I-tube yokudla iyisetshenziswa sezokwelapha esisetshenziselwa ukondla umuntu ongakwazi ukuthatha ukudla ngomlomo ngokuphepha. Le nkinga kungenzeka ngenxa yobunzima bokugwinya , izinga lokuqaphela, ukugula okudliwayo, noma ezinye izinkinga ezenza ukudla kube nzima. Kunezinhlobo eziningi zezitshalo zokudla kanye nezizathu eziningi zokuthi kungani ithuluzi lokudla lingadinga.
Isimo ngasinye sihlukile, futhi isinqumo sokuthola ithubhu yokudla esibekwe unomphela into ehluke kakhulu kunokuvumela ithubhu yesikhashana ibe khona.
Ukuze wenze isinqumo esinolwazi mayelana nokudla amathoyizi, kuyadingeka ukuthi uqonde ukuthi yikuphi ithanga lokudla, umehluko phakathi kwezinhlobo zezitshalo zokudla, lapho kubhekwa khona ithubhu ngokufanelekile, nokuthi lezi zimbiza zifakwa kanjani.
Iziphazamiso zokudla ezichazwe
I-tube yokudla iyitayipi lepulasitiki elisetshenziselwa ukudlula ukuhlafuna nokugwinya isiguli esingakwazi ukudla noma ukuphuza ngokuphepha. Lezi zilimo eziyizigaxa zingasetshenziswa ukuletha kokubili ukudla kanye namanzi, futhi zingasetshenziswa ekuhlinzekeni imithi uma kudingeka. I-tube yokudla ingasetshenziselwa ukususa isisu esiswini uma umzimba ungakhulumi kahle okuqukethwe kwesisu.
Ukusetshenziswa
Ukondla izilimo eziyizigaxa kuhle ngaphezu kokuhlinzeka ukudla, futhi kunganciphisa i-gas nokuvimbela, futhi kunciphise ukuhlanzeka nokuhlanza.
Ukusetshenziswa okujwayelekile kwe-tube yokudla kuhlanganisa:
- Ukuhlinzeka Ukudla: Ukudla, ngefomu, kunganikezwa nge-tube yokudla. Ukondla i-Tube, noma ukudla okunomsoco, kunganikezwa nge-tube ukuze unikeze ama-carbohydrate, amaprotheni, namafutha emzimbeni ngaphandle kokuthi isiguli sigxume noma sihlafune.
- Ukuhlinzeka ngamanzi : Amanzi anganikezwa nge-tube yokudla ukuze agcine isiguli singena ngaphandle kokudinga ukondla i-IV.
- Ukuhlinzeka Imithi: Imithi, kuhlanganise namaphilisi amaningi namaphilisi, anganikezwa nge-tube yokudla. Amathebulethi angadinga ukugaya futhi amanye ama-capsules angadinga ukuvulwa, kodwa uma izinhlayiya zingamancane imishanguzo eminingi ingahlanganiswa ngamanzi futhi iphathwe nge-tube yokudla.
- Ukunciphisa isisu: Ezinye izinhlobo ze-tube yokudla zingasetshenziswa ukususa umoya kusuka esiswini. Ezinye izinhlobo zamatayipi ezondla, okwesikhashana, ikakhulukazi, zingaxhunyaniswa ukuba zithande ukukhipha kahle igesi esiswini ukuze unciphise ukuthungwa nokuvinjelwa.
- Ukukhipha Isisu Okuqukethwe: Uma ungahambisani nokudla noma uketshezi, ungase ube nokudla okuhlezi esiswini okubangela ukungahambi kahle, ukuhlukunyezwa, ukuhlanza noma ubuhlungu besisu nokubhubhisa. Ukuncelisa okuncane kungasetshenziswa ukususa uketshezi kanye nezinhlayiyana ezincane zokudla ezivela esiswini sakho.
Lapho IThubhu Yokudla Iyadingeka
I-tube yokudla iyadingeka uma ungakwazi ukupheka ukudla noma uketshezi ngomlomo. Ngenkathi kungenzeka ukunikeza uketshezi nokudla ngokwanele nge-IV , umzimba wenza ngcono ngokudla okunikezwa emathunjini kunokuya emithanjeni yegazi. Noma kunini lapho kungenzeka khona, kuphephile futhi kungcono umzimba ukuthi uthole ukudla kanye neziphuzo esiswini esiswini sokugaya okuvamile, kodwa uma unzima ukugwinya, lokhu kungase kungabi iphephile.
Ukugwinya kungabangela ukuthi isiguli sigxile ekudleni nasezikhuculeni, noma "behla ipayipi engafanele" futhi izinto zihanjiswe emaphashini esikhundleni sokugwinya. Lokhu kungaholela ekuguleni okukhulu, kuhlanganise ne- pneumonia , kusukela ezinhlakeni zokudla ezifaka emaphashini.
Abanye bangagula kakhulu ukuba bangagcini, noma basesithombeni esinesibhubhe esifakwa emgwaqweni ovimbela ukugwinya. Ezinye iziguli ziqaphile futhi ziqondiswe kodwa zilahlekelwe amandla okugwinya kahle. Noma kunjalo, abanye banesifo noma ukugula okwenza kube nzima ukugwinya, njengomdlavuza womlomo.
Isinqumo sokubeka isitembu sokudla
Isinqumo sokubeka i-tube yokudla siyinkimbinkimbi futhi senze kube nzima uma isiguli singakwazi ukuhlanganyela engxoxweni noma singakabelani izifiso zabo ngokuphathelene nokunakekelwa kwezempilo.
Ezimweni eziningi, isiguli esidinga ithuluzi lokudla singasondeza noma singenasici futhi asikwazi ukwabelana ngezifiso zabo nabangane nabathandekayo.
Umbuzo walokho isiguli singafuna, nokuthi ngabe ithubhu kungenzeka ibe yesikhashana, isikhathi eside noma okuhlala njalo kudinga ukucatshangelwa. Ezinye imindeni zichitha izinsuku zixoxa ngesinqumo phakathi kwabo noma zingaba nomhlangano womndeni nabasebenzi bezokwelapha ukuze baxoxe ngesinqumo.
Ezimweni eziningi, isinqumo sokubeka ithubhu yokudla lihambisana nesinqumo sokubeka i-tracheostomy, umgodi emqaleni lapho umoya ongasisekela ukuphefumula kwakho. Lokhu kungenxa yokuthi intubation , inqubo lapho ithubhu ingenwa emlonyeni futhi ingene emoyeni ukuze i-ventilator isetshenziswe, ingasetshenziswa kuphela amasonto ambalwa kuze kube yilapho umonakalo ungenzeka emqaleni. Njengoba lezi zinto zombili zingaphansi komkhawulo wamasonto amabili, ukubekwa kwe-tracheostomy kanye ne-tube esiswini ngokuvamile kuvame ngesikhathi esisodwa noma ezinsukwini ezimbalwa zomunye nomunye.
Izinhlobo
Kunezinhlobo eziningi zamatayipi okudla, futhi asetshenziselwa izimo ezihlukahlukene. Imvelo yenkinga ebangela ubunzima ukugwinya , eyaziwa nangokuthi i-dysphagia, izosiza ekunqumeni uhlobo lwe-tube esebenzayo. Ezinye zihloswe ukuba zesikhashana, kanti ezinye zihloswe ukuba zinde isikhathi eside noma zihlale zihlala njalo.
I-tube yokudla yesikhashana, enye efaka emakhaleni noma emlonyeni, phansi emphinjeni, nasesisu (G-tube) noma ejulile emathunjini (J-tube), ingahlala kuphela ngokuphepha endaweni engaba yishumi nane izinsuku. Ukufakwa nge-throat isikhathi esingaphezu kwamasonto amabili kwandisa ingozi yokukhuphuka kwamathiski ezintekenteke zomphimbo nomgogodla. Lokhu kungaholela ezindabeni ezinomphela ezifana nomonakalo ebhokisini lezwi nasemqaleni.
Ithuluzi lokudla lokuhlala isikhathi eside noma elihlala njalo lihloselwe ukusebenzisa izinyanga, iminyaka noma ukubekwa okuhlala njalo. Njengeshubhu yesikhashana, lezi zilimo eziyizigaxa zingasuswa uma zingasadingeki kodwa zingagcina zihlala isikhathi eside ngaphandle kwengozi emlonyeni, emphinjeni, nasezintweni ngoba ukudla kuhamba ngqo ngaphakathi esiswini.
IziThubhu zokuThola isikhathi esifushane
I-Nasogastric (NG) Tube: Lolu hlobo lwebhayisikili lufakwe emmpeni, phansi emqaleni, phansi phakathi kwesisu kuya esiswini. Ingaba khona cishe amasonto amabili ngaphambi kokuba isuswe noma ishintshwe nge-tube yesikhathi eside yokudla.
I-Orogastric Tube (OG): Uhlobo olufanayo lwe-tube njengethubhu le-nasogastric, i-tube ishicilelwe emlonyeni, phansi umphimbo ungene emgodleni bese kugcina kuphumula esiswini. Le tube ingahlala futhi ibe khona kwaze kwafika amasonto amabili lapho kufanele isuswe noma ithathelwe indawo ithubhu elihlala njalo.
IziThubhu zokuThola okwesikhashana
I-tube yokudla yesikhashana ifakwe emlonyeni noma emakhaleni, phansi emqaleni, ibe segulini bese ekugcineni kuhlala esiswini (G-tube) noma phakathi kwamathumbu amancane (J-tube). Lezi zinhlobo zamatayipi zinama-radio opaque, okusho ukuthi kukhona izinto ezincane ezivumela ukuba zitholakale kuma-ray-ray ngasekupheleni kwe-tube. Ngemuva kokubekwa, i-x-ray yenziwa, futhi evumela ukubekwa kahle kufanele kuqinisekiswe ngaphambi kokuba ishubhu isetshenziswe.
Izinhlobo Zemibuzo Yokuhlala Yesikhathi Esihlala Phakade / Isikhathi Eside
Ishubhu se-Gastric (i-G tube): Lolu hlobo lwe-tube lunikeza ukufinyelela okuqondile kwesisu ngokusebenzisa ukungena kwesokunxele esingaphezulu kwesisu. Le tube ithambela ngokuphelele umlomo nomphimbo futhi ivumela ukudla, uketshezi, kanye nemithi okufanele inikezwe ngaphandle kokugwinya.
I-Jejunostomy Tube (i-J tube): Lolu hlobo lwe-tube lufana ne-tube ye-gastric, ngokufakwa kwesisindo esiswini esingaphansi kokubekwa kwe-G-tube, futhi sivumela ukufinyelela okuqondile ku-jejunum okuyingxenye yesithathu ephakathi emathunjini amancane. Le tube ithambe ibe yincane kune-G-tube, enganciphisa ukuthi yini engangeniswa emanzini amancane kanye nemithi epholile.
I-Gastrostomy ye-Endoscopic ye-Percutaneous (PEG): Leli gama livame ukusetshenziswa ngokungafani ne-G-tube, kodwa empeleni libhekisela kumasu asetshenziselwa ukubeka i-G-tube. I-percutaneous (ngokusebenzisa isikhumba) endoscopic (isebenzisa i-endoscope ekhanyisiwe) i-gastrostomy (ukubeka imbobo yokuhlinzwa esiswini) ichaza inqubo esetshenziselwa ukubeka i-G-tube, hhayi i-G-tube ngokwayo.
Yeka ukuthi i-Tube Gastric ifakwa kanjani
Inqubo yokubeka i-tube esiswini ngokuvamile iyashesha, futhi kungenzeka noma ingadingi i-anesthesia kuye ngesimo sakho. Ezigulini ezigula kakhulu ekunakekeleni okujulile, akudingeki ukuthi u-sedation owengeziwe ubeke ithubhu eceleni kombhede.
I-endoscope iyithuluzi elide elide elikhanyayo nekhamera ekugcineni evumela ukuthi umhlinzeki ukuthi abukele inqubo kumqapha. Ububanzi bufakwa emlonyeni, phansi komphimbo, futhi ngaphakathi esiswini. Uma esiswini esiswini, empeleni kungenzeka ukuba ubone ukukhanya okuvela emkhakheni okhanyayo esikhumbeni sesisu, kubonisa i-gastroenterologist lapho ukwenza khona ukuhlambulula. Ukucubungula okuncane kwenziwa cishe ubude bengu-intshi ubude, lapho izilimo eziyizigaxa eziguquguqukayo zifakwa khona. Ama-tubes ase-Old age angase abe nebhaluni egcina ithubhu ibe khona.
Ingxenye yangaphandle ye-tube ine-cap evumela ukuthi ithubhu ivuleke, futhi ukudla kanye namanzi okucwiliswa kufanele aqhutshwe ngephutha ngaphakathi kwebhushu ngaphakathi esiswini. Ngokunakekelwa kahle kwe-tube , ukufakwa kwe-incision kuyovala ngokuqinile eduze kwe-tube, futhi noma yikuphi ukuphazima kokudla noma uketshezi okwenzeka ezinsukwini ngokushesha kulandela inqubo kufanele kuncishiswe ngokuphulukiswa.
Ngenkathi ukuhlambalaza ukuphulukisa, ukubopha nge-slit in kuso kufakwe emhlabeni wonke. Lokhu kusiza ukumisa noma yikuphi oketshezi okungase kuvuza kusuka kusayithi. Uma amanzi ekhona futhi ecasula isikhumba, amafutha okugcoba angasetshenziselwa ukuvikelwa. Ukuhlanza ngesineke isayithi ngensipho namanzi kanye nokusikwa kwensipho yokuphumula kusuka endaweni ngokuvamile kuvame ukunakekelwa kwesayithi.
Isikhathi eside, iziguli eziningi azidingi amafutha noma i-gauze esakhiweni, kodwa abanye bakhetha ukugqoka uma kunomsele wokuvimbela isikhumba noma ukugqoka izingubo.
Ukususwa kweThubhu lesikhashana
Ukususwa kwe-tube yokudla okuyisikhathi esheshayo futhi kulula. Kungase kuthukuthele izicubu ezinomlomo zomlomo, umphimbo, kanye nekhala, kodwa lokhu kungavamile. Ukuze ususe ithubhu, i-tube isuswa ukudla kanye namanzi okushisa, nge-syringe enkulu eyenziwe nge-tube yokudla. Kube sekudonsa kahle, kuthatha imizuzwana engu-3-5 ukuze isuswe kalula. Uma iphuzu le-tube liqinile, libonisa ukuthi yonke ibhubhu isusiwe ngempumelelo, iphonswa kude.
Ukususwa kweThubhu lesigxina
Uma uthola amandla okudla nokuphuza kahle, kungenzeka ukuthi ususe ithubhu "yokugcina unomphela". Okumangazayo, inqubo iyashesha, kanti ngenkathi kukhona ubuhlungu, ngokuvamile kuvamile futhi kufushane. Abahlinzeki abafani nezidingo zabo zokuthi ibhuloho lisuswe; ezinye zingadinga ukuba ugcine isisindo sakho okungenani inyanga ngenkathi uthatha konke ukudla nokuketshezi nge-G-tube, kanti abanye bangadinga isikhathi eside.
Lapho kwenziwa isinqumo sokususa ithubhu, i-tube ingasuswa, kodwa lokhu kudinga ukuthi kusetshenziswe amandla angakanani. Isiguli ngokuvamile sinalo ithawula elilahlayo eligcinwe eduze nesayithi, futhi umhlinzeki uyayibamba ngokuqinile ishubhu futhi ayidonsa ngokuqinile kodwa ngokuqinile ukuyisusa kusayithi. Uma kukhona ibhaluni ngaphakathi kwesisu, ihlanjululwa ngaphambi kokususa ithubhu, kodwa izinhlobo eziningi zinomfutho kunokuba ibhaluni futhi lesi sinyathelo asidingi.
Le nqubo ivame ukugaya, kanti kunezixa ezithile zegazi kwezinye izimo, kodwa ubuhlungu budlula ngokushesha. Ungalindela ukuthi ukufakwa kwesikhumba kuvalwe, kodwa lokhu akudingekile, futhi ukugqoka okuhlanzekile kungaphezu kokwanele ukugcina izingubo zesiguli zihlanzekile ezinsukwini ezilandelayo uma kunamanzi. Umshini uvame ukuvala ingakapheli isonto lapho ishubhu isuswa khona.
Izwi elivela
Isinqumo sokubeka ithubhu yokudla akuyona into yokuthatha kalula, kubalulekile ukuthi uxoxe ngokuthi yikuphi umphumela wesikhathi eside ongalindela wena noma othandekayo wakho. Kwezinye iziguli, ithubhu kulindeleke ukuthi ibe yesikhashana ngenkathi ilulameka ekuguleni. Kwezinye iziguli, ithubhu yokudla ingalindelwa ukuba ihlale endaweni yawo yonke impilo yayo.
Kungakhathaliseki ukuthi lokhu kufanelekile noma wena othandekayo ngumbuzo oyinhloko. Uma ungumnakekeli esimweni esingafuna ithubhu yokudla, othandekayo kungenzeka ukuthi ubeke imibono eqinile esihlokweni, noma kungenzeka ukuthi akakaze abhekise izifiso zabo zokunakekelwa kwezempilo isikhathi eside. Uma ungaqiniseki ngezifiso zabo, usebenzisa ukwahlulela kwakho okuhle-kanye nemibono yeqembu elihlinzeka ukunakekelwa kanye nezeluleko zabanye abathandekayo-kuyoba yindlela yakho yokuqondisa izinqumo.
> Umthombo:
> Ukuqonda i-Endoscopic Gastrostomy (PEG) ngayinye. I-American Society Ye-Endoscopy Yamathumbu. https://www.asge.org/home/for-patients/patient-information/understanding-peg