Okukhethekile Ukwelapha Ukukhuluphala Nokulahlekelwa Isisindo
I-Bariatrics igatsha lomuthi elibhekene nesifundo, ukwelashwa nokuvimbela ukukhuluphala . Igama elithi bariatrics lisuselwa kwisiGreek isiqalo se-baro - okusho ukuthi sinzima noma sikhulu. Insimu ye-bariatrics ihlanganisa ukudla, ukuvivinya umzimba, ukwelapha, imithi, kanye nokuhlinza - konke okuhlosiwe ekufezeni nasekugcineni ukulahlekelwa isisindo.
Umhlinzeki wezempilo angakwazi ngokukhethekile amabhonatrics, kodwa hhayi ngempela udokotela ohlinzayo.
Umsoco onguchwepheshe wezokwelapha onguchwepheshe we-bariatrics kungaba umuntu onguchwepheshe ekusizeni iziguli ukuvimbela noma ukunqoba ukukhuluphala ngokweqile, njengoba nje ochwepheshe bezokwelapha abahlinzeka ngemisebenzi yokwelashwa kulabo bantu abanjalo. Izindawo eziningi zokunakekelwa kwezempilo zingaba nabantu abasebenza ngokukhethekile kwi-bariatrics.
Ukusetshenziswa okuvame kakhulu kwegama elithi "bariatrics" libhekisela endaweni yezokwelapha ezithinta ukukhuluphala ngokweqile ngezinketho zokuhlinzwa. Ukuhlinzeka nge-Bariatric kuhilela izinqubo zokunciphisa okwesikhashana noma okuhlala unomphela ubukhulu besisu noma ukunciphisa inani lokudla elingagcinwa futhi lisetshenziswe njengama-khalori emzimbeni. Ezinye izinqubo ze-bariatric zenza kokubili, njenge-roux en y, inqubo yokuthi kokubili ukunciphisa usayizi wesisu nokunciphisa inani lamakholori umzimba ongawuthola.
Abahlinzayo Bariatric: Imfundo kanye Neziqinisekiso
Odokotela abenza imithi ye-bariatric e-US bangase babe yi-board-baqinisekiswe yi-American Board of Obesity Medicine (ABOM).
Ngokuvamile, udokotela uzoqedela ukuhlala emithi yomndeni, imithi yangaphakathi, noma ukuhlinzekwa ngokujwayelekile ngaphambi kokuphishekela ukuqeqeshwa okwengeziwe ukuze uthole isitifiketi se-ABOM.
Abahlinzayo baseBariatric kukhona odokotela abaqeqeshwe ekuhlinzekeni kuhlanganise nezinqubo zokuhlinzeka nge-bariatric. Abahlinzeki abangasebenzi abahlinzayo ngokukhethekile ekunakekeleni ukukhuluphala bayaziwa njengabanatricians.
Ngaphezu kokubhekana nokukhuluphala ngokweqile, ama-bariatricians ngokuvamile ayazi kahle izifo ezihambisanayo ezivame ukuhambisana nokukhuluphala ngokweqile, kuhlanganise nesifo sikashukela , i-arthritis, nesifo senhliziyo.
Izinyathelo ezingelapheki zokwelapha
Ngenkathi ama-baratricians azogxila ekungeneleleni okungeyona yokuhlinza ekwelapheni kokuqala komgwaqo, ucwaningo lukhombisa ukuthi lezi zinsuku kuphela zingaphumelela futhi zingaphumelela kakhulu isikhathi eside. Ukungenelela kokuqala kungabandakanya ukudla okuqashwe, izinhlelo zokuzivocavoca ezihleliwe, kanye nezinqubo zokuziphatha ezijulile ukubhekisa nokulungisa imikhuba emibi yokudla.
Imithi ingasetshenziswa futhi. Phakathi kwazo:
- I-Belviq (i-lorcaserin) igxilisa isifiso ngokusungula isitholi se-serotonin esilawula umsebenzi we-gut.
- I-Byetta (exenatide) isetshenziselwa ukwelapha uhlobo lwesifo sikashukela sohlobo lwe-2 kodwa futhi ingakhuthaza ukulahleka kwesisindo ngokunciphisa ukuphuma kwesisu nokukwenza umuntu azizwe egcwele ngokugcwele.
- I-glucophage (metformin) isetshenziselwa abantu abanesifo sikashukela kodwa inganciphisa isisindo ngokunciphisa inani le-glucose elikhiqizwa yisibindi ngenkathi landa ukwanda kwe-glucose emisipha.
- I-Qsymia (i-phentermine ne-topiramate) ihlanganisa ukufisa ukudla okunomzimba we-anticonvulsant okukholelwa ukuthi kunomthelela wokulahlekelwa isisindo.
- I-Xenical (orlistat) inciphisa ukumuncwa kwamathumbu emathunjini ngokuvimbela ama-enzyme e-pancreatic ephula amafutha.
I-Bariatric Surgery
Ukuhlinzwa kweBariatric kungenye yezinto ezibalulekile ezibandakanya imithi ye-bariatric. Abahlinzayo baseBariatric badinga ukubambisana konyaka noma ngaphezulu emva kokuqedwa kokuhlala ngokujwayelekile. Lokhu kuqeqeshwa okuthuthukisiwe kunikeza ulwazi ngezandla ekusebenzeni izinhlobo ezahlukene zokuhlinzwa kwesisindo.
Ukuhlinzwa kweBariatric ngokuvamile kubhekwa kubantu abane-index mass mass (BMI) ye-40 kg / m 2 noma ngaphezulu lapho ukungenelela okungeyona ukuhlinzwa kuhlulekile.
Phakathi kokukhethwa kokuhlinzwa:
- Ukukhishwa kwe-gastric gastric (eyaziwa nangokuthi i-band band) kwenziwa i-laparoscopically futhi ihilela ukusetshenziswa kwebhanki elingahlali unomphela elivimbela isayizi sesisu.
- Ukuhlinzekwa kwe-gastric bypass (ifomu evamile kakhulu yi-bypass yeRoux-en-Y) yakhelwe ukunciphisa inani lokudla umuntu akwazi ukudla ukusika ingxenye yesisu.
- I-balloon ye-gastric iyindlela yokwelapha encane efaka ukufakwa kwesibhaluni ehlanjululwe ngaphakathi esiswini okube sekuhlonywe ukunciphisa isikhala esiswini.
- I-gastrectomy ye-Sleeve (eyaziwa nangokuthi umkhonto wesisu) ihilela ukunciphisa okungenakubuyiselwa kwesisu ngamaphesenti angama-15 ngokususa ingxenye efana nemikhono yesigungu.
- I-gastroplasty enezintambo ezimelelekile (eyaziwa nangokuthi i-stomach stapling noma inqubo ye-Mason) ihilela ukugxila okuhlala njalo kwesisu ukuze kwakha isikhwama esincane esiswini.
Izwi elivela
Ubuchwepheshe be-bariatrics buyinto entsha, kodwa ukuqhuma okukhulu kwenziwa ekwelapheni ukukhuluphala kokubili ngokuhlinzwa nangaphandle. Kulabo abathintekayo, kunezinhlobo eziningi zokwelapha ezitholakalayo kusukela ekungeneni kokudla kuya ezinkambisweni zokuhlinza ukunciphisa amakholori atholakalayo emzimbeni. Kulowo okhuluphele futhi angathanda ukulahlekelwa amafutha amaningi, kunezinketho eziningi ezitholakalayo.
> Umthombo:
> Gloy, V .; I-Bhatt, D.; Kashyap, S. et al. "Ukuhlinzeka nge-Bariatric ngokukwelashwa okungeyona ukwelashwa kokukhuluphala: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta yezilingo ezilawulwa ngokungahleliwe." BMJ . 2013; 347: f5934. I-DOI: 10.1136 / bmj.f5934.