Enye yezinto eziphambili zokubuyiswa kwimiba yokutya kuyisilungiso sokondla . Oko kuthetha ukuchitha iikhalori ezaneleyo ngokukhawuleza ukulungiselela iimfuno zomzimba kwaye uvumele ukuba uphilise. Abantu bazo zonke izilwanyana, ubudala, imilo, kunye nobukhulu bangadla ukutya nokuphazamiseka kokutya ; awukwazi ukuxelela ukuba umntu uphilile okanye uyagula nje kubajonga.
Kule nqaku, siza kuxubusha indima yesondlo esongezelelweyo kunyango lokuphazamiseka kokutya, ukususela kwizondlo zokuncedisa izondlo ezifana nokuqinisekisa okanye ukukhuthaza ukusetyenziswa kweentlobo ezahlukeneyo zamathambo okutya.
Ezinye Iingcamango Eziphambili Zokubuyiswa Kwempilo
Okokuqala, yintoni ekuqinisekiseni ukulungiswa kwesondlo, okubizwa ngokuba yi-refeeding, kuquka? Ekubeni izigulane ezineengxaki zokutya zidla ngokusondlo- kungakhathaliseki ubunzima bomzimba- yinkqubo eyenziwa ngabanye efanelekileyo eyenziwa phantsi kweengcali zonyango obhalisiweyo , ngokuqinisekileyo umntu onobungcali kwiingxaki zokutya. Isicwangciso sokutya esandayo sandisa ngokuqhubekayo, ngokuqhelekileyo siquka ukutya kunye nokutya okutyiwayo okufanelekileyo. Xa umntu enesondlo ngenxa yokunyuswa kwekharori (ukukhawulelwa kweekhalori, ukuhlanjululwa, okanye ukutya okunzulu), i-metabolism yabo iphucotha kakhulu ukugcina iikhalori kunye nokukhusela umzimba.
Yiyo ndlela esasinda ngayo indlala njengezilwanyana.
Xa abantu abaneengxaki zokutya beqala ukwenza umsebenzi wokubuyiselwa, kunokusongela ukucinga ukutya okungaphezulu kunokuba ubuncinane bokuba ingxaki yokutya ivumelekile. Emva koko, ukuba ukutya i-disorder voice kunokuvakala, kuthetha, kwaye kuyimfuneko. Nangona kunjalo, imizimba yethu inommangaliso kwaye inengqiqo kunokuba sibone i-credit.
Ukuqala ukudla iikholori ezininzi-zithi, i-1600 okanye ngaphezulu ngosuku-yinto enye yezinto eziphilayo: Ikhuthaza umonakalo womntu ngaphandle kokuvelisa ubunzima. Ufunda loo nto. Oko kuthetha ukuba xa umntu ekhusele iikhalori, kwaye uyakhungatheka kukuba ubunzima bawo abuyi kuphinda buyeke (kwaye mhlawumbi uvakalelwa ngumoya kwaye ukhathele kunye ne-cranky), uqala ukutya ubuncinane ama-calories angama-1600 ngosuku, ubunzima bawo bunokuhlala buzinzile, ngelixa i-metabolism isantya ngokukhawuleza.
Ngokumangalisa ngokwaneleyo, xa abantu abaswele ukutya beqhubeka besondeza inkqubo yokuvuselela izondlo, baba yi- hypermetabolic . Oko kukuthi, bangadinga ukuba badle ii-3000 okanye ngaphezulu khalori ngosuku ukubuyisela i-1-2 yeepounds zesisindo somzimba ngeveki. Kukho iingozi zokuphelisa, kuquka ukuhla kwezinga legazi le-phosphorus, elibizwa ngokuba yi-hypophosphatemia. Kwixesha elidlulileyo, isincomo kukuba iikhalori kufuneka ziqaliswe ngokukhawuleza, ukuphepha i-hypophosphatemia. Nangona kunjalo, uphando olutsha lubonise ukuba lungcono kakhulu ukufumana imetabolism ehambayo, ukondla umzimba kunye nengqondo, kwaye ungaqali ngokukhawuleza-kwaye amanqanaba e-phosphorus enza kakuhle.
Indlela yokufumana loo maKhalori
Umbuzo ke nguwo: Sifumana njani ezo calories? Uninzi lwabantu abaneentsholongwane zokutya lunokutya ukutya rhoqo , kwaye ukutya rhoqo kuseyona ndlela engcono yokufumana iikhalori kunye nama-micronutrients.
Nangona kunjalo, ngamanye amaxesha xa iimfuno zondloba ziphezulu, kunzima ukuyidla yonke into njengokutya. Kule meko, isongezelelo esinomdaka olunje njengoQinisekisa ngakumbi (kwi-355 kcal / ibhotile) okanye iMicrosoft Cup (kwi-290 khalori kwi-ounces 4) kulula kwi-tummy epheleleyo kuneekhalori ezifanayo ekutya okuqinileyo.
Abanye abadliwayo bakhetha ukubeka izicwangciso zokutya apho ukutya okuphambili (isidlo sasemini, isidlo sasemini kunye nesidlo) sihlala siqhubeka ngokuphelisa, kodwa ukunyuswa kwenyusa ngaphezu kwexesha, ngamanye amaxesha kusetyenziswa ukuxhaswa. Ngaloo ndlela, xa ububanzi bezinto ezijoliswe kuzo kuphunyeziweyo, ukuzaliswa kunye nobukhulu beentshukumo zokutshintsha, kodwa ukutya okusemgangathweni kuhlala okufanayo kwisicwangciso sokugcina, kubangela ukuxhalabisa okuphantsi kokutshintsha.
Kwakhona, ezinye izigulane zifuna "ukunyanga" iikhalori zazo ekuqaleni. Xa ukutya iintlobo ezahlukeneyo zokutya okuqinileyo kuyingozi kakhulu kwisifo sokutya, ukufumana nje iikhalori ngokuxhaswa kuyamkeleka ngokupheleleyo. Injongo, yebo, ihlala ibuyela ekutya ukutya okubanzi. Kwalabo abaphakamisa umba wokuxhaswa ukuba bangaphantsi kokutya "okwenene" okanye besetyenziselwa, siya kuthi: Akukho nto inobungozi ngaphezu kokuthintela. Ngoko ukuba isongezelelo sinceda umntu ukuba ahambe kwiintsuku zokuqala zokulungiswa kwesondlo, oku kulunge ngakumbi kunokugqithisa ngesisu esisisigxina.
Ukondla i Tubhu
Ngamanye amaxesha, izigulane ezineengxaki zokutya zidinga ityhubhu encinci, eguquguqukayo efakwe kwimpumlo, iphela kwisisu okanye emathunjini amancinci. Ezi zigubu ze-nasogastric (NG) okanye i-nasojejunal (NJ) zinganika isondlo esiqhubekayo ngokwazo okanye zingancedisa ukutya okutya ngexesha lobusuku kunye nokutya kwebusuku. Izigulane zezibhedlele, ukudibaniswa kwe-NG kunye nokutya kwemini kunokunceda izigulane zithathe iikhalori ezaneleyo zokuqhubeka nokubuyiswa kwesisindo, kunye nokutya okuqhubekayo kunciphisa umngcipheko weengxaki ezifana neshukela eliphantsi kwegazi.
Ukutya kwe-NG kunokukunceda "ukunyanga" iikhalori kusenokwenzeka xa izigulana zifuna ukuqhubela phambili kodwa zilungele ukutya. Ngokuqhelekileyo, izigulane zingasebenzisa ii-TB zamakhaya. Oku akunakucetyiswa ngokuqhelekileyo, kuba kukho umngcipheko ophezulu wezigulane zokuxhatshazwa ngokuphelisa izifo zethubhu, ukuzisebenzisi kakuhle, okanye ukukhupha ityhubhu. Ukuba isigulane sinogulayo kwisifo sabo, ngokuqhelekileyo sisezingeni eliphakamileyo lokhathalelo olukhethekileyo . I-tube ye-NG inokuhlala kwindawo ukuya kwiiveki ezingama-6 ngokunyamekela okukhulu, kodwa ingozi yokusetyenziswa iquka isifo (sinus infection), reflux, aspiration pneumonia (xa isisu sesisu siphumelela isipopu uze siye emiphakeni), kunye nentambo yezwi ukucasula okanye ukulimala.
Kukho nezinye izigulane zokutya ezihlala zihlala zihlala ziphazamisekile, ezifana ne-tube ye-gastrostomy (PEG) nganye okanye i-jejunostomy nganye (PEJ). Ezi zinokufakwa ngugqirha, ugqirha we-GI, okanye i-radiologicalist intervention. Ingongoma ebalulekileyo yokwenza apha kukuba iipilisi ze-PEG akufanele zifakwe nje kuba umntu ukhawulela ukungenisa kwabo. Ngokuqhelekileyo, oogqirha abanamava baya kuthetha ngomntu onomdlavuza we-anorexia nervosa, "Mane ufake i-PEG." Ukuba umntu ukhawulelisa iikhalori ngomlomo, ziyakucima iikhalori nge-tube!
I-PEG kufuneka igcinwe kwiimeko apho UKUPHATHWA komntu onokufumana ukutya okwaneleyo yi-PEG. Iimeko ezinjalo zibandakanya ukuhlanza okuqhubekayo, apho i-PEJ ivumela ukondla ngaphantsi kwesisu apho ingenakuhlanza khona. Kwakhona, kwi-artery syndrome ye-mesenteric, apho intlungu ibanjwa phakathi kwemibhobho emibili kwisimo sokukhawuleza okanye ukulahleka ngokweqile, umgangatho wokunyamekela ukunikezela ngokutya okunesondlo kuze kube yilapho ukubuyiswa kwesisindo esaneleyo. Kuphela ukuba ukukhutshwa kunzima kakhulu kufuneka i-PEJ ibekwe.
Kubalulekile ukuba uqaphele ukuba ezi zibuko zibuhlungu kakhulu ekuqaleni, kwaye ukubekwa kwazo kubonakala kunzima ngeentlungu, ukufudumala, ukuphefumula okubuhlungu, kunye nobunzima bokuqalisa ukuthambisa i-tube. Ukususa ityhubhu phambi kweeveki ezintandathu kunokubangela ukusuleleka kwezifo zesisu. Ukusetyenziswa kwabo kufuneka kugcinwe abo baneengcali.
> Imithombo
> Garber AK, uSawyer SM, Golden NH, Guarda AS, uKatzman DK, Kohn MR, Le Grange D, uMadden S, uMhlophelaw M, u-Redgrave GW. Ukuphononongwa ngokuchanekileyo kweendlela zokuphelisa izigulane ezine-anorexia nervosa. Int J Eat Disord. Ngo-2016 Mar; 49 (3): 293-310
> Gaudiani JL, Mehler PS. Ukubonakaliswa kwezonyango zobunqanda obunzima kunye nokuhlanjululwa: "ii-Zebra," ukuxilongwa kwezinto ezingekho phantsi, kunye nezenzo ezilungileyo. Int J Eat Disord. Ngo-2016 uMar; 49 (3): 331-44
> Madden S, Miskovic-Wheatley J, Clarke S, Touyz S, Hay P, Kohn MR. Iziphumo zenkqubo yokuvuselela ngokukhawuleza kwi-Adorecent Anorexia Nervosa. Ukutya okungahambiyo. 2015 Mar 25; 3: 8
> Maginot TR, Kumar MM, Shiels J, Kaye W, Rhee KE. Iziphumo zesigulana sokunciphisa isifo somntwana kwisifo se-anorexia nervosa: Isibhedlele sabantwana base-Rady iSan Diego / iYunivesithi yaseCalifornia, eSan Diego. Ukutya okungahambiyo. 2017 Jan 3; 5: 1