Izinyathelo zokuphepha zokunakekelwa kokudla okunomsoco

Izinyathelo zokuphepha zokunakekelwa kokudla okunomsoco

Izinyathelo zokuphepha zokunakekelwa kokudla okunomsoco

Izinyathelo zokuqapha ukunakekelwa kwe-enteral nutrition zimi kanje:
1. Qinisekisa ukuthi ikhambi lezakhi kanye nempahla yokufaka ihlanzekile futhi ayinyumba
Isixazululo sezakhi kufanele silungiswe endaweni engenalutho, sibekwe esiqandisini esingaphansi kuka-4℃ ukuze sigcinwe okwesikhashana, futhi sisetshenziswe phakathi namahora angu-24.Isitsha sokulungiselela kanye nempahla yokufafaza kufanele igcinwe ihlanzekile futhi ingenayo inyumba.

2. Vikela ulwelwesi lwamafinyila nesikhumba
Iziguli ezinethubhu ye-nasogastric ehlala isikhathi eside noma i-nasointestinal tube zivame ukuba nezilonda ngenxa yokucindezela okuqhubekayo ku-mucosa yamakhala kanye ne-pharyngeal.Kufanele bagcobe amafutha nsuku zonke ukuze bagcine ikhala ligcotshiwe futhi bagcine isikhumba esizungeze i-fistula sihlanzekile futhi somile.

3. Vimbela ukulangazelela
3.1 Ukususwa kwe-gastric tube futhi unake isikhundla;qaphela ngokukhethekile ukugcina indawo ye-nasogastric tube ngesikhathi sokuthelwa kwesisombululo somsoco, futhi ungasihambisani phezulu, ukuphuma kwesisu kuhamba kancane, futhi isisombululo somsoco siphuma epayipini le-nasogastric noma i-gastrostomy Isiguli sithatha isikhundla se-semi-recumbent ukuvimbela i-reflux kanye nesifiso.
3.2 Linganisa inani loketshezi olusele esiswini: ngesikhathi sokuthelwa kwesisombululo sezakhi, pompoza inani elisele esiswini njalo emahoreni ama-4.Uma kungaphezu kuka-150ml, ukumnika kufanele kumiswe okwesikhashana.
I-3.3 Ukubuka nokwelashwa: Ngesikhathi sokujova kwesisombululo sezakhi, ukusabela kwesiguli kufanele kubhekwe eduze.Uma kwenzeka ukukhwehlela, ukukhwehlela kwamasampula esixazululo sezakhi, ukuqunjelwa noma ukuphelelwa umoya, kunganqunywa njengokufisa.Khuthaza isiguli ukuthi sikhwehlele futhi silangazelele., Uma kunesidingo, susa into ehogelwe nge-bronchoscope.

4. Vimbela izinkinga zesisu
4.1 Izinkinga ze-catheterization:
4.1.1 Ukulimala kwe-nasopharyngeal kanye ne-esophageal mucosal: Kubangelwa ishubhu eliqine kakhulu, ukuhlinzwa okungalungile noma isikhathi eside kakhulu sokungena;
4.1.2 Ukuvaleka kwamapayipi: Kubangelwa ukuthi ilume ibe mncane kakhulu, ingxube yezakhi zomzimba ishubile, ayilingani, ihlule, futhi izinga lokugeleza lihamba kancane kakhulu.
I-4.2 Izinkinga zesisu: isicanucanu, ukuhlanza, ubuhlungu besisu, ukukhishwa kwesisu, isifo sohudo, ukuqothulwa, njll, okubangelwa izinga lokushisa, isivinini kanye nokugxila kwesisombululo sezakhi kanye nokucindezela okungalungile kwe-osmotic okubangelwa yikho;ukungcoliswa kwesixazululo sezakhi kubangela ukutheleleka kwamathumbu;Izidakamizwa zidala ubuhlungu besisu kanye nesifo sohudo.
Indlela yokuvimbela:
I-1) Ukugxila kanye nokucindezela kwe-osmotic kwesisombululo sezakhi ezilungisiwe: Ukugxila kwesisombululo sezakhi eziphezulu kakhulu kanye nokucindezela kwe-osmotic kungabangela kalula isicanucanu, ukuhlanza, ubuhlungu besisu kanye nesifo sohudo.Kusukela ekugxiliseni okuphansi, ngokuvamile okusuka ku-12% futhi kancane kancane kukhuphuke kuya ku-25%, amandla aqala ukusuka ku-2.09kJ/ml futhi akhuphuke aye ku-4.18kJ/ml.
2) Lawula ivolumu ye-liquid nesivinini sokumnika: qala ngenani elincane loketshezi, umthamo wokuqala ungama-250 ~ 500ml / d, futhi kancane kancane ufinyelele umthamo ogcwele phakathi nesonto elingu-1.Izinga lokumnika liqala ukusuka ku-20ml/h futhi kancane kancane likhuphuka lifinyelele ku-120ml/h nsuku zonke.
I-3) Lawula izinga lokushisa lesisombululo sezakhi: izinga lokushisa lesisombululo sezakhi akufanele libe phezulu kakhulu ukuvimbela ukuqhuma kwe-mucosa yamathumbu.Uma iphansi kakhulu, ingase ibangele ukuvuvukala kwesisu, ubuhlungu besisu, kanye nesifo sohudo.Ingashiswa ngaphandle kweshubhu eliseduze leshubhu yokudla.Ngokuvamile, izinga lokushisa lilawulwa cishe ku-38°C.
4.3 Izinkinga ezithathelwanayo: I-Aspiration pneumonia ibangelwa ukubekwa kwe-catheter okungafanele noma ukususwa, ukubambezeleka kokuphuma kwesisu noma i-reflux yoketshezi olunomsoco, izidakamizwa noma ukuphazamiseka kwengqondo okubangelwa i-reflexes ephansi.
4.4 Izinkinga ze-Metabolic: i-hyperglycemia, i-hypoglycemia, nokuphazamiseka kwe-electrolyte, okubangelwa isisombululo esingalingani sezakhi noma ifomula yengxenye engafanele.

5. Ukunakekelwa kweshubhu yokudla
5.1 Lungisa kahle
5.2 Vimbela ukusonteka, ukugoqa, nokuminyanisa
5.3 Gcina ihlanzekile futhi inyumba
5.4 Geza njalo


Isikhathi sokuthumela: Jul-16-2021