nzira yacho pakutevera. Nhamba yacho inowanikwa mumuromo, pasi nehuro, uye mudumbu. Kamwe kamwe mudumbu, inonyanya kukwanisika kuona chiedza chinobva pachiedza chichipenya kuburikidza neganda remuviri, kuratidza gastroenterologist kupi uko kugadzirisa kubatwa. Chinhu chiduku chinoshandiswa chinoitwa inenge hafu yema inch refu, kuburikidza nekushongedzeka kwehutano kunoiswa panzvimbo. Vakwegura G-tubes vanogona kunge vane bharuti rinochengetedza tubhu munzvimbo.
Chikamu chekunze chemuchina chinenge chivharo chinobvumira tubhu kuti izarurirwe, uye kuti zvokudya uye mvura inonyoreswa zvinyoronyoro zvigadziridzwe mukati mehutu mukati mudumbu. Nehutachiona hwakanaka hunochengetedzwa , iyo incision ichavhara zvakasimba zvakapoteredza tibhu, uye chero chinotyisa chekudya kana mvura inonaya inowanikwa mumazuva achangotevera nzira yacho inofanira kuderedzwa nekuporesa.
Kunyange zvazvo kuvharwa kuri kuporesa, bhanhire rine tsvina mukati mayo rinowanikwa nepamusoro pe tube. Izvi zvinobatsira kubvisa chero kusvibisa kunogona kuora kubva panzvimbo. Kana mvura yakasviba iripo uye inogumbura ganda, mafuta anodzivirira anogona kushandiswa kudzivirira. Kunyatsochenesa nzvimbo yacho nesipo nemvura uye kushambidza sese yakasara kubva munzvimbo yacho inowanzotarisira nzvimbo iyo inoda.
Nguva yakareba, varwere vazhinji havadi mafuta kana girafu panzvimbo yacho, asi vamwe vanosarudza kupfeka kana paine mvura yekudzivirira kudzivirira ganda kana mbatya kubva pakasvibiswa.
Zvokudya Zvenguva Pfupi Kugadziriswa kweTiyo
Kubviswa kwehutano hwekudya huri kwenguva pfupi hunokurumidza uye huri nyore. Icho chinogona kunge chinogumbura kumapundu akaoma emuromo, mumutsipa, uye mumhino, asi izvi zvisinganyanyi kukosha. Kuti ibvise tubhu, iyo tube inodonwa zvokudya uye mvura, ine sirasi huru yakagadzirwa kushandiswa nehutupa yekudya. Iko zvino zvinyoronyedzwa zvinyorwa, kutora mashizha 3-5 kusvika zvishoma nezvishoma kubviswa. Kana tsanho ye tube iri yakasimba, zvichiratidza kuti iyo yose tube yakabviswa zvakanaka, inokandwa kunze.
Permanent Feeding Tube Removal
Kana iwe ukawana zvakare kukwanisa kudya nokunwa zvakanaka, zvinobvira kubvisa "chigarire" yekudya tube. Zvinotoshamisa kuti nzira yacho inokurumidza, uye apo pane marwadzo, inowanzoenzanisa uye pfupi. Vashandi vanosiyana pane zvavanofanira kuita kuti bhuti ribviswa; dzimwe dzingada kuti iwe uchengetedze uremu hwako mwedzi unenge uchitora zvokudya zvose uye mvura inoshandisa nzira yeG-tube, asi dzimwe dzingada nguva yakareba.
Kana imwe nguva chisarudzo chikaitwa kubvisa tube, tube inokwanisa kubviswa kunze, asi izvi zvinoda imwe simba rekushandisa kuti rishandiswe. Murwere anowanzo ane tambo yakachengetedzwa iri pedyo nenzvimbo, uye mupiro anobata purasitiki zvakasimba uye anotora zvishoma asi asimbise kubvisa kubva panzvimbo. Kana paine bhoron mukati memudumbu, inosvibiswa musati yabvisa bhuti, asi mhando dzakawanda dzine ruzivo pane bhoron uye danho iri harisi kudiwa.
Nzira yacho inowanzoita, uye pane ropa shoma pane dzimwe nguva, asi marwadzo anopfuura nokukurumidza. Iwe unogona kutarisira kuti kuvharwa kuvharwe, asi izvi hazvidiwi, uye kupfeka kwakachena kunopfuura kukwana kuchengetedza vashandi vembatya kuchenesa mumazuva anotevera kana pane chero mvura yakasviba. Iyo incision inowanzovhara mukati mevhiki yehubhu iyo inobviswa.
Shoko Rinobva
Chisarudzo chekuisa chikwata chekudya hachisi chekuita zvishoma, zvinokosha kuti ukurukure kuti ndeupi mutambo wenguva refu unogona kutarisirwa iwe kana mudiwa wako. Kune vamwe varwere, tubhu inotarisirwa kuva yenguva pfupi pavanopora kubva kurwere. Kune vamwe varwere, chikwata chokudya chinogona kutarisirwa kuramba chiri munzvimbo yese yeupenyu hwavo hwose.
Zvingave kana kwete izvi zvakakodzera iwe kana mudiwa wako mubvunzo wekutanga. Kana iwe uri mutarisiri mune mamiriro ezvinhu angave achida kudya tube, iwe unoda iwe unogona kunge wakareva pfungwa dzakasimba pamusoro pehurukuro, kana vangasave vakataura zvavanoda nokuda kwehutano hwavo hwemazuva mazhinji. Kana usina chokwadi nezvavanoshuva, kushandisa maonero ako akanaka-pamwe chete nemafungiro eboka uchitarisira uye zvingangove mazano evamwe vadikanwa-zvichava mutungamiri wako wekuita zvisarudzo.
> Kwakabva:
> Kunzwisisa percutaneous Endoscopic Gastrostomy (PEG). American Society For Gastrointestinal Endoscopy. https://www.asge.org/home/for-patients/patient-information/understanding-peg