Izvo zvinodzivirira zvekuchengetedza chikafu chekudya ndeizvi:
1. Iva nechokwadi chekuti mushonga wekudya uye midziyo yekupinza yakachena uye haina hutachiona
Mushonga unovaka muviri unofanirwa kugadzirirwa munzvimbo isina utachiona, woiswa mufiriji iri pasi pe 4 ℃ kuitira kuchengetedza kwenguva pfupi, uye woshandiswa mukati memaawa makumi maviri nemana. Chigadziko chekugadzirira uye midziyo yekupinza inofanira kuchengetwa yakachena uye isina hutachiona.
2. Chengetedza mucous membranes uye ganda
Varwere vane nguva refu yekugara nasogastric chubhu kana nasointestinal chubhu vanowanzoita maronda nekuda kwekumanikidza kunoramba kuripo pamhino uye pharyngeal mucosa. Vanofanira kuzora chizoro zuva nezuva kuchengetedza mhango yemhino ine mafuta uye kuchengetedza ganda rakatenderedza fistula rakachena uye rakaoma.
3. Dzivirira chido
3.1 Displacement ye gastric chubhu uye teerera kune chinzvimbo; nyatsoteerera kuchengetedza nzvimbo ye nasogastric tube panguva yekuiswa kwemushonga wezvokudya, uye usaifambisa kumusoro, kubuda kwemudumbu kunononoka, uye mushonga wekudya unopinzwa kubva mu nasogastric tube kana gastrostomy Murwere anotora semi-recumbent nzvimbo kudzivirira reflux uye aspiration.
3.2 Kuyera huwandu hwemvura yasara mudumbu: panguva yekuiswa kwemushonga wekudya kunovaka muviri, pomba huwandu hwasara mudumbu maawa mana ega ega. Kana yakakura kudarika 150ml, infusion inofanira kumiswa.
3.3 Kucherechedza uye kurapwa: Panguva yekuputirwa kwekugadzirisa kwezvokudya, maitiro emurwere anofanira kunyatsocherechedza. Pakangotanga kukosora, kukosora kwemasampureta ekugadzirisa zvinovaka muviri, kushaya mweya kana kupfupika kwekufema, zvinogona kutariswa sekushuvira. Kurudzira murwere kukosora uye kushuvira. , Kana zvichidikanwa, bvisa chinhu chinofemerwa kuburikidza nebronchoscope.
4. Kudzivirira matambudziko emudumbu
4.1 Matambudziko ecatheterization:
4.1.1 Nasopharyngeal uye esophageal mucosal kukuvara: Inokonzerwa nechubhu yakaoma kwazvo, kushanda kusina kunaka kana nguva yakareba intubation;
4.1.2 Kuvharika kwepombi: Kunokonzerwa nekuti lumen yakanyanya kutetepa, mushonga wekudya wakakora zvakanyanya, hauna kuenzana, wakagwamba, uye kuyerera kunononoka.
4.2 Zvinetso zvepamuviri: kunyunyuta, kurutsa, kurwadziwa kwepamuviri, kuputika kwepamuviri, chirwere, kuvhara, nezvimwewo, izvo zvinokonzerwa nekupisa, kukurumidza uye kusungirirwa kwechigadziro chekudya uye kusakanganiswa kweosmotic kunokonzerwa nazvo; Nutrient solution kusvibiswa kunokonzera utachiona hwematumbo; Mishonga inokonzera kurwadziwa mudumbu uye manyoka.
Nzira yekudzivirira:
1) Iko kusungirirwa uye osmotic kudzvinyirirwa kweyakagadzirirwa nutrient mhinduro: Yakanyanya kukwira kudya kunovaka muviri kugadzirisa uye osmotic kumanikidzwa kunogona kukonzera kusvotwa, kurutsa, kurwadziwa mudumbu uye manyoka. Kutanga kubva pakadzika pasi, kazhinji kutanga kubva ku12% uye zvishoma nezvishoma kuwedzera kusvika ku25%, simba rinotanga kubva ku2.09kJ / ml uye rinowedzera kusvika ku4.18kJ / ml.
2) Kudzora vhoriyamu yemvura uye infusion kumhanya: tanga nehuwandu hushoma hwemvura, vhoriyamu yekutanga ndeye 250 ~ 500ml / d, uye zvishoma nezvishoma inosvika iyo yakazara vhoriyamu mukati mevhiki 1. The infusion rate inotanga kubva pa20ml/h uye zvishoma nezvishoma inowedzera kusvika 120ml/h zuva rega rega.
3) Chengetedza kutonhora kwechigadziro chekudya: kutonhora kwechigadziro chekudya hakufaniri kunge kwakanyanyisa kudzivirira scalding ye gastrointestinal mucosa. Kana yakanyanya kuderera, inogona kukonzera dumbu redumbu, kurwadziwa mudumbu, uye manyoka. Inogona kupiswa kunze kweproximal chubhu yechubhu yekudyisa. Kazhinji, tembiricha inodzorwa panenge pa38°C.
4.3 Zvinetso zvinotapukira: Aspiration pneumonia inokonzerwa nekuisa catheter kusina kunaka kana kutama, kunonoka kupera kwegastric kana nutrient fluid reflux, zvinodhaka kana neuropsychiatric disorders inokonzerwa ne-low reflexes.
4.4 Metabolic complications: hyperglycemia, hypoglycemia, uye kukanganiswa kwe electrolyte, kunokonzerwa nemhinduro isina kuenzana yezvokudya kana chikamu chisina kukodzera.
5. Kudyisa tube care
5.1 Gadzirisa nemazvo
5.2 Dzivirira kumonyoroka, kupeta, nekudzvanya
5.3 Ramba wakachena uye usina utachiona
5.4 Geza nguva nenguva
Nguva yekutumira: Jul-16-2021