Isibonakaliso Esivamile Kwabaningi Ngokugula Okulinganiselwe Ukuphila
Ukuqokwa kuyisifo esivamile iziguli eziseduze nokuphela kokuphila. Ukuqokwa kungaba nethonya elikhulu emkhakheni wokuphila ngakho ukuvimbela nokwelapha kubalulekile.
Ukuvimbela ukuqokwa
Kungcono ukuvimbela ukuqotshwa lapho kunokwenzeka. Ukunakekelwa kwe-palliative kanye nabaqeqeshi be-hospice baqeqeshwe ukubuza mayelana nokunyakaza kwesibindi njalo futhi kubalulekile, ukwethembeka ngezimpendulo zakho.
Ukuvimbela ukuqothulwa kuzoxhomeka engozini yokuqothulwa. Isibonelo, isiguli esinesifo somdlavuza wesisu, isifo sikashukela futhi sithatha imithi yokuhlunguphaza i-opioid ejwayelekile isengozini enkulu yokuqothulwa. Kungenxa yokuthi izicubu zomzimba zingacindezela noma zivimbele isilonda, isifo sikashukela silimaza izintambo zenhliziyo futhi sinciphise ukuhamba kwamathumbu emathunjini, futhi i-opioids ihamba kancane kancane emzimbeni futhi ikhulise ithoni ye-sphincter . Ukuvinjelwa kwalesi siguli kuyoba nobudlova ngaphezu kwesiguli esinezo kuphela, zithi, ukuwohloka komqondo.
Ukuvimbela kugxile ekutheni uketshezi olwanele, ukudla okufanele, nokusebenza (ukusebenza okugqugquzela izibilini).
Izifo, Ukudla Okufanele kanye Nokuzivocavoca Amathuluzi Okuvimbela
Lezi zinto ziningi izinto ezinzima ukwandisa kumuntu ogulayo, kodwa ngisho nokunyuka okuncane kokungenisa kwamanzi kungasiza. Ukwandisa ukudla okudliwayo kungabangela ukungakhululeki okukhulu futhi akufanele kuphoqelelwe, kepha ukukhuthaza ngomusa ukudla okuncane okuncane kungasiza.
Ukwenyuka komsebenzi, noma ngabe kuwuhlobo lwezinyathelo zokuhamba ngezinyathelo zosizo lwezempilo noma uchwepheshe wezempilo , kungasebenza kakhulu.
Izithambisi zokugcoba zingasetshenziswa ukugcina izithambile zilula, okwenza kube lula ukudlula. Abathengisi bezitofu, njenge-senna, kubaluleke kakhulu ezigulini zokwelapha i-opioid.
Ukwelapha ukuqashwa
Lapho ukuvimbela kungenele futhi isiguli sigxilile, kubalulekile ukuqala ukwelashwa ngokushesha. Ama-laxatives asetshenziselwa ukuphatha ukuqunjelwa futhi ahlukaniswa izenzo zabo.
Ama-Laxatives amaningi. Ama-laxatives amaningi anika amathumbu amathumbu ukwandisa isibalo se-stool, eshukumisa amathumbu ukuba athuthe. I-fiber ye-diet is isibonelo se-laxative eningi. Ama-laxatives amaningi angase abe yimpendulo yeziguli eziningi zokunakekelwa kwezilonda kanye neziguli ngoba zifuna ukungena kwamanzi amaningi ukuze kusebenze. Uma isiguli singenakukwazi ukulondoloza ukungenisa okwanele kwamanzi, ama-laxatives amaningi angabangela ukungahambi kahle futhi aqhubeke nenkinga. Amakhemikhali amaningi angabangela negesi nokubhuqa.
Ama-Laxatives aseLubricant. Ama-laxatives ane-lubricant athambisa isikhala futhi agcobe ubuso bendawo, okwenza kube lula ukudlula. Amaminerali ama-mineral yilona uhlobo oluvame kakhulu lwamafutha okugcoba. Amafutha amaminerali awunconywa iziguli ezisengozini yokufisa , noma labo abathatha i-docusate (Colace).
Ama-Laxatives angenawo ama-Surfactant / Detergent. Lezi zinhlayiya, ezivame ukubizwa ngokuthi i-stool softeners, zinciphisa ukungezwani komzimba, ngaleyo ndlela zandisa ukunwa kwamanzi namafutha zibe ezitheni ezomile. Amadokhumenti, i-senna, namafutha we-castor yizibonelo.
Ama-Laxatives ase-Osmotic. Ama-laxatives ase-Osmotic ayisisekelo ushukela ongeke ukwazi ukugaya umzimba futhi ube nomphumela osmotic emathunjini.
I-Lactulose ne-sorbitol yizinhlobo zamanzi ezinama-osmotic laxatives futhi ngokuvamile zisebenza kahle. Ukunambitheka kwale mithi kuyinselele yeziguli eziningi futhi kungabangela ukubhoboza kanye negesi. Zingabili zihlanganiswe nejusi, itiye, amanzi, noma enye i-liquid ukuze unciphise ubumnandi.
I-Glycerin suppository yinye isibonelo se-laxatives ye-osmotic. I-Glycerin suppository ingase ingabi yimpumelelo njengezinye izindlela kulesi siguli esingagula noma esigulayo.
I-Saline Laxatives: Ubisi lwamagnesia mhlawumbe uhlobo oluvame kakhulu lolu hlobo lwe-laxative. Ama-saline laxatives akhulisa isisu, isifo se-pancreatic, nesibindi samathumbu emathunjini nokukhulelwa kwamathumbu emathumbu.
Le mithi ingabangela ukucindezeleka okukhulu nokungahambi kahle futhi kuvame ukusetshenziswa njengendlela yokugcina yezigulane ezigulayo.
Ama-Suppository ne-Enemas: Amanye ama-laxatives atholakala kwifomu lokudinga, okusho ukuthi efakwe ngqo kwi-rectum. Nakuba umcabango wokusebenzisa imithi yama-rectal kungase kungabi mnandi iziguli nabanakekeli bangase baqede ukuba bafake, ama-suppository avame ukushesha futhi aphumelele. I-Bisacodyl (i-Dulcolax) iyisisindo se-bowel esisebenza ngokuqondile ekoloni ukuze kuqhutshwe i-peristalsis. Ngoba kuyisimo esishukumisayo, ukugumbana kungumphumela ovamile ohlangothini. I-Dulcolax ayikhuthazwa ngaso sonke isikhathi ngenxa yeziguli zesifo somdlavuza kanye neziguli ezinezifo zesibindi ngenxa yesidingo sokuthi zifakwe ngokomzimba, noma ziphulwe phansi esibindi.
I-Enemas ihloswe ukuthi isetshenziswe ngokungapheli futhi njengendlela yokugcina ekuguleni iziguli eziqine kakhulu. I-saline enemas (i-Fleet Enema) ikhulula isitoreji futhi ivuse ukunyakaza kwesisu . Uma zisetshenziselwa njalo, zingabangela ukungalingani kwe-metabolic ezifana ne-hypocalcemia (ukwehla kwamazinga e-calcium egazi) kanye ne-hyperphosphatemia (ukwanda kwamazinga egazi le-phosphate).
I-oil retention enemas ingaba usizo ezigulini ezithintekayo, okusho ukuthi isitokisi sikhulu kakhulu futhi kunzima ukuthi kuvimbele ikoloni. Uma isiguli sikwazi ukugcina i-enema yamafutha ubusuku bonke, lokho kungase kuvivinywa ngaphambi kokuba umhlengikazi angawafaki amandla. Isibonelo se-enema yokugcina amafutha yi-enema yobisi-futhi-molasses.
Ukungaziphathi kahle: Uma isiguli sithintekile futhi sinezinhlayiya, i-suppository, ne-enemas ayisebenzi noma ayinconywa, umhlengikazi angadinga ukuwaphazamisa. Lena inqubo engaqondakali lapho umhlengikazi kufanele afake umunwe wakhe emgqeni ukuze akhulule futhi asuse isitoreji. Ungase ucindeze ngisho nokufunda mayelana nenqubo yakhe. Qinisekisa ukuthi ukungafuni ukuphendula kungenziwa kuphela uma kudingekile emtholampilo. Ngenxa yokuthi ayinandaba futhi ingaba buhlungu kakhulu, iziguli kufanele zilungiselelwe nge- opioid analgesic futhi mhlawumbe i-anxiolytic, njenge-lorazepam.
Ukuqokwa kuyisimo esicindezelayo esithinta kakhulu izinga lempilo. Kubalulekile ukugcina umhlinzeki wakho wokunakekelwa kwempilo ngolwazi ngokunyakaza kwakho kwesiguli noma ngesiguli sakho bese ubaxwayisa kunoma yikuphi ukuguqulwa kwamaphethini wokunyakaza kwamathumbu.
Imithombo:
> Bleser S, Brunton S, Carmichael B, Omdala K, Rasch R, Steele J. Ukuphathwa kokuqokwa okungapheli: Izincomo ezisuka kuphaneli yokuvumelana. J Fam Pract. 2005 Aug; 54 (8): 691-8.
> Ferrell, > BR >, noCoyle, N; I-Bookbook ye-Nursing Palliative, i-Oxford University Press, ngo-2006.