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 isikhundla se-nasogastric tube ngesikhathi sokufakwa kwesisombululo sezakhi, futhi ungasihambisani phezulu, ukukhipha isisu kuhamba kancane, futhi isisombululo somsoco sifakwe ku-nasogastric tube noma i-gastrostomy Isiguli sithatha isikhundla se-semi-recumbent ukuvimbela i-reflux ne-aspiration.
3.2 Linganisa inani loketshezi olusele esiswini: ngesikhathi sokuthelwa kwesixazululo 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