Mālama makua: he aha ia, he aha ia a pehea e hoʻokele ai

Anter

• Ke kuhikuhi ʻia
• Pehea e mālama ai i ka meaʻai pilikino makua
• He aha e kiaʻi ai i ka wā o ka hoʻokele
• Ke ʻano o ka meaʻai makua
• Nā pilikia i hiki
• 1. Wā pōkole
• 2. Manawa lōʻihi

ʻO ka makua, a i ʻole ka parenteral (PN) meaʻai, kahi ʻano o ka lawelawe ʻana i nā meaola i hana pololei ʻia i ka aa, ke hiki ʻole ke loaʻa nā meaola ma o ka meaʻai maʻamau. No laila, hoʻohana ʻia kēia ʻano meaʻai inā ʻaʻohe o ke kanaka i kahi gastrointestinal tract i hana pinepine ʻia i nā poʻe i kahi kūlana koʻikoʻi loa, e like me ka ʻōpū a me ka maʻi ʻaʻai ʻōpū i kahi pae holomua loa, no ka laʻana.

ʻElua ʻano nui o ka meaʻai pilikino makua:

• Palapala hānai makua makua: ʻo kekahi mau ʻano huaora a me nā wikamina e lawelawe ʻia ma o ka aa koko;
• Huina nui o ka meaʻai makua (TPN): lawelawe ʻia nā ʻano huaola a me nā wikamina āpau ma o ka aa koko.

ʻO ka mea maʻamau, ʻo nā poʻe e hana nei i kēia ʻano meaʻai e ʻae ʻia i ka haukapila e mālama i ka loiloi mau o ko lākou kūlana olakino, eia nō naʻe, i kekahi mau hihia, hana pū ʻia ka meaʻai makua i ka home a, i kēia mau hanana, pono ke kauka a kahu paha e wehewehe pehea e lawelawe pololei ai i ka meaʻai.

Ke kuhikuhi ʻia

Hoʻohana ʻia ka meaʻai makua e pale ai i ka palehua, ʻoi aku i ka poʻe, no kekahi kumu, ʻaʻohe o lākou wahi gastrointestinal e pono ai a i ʻole e pono e hāʻawi i ko lākou ʻōpū a me ko lākou ʻōpū i kahi hoʻomaha.

No kēia kumu, hōʻike pū ʻia ka meaʻai makua makua ke hānai waha ʻia, ʻoiai me ka paipu, ʻaʻole hiki ke hana ʻia ma lalo o nā kūlana maikaʻi no 5 a 7 mau lā paha.

Hiki ke hana ʻia ka hōʻailona o kēia ʻano meaʻai i ka manawa pōkole, ke hana ʻia a hiki i ka 1 mahina, a i ka wā lōʻihi, e pili ana i ke kūlana o kēlā me kēia kanaka.

Pehea e mālama ai i ka meaʻai pilikino makua

ʻO ka hapanui o ka manawa, hana ʻia nā meaʻai makua makua e nā limahana hānai ma ka haukapila, akā naʻe, inā pono e hana i ka hoʻokele ma ka home, he mea nui e loiloi mua i ka ʻeke meaʻai, e hōʻoia ana aia ia i loko o ka lā palena pau, paʻa mau ka ʻeke a mālama i kāna mau ʻano maʻamau.

A laila, i ka hihia o ka hoʻomalu ma o ka catheter catheter, pono kekahi e hāhai i kēlā me kēia ʻanuʻu

1. E holoi i kou mau lima me ke kopa a me ka wai;
2. Kāohi i kahi infusion o ke serum a lāʻau paha e lawelawe ʻia ana ma o ka catheter;
3. Disinfect i ka pilina o ke kikowaena, e hoʻohana ana i kahi swab waiʻona steril;
4. Wehe i ka ʻōnaehana serum i kū i kahi;
5. E hoʻolohi mālie i 20 mL o ka paʻakai;
6. E hoʻohui i ka ʻōnaehana hānai makua.

Pono e hana i kēia kaʻina hana āpau me ka hoʻohana ʻana i nā mea i hōʻike ʻia e ke kauka a kahu wahine paha, a me kahi pauma lawe calibrated e hōʻoia ana e hāʻawi ʻia nā meaʻai i ka wikiwiki pololei a no ka manawa i hōʻike ʻia e ke kauka.

E aʻo a hoʻomaʻamaʻa pū ʻia kēia ʻanuʻu me kēlā me kēia kahu maʻi i ka haukapila, e hoʻomaʻemaʻe i nā kānalua a hōʻoia ʻole i ala aʻe nā pilikia.

He aha e kiaʻi ai i ka wā o ka hoʻokele

Ke lawelawe ʻana i ka meaʻai makua, he mea nui e loiloi i ka pūnaewele hoʻokomo catheter, e loiloi ana i ke alo o ka pehu, ʻulaʻula a ʻeha paha. Inā kū kekahi o kēia mau hōʻailona, ​​pono e kāpae i ka hānai makua ʻana a hele i ka haukapila.

Ke ʻano o ka meaʻai makua

Hiki ke hoʻokaʻawale ʻia ke ʻano o ka meaʻai pilikino makua e like me ke ala o ka hoʻomalu:

• Nutritional mākua waena: hana ʻia ia ma o ka catheter venous kikowaena, kahi paipu liʻiliʻi i kau ʻia i loko o kahi aa nui, e like me ka vena cava, a e ʻae ai i ka hoʻokele o nā meaola no kahi manawa ma mua o 7 mau lā;
• Peripheral parenteral meaʻai (NPP): hana ʻia ma o ka catheter venous peripheral, kahi i hoʻonoho ʻia i kahi aa liʻiliʻi o ke kino, ma ka lima a lima paha. Hōʻike maikaʻi ʻia kēia ʻano ke mālama ʻia ka meaʻai a hiki i nā lā he 7 a 10 paha, a i ka wā hiki ʻole ke waiho i kahi catheter venous kikowaena.

Hiki ke loli ke ʻano o nā ʻeke i hoʻohana ʻia i ka meaʻai makua e like me kēlā me kēia hihia, akā ʻo ka mea maʻamau nā momona, glucose a me nā amino acid, a me ka wai a me nā minelala a me nā huaora like ʻole.

Nā pilikia i hiki

ʻO nā pilikia i hiki ke ala aʻe me ka meaʻai makua makua ʻokoʻa loa a, no laila, he mea nui mau ka mālama ʻana i nā alakaʻi āpau i hana ʻia e ke kauka a me nā ʻoihana olakino ʻē aʻe.

Hiki ke hōʻuluʻulu ʻia nā ʻano nui o nā pilikia e like me ka lōʻihi o PN:

1. Wā pōkole

I ka wā pōkole, ʻo nā pilikia pinepine pinepine e pili ana i nā mea e pili ana i ke kau ʻana o ka catheter venous kikowaena, e like me pneumothorax, hydrothorax, hemorrhage o loko, hōʻino i nā aʻa i ka lima a i ʻole ka hōʻino ʻana i ke kīʻaha koko.

Eia kekahi, ʻo ka maʻi o ka ʻeha catheter, ka hoʻāhu o ke kīʻaha koko, ka pale ʻana o ka catheter, thrombosis a i ʻole ka maʻi āpau e nā virus, bacteria a fungi paha.

I ka pae metabolic, ʻo ka hapa nui o nā pilikia e pili ana i nā loli i ke kiʻekiʻe o ke kō o ke kō, acidosis metabolic a i ʻole alkalosis, hoʻemi i nā waikawa momona momona, nā loli i nā electrolytes (sodium, potassium, calcium) a hoʻonui i ka urea a i ka creatinine.

2. Manawa lōʻihi

Ke hoʻohana ʻia ka meaʻai pilikino makua no kahi wā lōʻihi, ʻo nā pilikia nui me nā loli i ke ake a me ka vesicle, e like me ke ake momona, cholecystitis a me portal fibrosis. No kēia kumu, he mea maʻamau ia e hōʻike ke kanaka i ka hoʻonui ʻana o nā enzymes ate i nā hoʻokolohua koko (transaminase, alkaline phosphatase, gamma-GT a me ka bilirubin huina).

Eia kekahi, ʻo ka momona momona a me ka hemahema carnitine, ka hoʻololi ʻana o ka flora ʻōpū a me ke atrophy o nā wikiwiki o ka ʻōpū a me nā mākala e kū pū kekahi.