Kune rudzi rwechikafu, icho chinotora chikafuwo zvacho sechinhu chisina kubikwa uye chakasiyana nechimiro chechikafuwo zvacho. Inowanikwa muchimiro chehupfu, mvura, nezvimwewo. Zvakafanana neupfu hwemukaka uye mapuroteni ehupfu, inogona kudyiwa nemuromo kana nemhino uye inogona kugayiwa nyore nyore kana kubatwa pasina kugaya. Inonzi "fomula chikafu chezvinangwa zvekurapa zvakakosha", ndiko kuti, isu tave kushandisa zvakanyanya kudya kunovaka muviri kukiriniki.
1. Chii chinonzi kudya kunovaka muviri?
Enteral Nutrition (EN) inzira yekutsigira hutano inopa zvakasiyana siyana zvinovaka muviri kumuviri kuburikidza nemudumbu turakiti kusangana nezvinodiwa zvemuviri uye pathological zvinodiwa nemuviri. Zvakanakira kuti zvinovaka muviri zvinonyudzwa zvakananga uye zvinoshandiswa kuburikidza nemudumbu, izvo zvakanyanya physiological, zviri nyore kutungamira, uye yakaderera mumutengo. Izvo zvinobatsirawo kuchengetedza kutendeseka kwemukati mucosa chimiro uye chipingamupinyi basa.
2. Ndezvipi zvinhu zvinoda kudya kunovaka muviri?
Vese varwere vane zviratidzo zvekutsigirwa kwekudya uye kushanda uye kunowanikwa gastrointestinal turakiti vanogona kugamuchira enteral nutritional support, kusanganisira dysphagia uye mastication; Kusakwanisa kudya nekuda kwekuvhiringidzika kwekuziva kana coma; Nguva yakagadzikana yezvirwere zvekudya, zvakadai segastrointestinal fistula, short bowel syndrome, chirwere chinoputika uye pancreatitis; Hypercatabolic state, yakadai sevarwere vane hutachiona hwakanyanya, kuvhiyiwa, kushungurudzika uye kupisa kwakanyanya. Kune zvakare zvirwere zvisingaperi zvinodya, senge tibhii, bundu, nezvimwe; Preoperative uye postoperative rubatsiro rwekudya; Adjuvant kurapwa kwe tumor chemotherapy uye radiotherapy; Kutsigira kwekudya kunovaka muviri nekupisa uye kushungurudzika; Kukundikana kwechiropa uye itsvo; Chirwere chemwoyo; Congenital kukanganisa kweamino acid metabolism; Iyo yekuwedzera kana shanduko yevabereki chikafu.
3. Ndeapi mapoka ekudya kunovaka muviri?
Pamusangano wekutanga pahwaro hwekugadzwa kwegadziriro yezvokudya zvinovaka muviri, Beijing Bazi reChinese Medical Association rakaronga kurongeka kwakaringana kwegadziriro yekudya kunovaka muviri, uye yakaronga kupatsanura gadziriro dzekudya kunovaka muviri mumhando nhatu, dzinoti amino acid, rudzi rweprotein yakazara uye chikamu chechikamu. Amino acid matrix ndeye monomer, kusanganisira amino acid kana pfupi peptide, glucose, mafuta, mineral uye vhitamini musanganiswa. Inokodzera varwere vane kusagadzikana kwegastrointestinal digestion uye kubata basa, asi ine kuravira kwakashata uye yakakodzera kudyisa mhino. Mhando yeprotein yese inoshandisa puroteni yakazara kana mapuroteni emahara seiyo nitrogen sosi. Inokodzera varwere vane zvakajairika kana pedyo nemaitiro egastrointestinal basa. Iine kuravira kwakanaka, uye inogona kutorwa nemuromo kana kupihwa nemhino. Component type inosanganisira amino acid component, short peptide component, whole protein component, carbohydrate component, long chain triglyceride (LCT) component, medium long chain triglyceride (MCT) component, vitamin component, etc., iyo inonyanya kushandiswa sezvinowedzera kana kuti zvigadziriso zvehutano hwakakwana.
4. Varwere vanosarudza sei kudya kunovaka muviri?
Varwere veNephrotic vakawedzera mapuroteni uye vanotarirwa kune yakaipa nitrogen chiyero, inoda yakaderera mapuroteni uye amino acid akapfuma kugadzirira. Kugadziriswa kwekudya kunovaka muviri kwerudzi rwechirwere cheitsvo kwakapfuma mune yakakosha amino acids, yakaderera muhuwandu hweprotein, yakaderera musodium uye potassium, iyo inogona kunyatso kudzikisa mutoro paitsvo.
Iyo metabolism yeanonhuhwirira amino acids, tryptophan, methionine, nezvimwewo muvarwere vane kusagadzikana kwechiropa basa yakavharwa, iyo branched chain amino acids inoderedzwa, uye inonhuhwirira amino acids inowedzera. Nekudaro, iyo branched cheni amino acids inogadziriswa nemhasuru, iyo isingawedzere mutoro pachiropa, uye inogona kukwikwidza neanonhuhwirira amino acids kupinda muropa uropi chipingamupinyi, kuvandudza chiropa nehuropi zvirwere. Nokudaro, branched chain amino acids inogona kuverengera kupfuura 35% ~ 40% yehuwandu hweamino acids muchirwere chechiropa chemhando yezvokudya.
Mushure mekupisa kwakanyanya, kutonhora kwemuviri wemurwere kunokwira, mahomoni uye zvinhu zvinoputika zvinobudiswa muhuwandu hukuru, uye muviri uri mumamiriro ekugadzirisa metabolism. Kunze kweronda, ura ndeimwe yenhengo huru dzine endogenous high metabolism. Naizvozvo, kupisa kunovaka muviri kunofanirwa kuve neprotein yakakwira, simba rakawanda uye mafuta anogayiwa nyore ane mvura shoma.
Kugadzirira kwekudya kwemukati kune varwere vane zvirwere zvemapapu kunofanirwa kuve nemafuta akawandisa, yakaderera carbohydrate yemukati, uye mapuroteni emukati chete kuchengetedza yakaonda tishu uye anabolism, kuitira kuvandudza basa rekufema.
Nekuda kwesimba rekemotherapy, chimiro chekudya uye mashandiro ezvirwere zvevarwere vane mabundu akaipa haana kunaka, uye bundu racho rinoshandisa mafuta mashoma. Nokudaro, kugadzirira kwezvokudya zvine mafuta akawanda, mapuroteni akawanda, simba guru uye carbohydrate yakaderera inofanira kusarudzwa, umo glutamine, arginine, MTC uye mamwe maitiro ekudzivirira zvirwere anowedzerwa.
Makabhohaidhiretsi mukugadzirira kwekudya kwevarwere vane chirwere cheshuga anofanira kunge ari oligosaccharides kana polysaccharides, pamwe nemafuta akakwana ekudya, izvo zvinobatsira kudzikisa chiyero uye chiyero chekukwira kweshuga yeropa.
Nguva yekutumira: Sep-14-2022