Kweanopfuura makore 25, yakazara parenteral nutrition (TPN) yakaita basa rakakosha mukurapa kwemazuva ano. Pakutanga yakagadzirwa naDudrick nechikwata chake, kurapwa kwekuchengetedza hupenyu uku kwakavandudza zvakanyanya mararamiro evarwere vane intestinal kukundikana, kunyanya avo vane bowel syndrome. Kuenderera mberi kwekunatsiridza mutekinoroji yekatekinoroji uye masisitimu ekupinza, akasanganiswa neruzivo rwakadzama mune zvinodiwa zvemetabolism, zvakabvumira kugadziridzwa kwekudya kunovaka kunonangana nezvinodiwa nemurwere wega. Nhasi, TPN inomira seyakakosha yekurapa sarudzo, ine yakatsanangurwa zvakajeka makiriniki maapplication uye yakanyatso yakanyorwa yekuchengetedza nhoroondo. Pakati pavo,TPN mabhegiyakagadzirwa neEVA zvinhu yave iyo yakasarudzika yekurongedza mhinduro yekiriniki neyekudya chikafu chemumba nekuda kwekunaka kwavo biocompatibility, kugadzikana kwekemikari uye kuchengetedza kwenguva refu yekuchengetedza. Shanduko yakanangana nekutonga kwepamba kwakawedzera kushanda kwayo, kudzikisa mitengo yekuchipatara uku ichichengetedza kushanda kwayo. Vatsvakurudzi iye zvino vari kuongorora zvingangoshandiswa zvitsva zveTPN, kusanganisira basa rayo mukugadzirisa zvirwere zvisingaperi zvakadai se atherosclerosis.
Usati watanga TPN, kunyatsoongorora kudya kunovaka muviri kwakakosha kuti uwedzere mhedzisiro yekurapa. Zvikamu zvakakosha zvekuongorora zvinosanganisira kuongorora nhoroondo yehutano hwemurwere nekuda kwekureruka kwekureruka (10% kana kupfuura), kushaya simba kwemhasuru, uye edema. Kuongorora kwemuviri kunofanirwa kutarisisa kuyerwa kweanthropometric, kunyanya triceps skinfold ukobvu, iyo inopa ruzivo rwakakosha mumafuta akachengetwa. Kuongororwa murabhoritari kunowanzo sanganisira serum albumin uye mazinga etransferrin, anoshandiswa zvakanyanya mamaki echimiro cheprotein, kunyangwe mimwe bvunzo dzakanyanya senge retinol-inosunga protein inogona kupa rumwe ruzivo kana iripo. Basa rekudzivirira muviri rinogona kuongororwa kuburikidza nehuwandu hwe lymphocyte count uye kunonoka hypersensitivity ganda kuongororwa nemaantigens akadai sePPD kana Candida.
Chishandiso chinonyanya kukosha chekufungidzira ndeye Prognostic Nutritional Index (PNI), iyo inosanganisa akati wandei ma parameter kuita imwechete njodzi mamakisi:
PNI(%) = 158 - 16.6(serum albumin mu g/dL) - 0.78(triceps skinfold in mm) - 0.20(transferrin in mg/dL) - 5.8(hypersensitivity score).
Varwere vane PNI iri pasi pe40% vanowanzova nenjodzi yakaderera yematambudziko, nepo avo vanowana 50% kana kupfuura vanotarisana nenjodzi yakanyanya yekufa inosvika 33%. Iyi nzira yekuongorora yakazara inobatsira varapi kuita sarudzo dzine ruzivo nezve nguva yekutanga TPN uye maitiro ekutarisa kushanda kwayo, pakupedzisira kugadzirisa kuchengetwa kwevarwere mune zvese zvakakomba uye zvisingaperi zvigadziriso. Kubatanidzwa kwerutsigiro rwepamusoro pekudya kunovaka muviri nemaprotocol akasimba ekuongorora kunoramba kuri musimboti wetsika yemazuva ano yekurapa.
Serutsigiro rwakakosha rwekurapa kweTPN, kambani yedu inopa emhando yepamusoro EVA zvinhu zveTPN mabhegi. Zvigadzirwa izvi zvinonyatso tevera mwero wepasirese, zvakapfuura FDA uye CE certification, uye zvakazivikanwa zvakanyanya mumisika zhinji pasirese, zvichipa zvakachengeteka uye zvakavimbika mhinduro dzekiriniki uye chikafu chekudya kumba.
Nguva yekutumira: Aug-04-2025