Isondlo sabazali: yintoni, iyintoni kwaye ungayilawula njani

Umxholo

• Xa kubonisiwe
• Indlela yokulawula isondlo sabazali
• Yintoni omele uyijonge ngexesha lolawulo
• Uhlobo lwesondlo sabazali
• Iingxaki ezinokwenzeka
• 1. Ixesha elifutshane
• 2. Ixesha elide

Isondlo se-Parenteral, okanye i-parenteral (PN), yindlela yokulawula izakhamzimba ezenziwa ngokuthe ngqo emthanjeni, xa kungenakwenzeka ukufumana izondlo ngokutya kwesiqhelo. Ke, olu hlobo lwesondlo lusetyenziswa xa umntu engasasebenziyo emathunjini, okuhlala kwenzeka kubantu abakwimeko ebaluleke kakhulu, njengesisu okanye umhlaza wamathumbu kwinqanaba eliphambili kakhulu, umzekelo.

Zimbini iintlobo eziphambili zesondlo sabazali:

• Isondlo somzali okhethekileyo: zimbalwa kuphela iintlobo zezakhamzimba kunye neevithamini ezilawulwa ngomthambo;
• Isondlo esipheleleyo se-parenteral (TPN): Zonke iintlobo zezakhamzimba kunye neevithamini zilawulwa ngomthambo.

Ngokubanzi, abantu abenza olu hlobo lokutya bayangeniswa esibhedlele ukuze baqhubeke nokuvavanya imeko yabo yezempilo, nangona kunjalo, kunokwenzeka ukuba, kwezinye iimeko, isondlo se-parenteral senziwa nasekhaya kwaye, kwezi meko, ugqirha okanye umongikazi kufuneka achaze indlela yokukutya ngokuchanekileyo.

Xa kubonisiwe

Isondlo sabazali sisetyenziselwa ukuthintela ukungondleki, ngakumbi kubantu abathi, ngasizathu sithile, bangabinamsebenzi wokusebenza kwesisu okanye abafuna ukunika isisu okanye amathumbu ukuphumla.

Ngesi sizathu, isondlo sabazali sikwaboniswa xa ukondla ngomlomo, nokuba unetyhubhu, akunakwenziwa phantsi kweemeko ezifanelekileyo ngaphezulu kweentsuku ezi-5 okanye ezisi-7.

Ukuboniswa kolu hlobo lwesondlo kunokwenziwa ngexesha elifutshane, xa kusenziwa ukuya kuthi ga kwinyanga enye, okanye kwixesha elide, kuxhomekeke kwimeko yomntu ngamnye:

Indlela yokulawula isondlo sabazali

Uninzi lwexesha, isondlo se-parenteral senziwa ngabongikazi esibhedlele, nangona kunjalo, xa kufuneka kwenziwe ulawulo ekhaya, kubalulekile ukuba kuqala kuvavanywe ibhegi yokutya, kuqinisekiswe ukuba kungaphakathi komhla wokuphelelwa, ibhegi ihlala ihleli kwaye igcina iimpawu zayo eziqhelekileyo.

Ke, kwimeko yolawulo kusetyenziswa ipheripheral catheter, umntu makalandele inyathelo ngenyathelo:

1. Hlamba izandla zakho ngesepha namanzi;
2. Yeka naluphi na ukumnika i-serum okanye amayeza alawulwa nge-catheter;
3. Ukubulala iintsholongwane kwinkqubo ye-serum, usebenzisa i-swab engenazintsholongwane yotywala;
4. Susa inkqubo ye-serum eyayikho;
5. Cotha kancinci i-20 ml ye-saline;
6. Qhagamshela inkqubo yesondlo yabazali.

Yonke le nkqubo kufuneka yenziwe kusetyenziswa imathiriyeli eboniswe ngugqirha okanye ngumongikazi, kunye nempompo yokuhambisa yokulinganisa eqinisekisa ukuba ukutya kunikezelwa ngesantya esifanelekileyo nangexesha eliboniswe ngugqirha.

Eli nyathelo ngenyathelo kufuneka lifundiswe kwaye liqeqeshwe nomongikazi esibhedlele, ukucoca nakuphi na ukuthandabuza nokuqinisekisa ukuba iingxaki aziveli.

Yintoni omele uyijonge ngexesha lolawulo

Xa ulawula isondlo se-parenteral, kubalulekile ukuvavanya indawo yokufaka i-catheter, ukuvavanya ubukho bokudumba, ubomvu okanye intlungu. Ukuba kukho nayiphi na le miqondiso, kuyacetyiswa ukuba uyeke ukondla ngabazali kwaye uye esibhedlele.

Uhlobo lwesondlo sabazali

Uhlobo lokondla kwabazali lunokuhlelwa ngokwendlela yolawulo:

• Isondlo esiphakathi kwabazali: yenziwa nge-catheter ye-venous esembindini, eyityhubhu encinci ebekwe ngaphakathi komthambo omkhulu, njenge-vena cava, kwaye evumela ukulawulwa kwezondlo ixesha elingaphezulu kweentsuku ezisi-7;
• Isondlo sePeripheral parenteral (NPP): yenziwa ngepheripheral venous catheter, ebekwe kumthambo omncinci womzimba, ihlala ingalo okanye isandla. Olu hlobo luboniswa kakuhle xa isondlo sigcinwa ukuya kuthi ga kwiintsuku ezisi-7 okanye ezili-10, okanye xa kungenakwenzeka ukubeka i-catheter ye-venous esembindini.

Ukubunjwa kweengxowa ezisetyenziswe kwisondlo se-parenteral kuyahlukahluka kwimeko nganye, kodwa ngokuqhelekileyo kubandakanya amafutha, i-glucose kunye ne-amino acid, kunye namanzi kunye neemaminerali ezahlukeneyo kunye neevithamini.

Iingxaki ezinokwenzeka

Iingxaki ezinokuvela ngokutya kwabazali zahluka kakhulu, ke ngoko, kuhlala kubalulekile ukulandela zonke izikhokelo ezenziwe ngugqirha kunye nabanye abaqeqeshi bezempilo.

Ezona ntlobo ziphambili zeengxaki zinokuhlelwa ngokwamaxesha e-PN:

1. Ixesha elifutshane

Ngexesha nje elifutshane, ezona ngxaki zixhaphakileyo zibandakanya ezinxulumene nokubekwa kwecatheter ye-venous esembindini, enje nge-pneumothorax, i-hydrothorax, ukuphuma kwegazi ngaphakathi, ukonakala kwemithambo-luvo engalweni okanye ukonakala komthambo wegazi.

Ukongeza, usulelo lwenxeba lekatala, ukudumba kwenqanawa yegazi, isithintelo se-catheter, i-thrombosis okanye usulelo ngokubanzi ngamagciwane, ibhaktiriya okanye umngundo.

Kwinqanaba le-metabolic, uninzi lweengxaki zibandakanya utshintsho kumanqanaba eswekile yegazi, i-metabolic acidosis okanye i-alkalosis, ukunciphisa ii-acid ezifanelekileyo, utshintsho kwi-electrolyte (isodiyam, potasium, calcium) kunye nokwanda kwe-urea okanye i-creatinine.

2. Ixesha elide

Xa isondlo se-parenteral sisetyenziselwa ixesha elide, iingxaki eziphambili zibandakanya utshintsho kwisibindi kunye ne-vesicle, njengesibindi esinamafutha, i-cholecystitis kunye ne-portal fibrosis. Ngesi sizathu, kuqhelekile ukuba umntu abonise ukwanda kwee-enzyme zesibindi kuvavanyo lwegazi (i-transaminase, i-alkaline phosphatase, i-gamma-GT kunye ne-bilirubin iyonke).

Ukongeza, i-fatty acid kunye ne-carnitine defence, ukutshintsha kwe-flora yamathumbu kunye ne-atrophy ye-velocities yamathumbu kunye nezihlunu.