I-tube yokutya yinkqubo yezobugcisa esetyenziselwa ukondla umntu ongakwazi ukufumana ukutya ngomlomo ngokukhuselekileyo. Olu bunzima lunokubangelwa ubunzima bokugwinya , iqondo lokuguqulwa kwengxaki, ingxaki yokutya, okanye enye imiba eyenza ukutya kucelomngeni. Kukho iintlobo ezininzi zezibilini zokutya kunye nezizathu ezininzi zokubangela ukuba ityhubhu yokutya ifumaneke.
Imeko nganye iyahluke, kwaye isigqibo sokuba netyhulo yokutya isetyenziswe ngokusisigxina into ehluke kakhulu kunokuvumela ukuba ityhutyana yexeshana ibe khona.
Ukwenza isigqibo esinolwazi malunga nokutya iibhubhu, kuyimfuneko ukuqonda ukuba yintoni ityhulo yokutya, ulwahlulo phakathi kweentlobo zamathambo okutya, xa ibhubhu iyimfuneko ngokuchasene nokuzikhethela, kunye nendlela ezi zibeka ngayo.
Ukondla iiphulo ezichazwe
I-tube yokuthambisa iyisimboli seplastiki esisetyenziselwa ukudlula ukutshiza nokugwinya kwisigulane esingakwazi ukutya okanye ukusela ngokukhuselekileyo. Ezi zivalo zingasetyenziselwa ukubonelela kokutya kunye namanzi, kwaye zingasetyenziselwa ukubonelela unyango xa kufuneka. Isitampu sokutya singasetyenziselwa ukususa umthamo kwisisu xa umzimba ungayisebenzisi kakuhle isisu esiswini kakuhle.
Ukusetyenziswa
Ukutya izibilini zilungele ngaphezu kokubonelela ukutya, zinokukhupha i-gas kunye nokuqhaqha, nokunciphisa isicupucu kunye nokuhlanza.
Ukusetyenziswa ngokuqhelekileyo kwiphubhu yokutya kuyabandakanya:
- Ukubonelela ngesondlo: Ukutya, kwimo yefayili, kunokubonelelwa nge-tube yokutya. Ukutya kweT Tube, okanye ukutya okunomsoco, kunokunikwa ngetyhubhu ukubonelela i-carbohydrates, iprotheni kunye namafutha emzimbeni ngaphandle kokuba isigulane sigqibe okanye sihlafune.
- Ukubonelela ngamanzi : Amanzi anokubonelelwa ngefayili yokutya ukuze kugcinwe isigulane ngaphandle kokufuna ukukhupha ii-IV.
- Ukubonelela iMilisi: Imithi, kuquka iipilisi ezininzi kunye neepilisi, inokunikezwa nge-tube yokutya. Iibhulethi zingadinga ukugaya kwaye ezinye iifomsile zingadinga ukuvulwa, kodwa ukuba iincinci zincinci ngokwaneleyo imishanguzo eninzi inokudibaniswa ngamanzi kwaye ilawulwe ngetyhubhu yokutya.
- Ukunciphisa isisu: Ezinye iintlobo zesibhulo sokutya zisetyenziselwa ukususa umoya kwisisu. Ezinye iindidi zezigulana zokutya, okwethutyana, ngokukodwa, zinokudibaniswa nokunyamekela ukususa igesi kwisisu ukuze kuncitshiswe ukuphazamiseka nokuqhaqha.
- Ukususa Isisu Esiqulathekileyo: Ukuba awuyikucubungula ukutya okanye utywala, unokufumana ukutya okuhleliyo esiswini, esibangela ukungahambi kakuhle, isisonguluko, ukuhlanza okanye ubuhlungu besisu nokuqhaqha. Ukunyameka okunokusetyenziswa kunokususa ukususa amanzi kunye neentlobo ezincinane zokutya esiswini sakho.
Xa i-Tube Yokutya iyimfuneko
I-tube yokutya iyimfuneko xa ungenakuphepha ngokutya okanye kumanzi ngomlomo. Nangona kunokwenzeka ukuba unike umbane kunye nesondlo nge-IV , umzimba ulunge ngakumbi ngokutya okuhanjiswa emanzini kunokuba ungene emithanjeni yegazi. Xa kunokwenzeka, kuphephile kwaye kulungele ukuba umzimba ufumane ukutya kunye nezifo kwisisu ukuze utyilwe ngokuqhelekileyo, kodwa ukuba unzima ukugwinya, oku akunako ukukhuseleka.
Ingxaki yokugwinya ingathetha ukuba isigulane sitshisa ukutya kunye namanzi, okanye "behla ipayipi engafanelekanga" kwaye izinto ziyakhutshwa kwimiphunga esikhundleni sokuginywa. Oku kunokukhokelela kwisifo esibi, kubandakanywa ne- pneumonia , ukusuka kwiintlobo zezinto zokungena ezimpompo.
Abanye bangagula kakhulu ukuba bangagwinyi, okanye basesidini sefayili enesibhubhe esifakelwe kwindlela esinqabela ukugwinya. Ezinye izigulane ziqaphele kwaye zikhokelelwa kodwa zilahlekelwe amandla okugwinya kakuhle. Sekunjalo, abanye banesifo okanye ukugula okwenza kube nzima ukugwinya, njengomhlaza womlomo.
Isigqibo sokubeka i-Tube yokutya
Isigqibo sokubeka ityhubhu yesondlo sinzima kwaye senziwa nzima xa isigulane singakwazi ukuthatha inxaxheba kwingxoxo okanye singabelana ngesifiso sabo malunga nokunyamekela kwezempilo.
Kwiimeko ezininzi, isigulane esidinga ityhubhu yokutya sinokuhlala okanye ingabi nalwazi kwaye ayikwazi ukwabelana ngesifiso sabo kunye nabahlobo nabathandekayo.
Umbuzo wesigulane uya kuwufuna, nokuba ingaba ityhutyana inokuba yesikhashana, ixesha elide okanye isigxina lifuna ukuqwalasela. Ezinye iintsapho zichitha iintsuku zixubusha ngesigqibo phakathi kwabo okanye zinokudibana nentlanganiso yentsapho kunye nabasebenzi bezonyango ukuxoxa ngesigqibo.
Kwiimeko ezininzi, isigqibo sokubeka ityhubhu yokutya sinxulumene nesigqibo sokubeka i-tracheostomy, umgodi entanyeni apho i- ventilator inokuxhasa ukuphefumla kwakho. Oku kungenxa yokuba intubation , inkqubo apho ityhubhu ingeniswa emlonyeni ize iphinde ingene umoya ukuze i-ventilator isetyenziswe, ingasetyenziselwa iiveki ezimbalwa kude kube nomonakalo emqaleni. Ekubeni ezi zinto zingaphantsi kweeveki ezimbini zeeveki ezimbini, ukufakwa kwetracheostomy kunye nentsimbi yesisu kuya kwenziwa rhoqo ngexesha okanye kwiintsuku ezimbalwa zomnye.
Iintlobo
Kukho iintlobo ezininzi zeembatho zokutya, kwaye zisetyenziselwa iimeko ezahlukeneyo. Ubume beengxaki obangela ubunzima bokugwinya , eyaziwa nangokuthi i-dysphagia, kuya kunceda ukucacisa uhlobo lwesitampu esisetyenziswayo. Ezinye zenzelwe ukuba zisesigxina, kwaye ezinye zenzelwe ukuba zithuba elide okanye zize zigcine.
I-tube yondlo yesikhashana, enye leyo ifakwe kwimpumlo okanye emlonyeni, phantsi komqala, kwaye isisu (G-tube) okanye ingene ngaphakathi emathunjini (J-tube), inokuhlala ikhuselekile ngokuqhubekayo malunga neshumi elinesine iintsuku. Ukufakwa emqaleni kwexesha elide kuneentsuku ezimbini kuphakamisa umngcipheko wokukhukhula kweethambo ezinobungozi zomqala nomqala. Oku kungakhokelela kwimicimbi engunaphakade njengomonakalo kwibhokisi yezwi nomqala.
Ithuba lokutya lokuhlala ixesha elide okanye lokusisigxina lijoliswe ekusebenziseni iinyanga, iminyaka okanye ukubekwa ngokusisigxina. Njengothubhu yesikhashana, ezi zi-tubes zingasuswa xa zingasadingeki kodwa zihlala zihlala ixesha elide ngaphandle kwengozi emlonyeni, emqaleni, nangomtya ngenxa yokutya kuhamba ngqo kwisisu.
Iibhulo zokutya ezifutshane
I-Nasogastric (NG) Tube: Olu hlobo lweshubhu lufakwe kwimpumlo, phawula emqaleni, ngaphantsi kwe-esophagus ukuya esiswini. Iyakwazi ukuhlala kwindawo engama-iveki ezimbini ngaphambi kokuba isuswe okanye ithathelwe indawo yesikhuni sokutya eside.
I-Orogastric Tube (OG): Uhlobo olufanayo lwebhubhu njengombhobho we-nasogastric, ityhubhu ifakwe emlonyeni, phantsi komqala ukuya kwisisu kunye nokuphela kuphumla esiswini. Le bhubhe inokuhlala isendaweni ukuya kwiiveki ezimbini xa kufuneka isuswe okanye ithathe indawo yesikhuseli esisigxina.
Ukutya okuTyhutyana
I-tube yokutya yesikhashana ifakwe emlonyeni okanye empumleni, phantsi komqala, ibe yintonga kwaye isiphelo sihlala esiswini (G-tube) okanye phakathi kwesisu esincinci (J-tube). Ezi ntlobo zethubhu zinomxholo we-radio-opaque, oku kuthetha ukuba kukho inani elincinci lezinto ezivumela ukuba zifunyenwe kwi-ray-ray ekupheleni kwebhubhu. Emva kokubekwa, i-x-ray yenziwe, kwaye ivumela ukubekwa ngokufanelekileyo ukuqinisekiswa ngaphambi kokuba ityhuse isetyenziswe.
Iindidi zexesha elihlala kwixesha elide / ixesha elide
I-Tube yesisu (G tube): Olu hlobo lwesibhubhe luvumela ukufikelela ngokuthe ngqo kwisisu ngokuchaneka kwicala elingasentla lesisu. Le tube ityelela umlomo nomlomo kwaye ivumela ukutya, amayeza, kunye namayeza ukuba anikwe ngaphandle kokugwinya.
I-Jejunostomy Tube (i-tube tube J): Olu hlobo lwesibhubhe lufana ne-tube gastric, ngokufakwa kwisicathulo esingaphantsi kwe-G-tube placement, kwaye ivumela ukufikelela ngokuthe ngqo kwiJejunum ephakathi kweyesithathu Ndibonise uthando. Le tube ithambe ibe yincinci kune-G-tube, enokuthi sinciphise oko kunokungeniswa kumanzi amancinci kunye namachiza aphantsi komhlaba.
I-Percutaneous Endoscopic Gastrostomy (PEG): Eli gama lisetyenziselwa ngokungafaniyo kunye ne-G-tube, kodwa oku kubhekisela kwindlela yokusetyenziswa kweG-tube. I-percutaneous (ngokusebenzisa ulusu) endoscopic (usebenzisa i-endoscope ekhanyisiweyo) i-gastrostomy (ukubeka umbhobho ophuphayo esiswini) ichaza inkqubo esetyenziselwa ukubeka i-tube-G, kungekhona i-G-tube ngokwayo.
Indlela i-Tube yeGastric efakwa ngayo
Inkqubo yokubeka i-tube gastric ngokuqhelekileyo iyakhawuleza, kwaye iyakwenza okanye ayifuneki i-anesthesia kuye kuxhomekeke kwimeko yakho. Kwizigulane ezigula kakhulu kwiinkathalo ezinzulu, akukho dityu olongezelelweyo lungafuneka ukuba ufake ityhubhu kwicala lokulala.
I-endoscope yinto enomzimba omde onokukhanya kunye nekhamera ekupheleni ekuvumela umniki-mboleko ukuba abukele inkqubo kwinkangeleko. Ububanzi bufakwe emlonyeni, phantsi komqala, kunye nasesisu. Ngesinye esiswini, ngokwenene kunokwenzeka ukubona ukukhanya okuvela kwindawo ekukhanyeni ngesikhumba sesisu, kubonisa i-gastroenterologist apho ukwenza khona ukukhangela. Isicatshulwa esincinci senziwe malunga nesiqingatha sesentimitha ubude, apho i-tubing eguquguqukayo ifakwe khona. Iibhola ze-G ezindala zingaba ibhaluni egcina ityhubhu ibe khona.
Inxalenye yangaphandle yebhubhu inesitampu esivumela ukuba ityhubhu ivule, kwaye ukutya kunye namanzi okucoca ukunyanzeliswa ngenyameko kwi-tube ngaphakathi esiswini. Ngokunakekelwa kakuhle kwetyhubhu , i-incision izakuvalwa ngokubanzi ngokujikeleza kwiphubhu, kwaye naluphi na ukuphazamiseka kokutya okanye uketshezi olwenzekayo kwiintsuku ezilandelayo ngokulandela inkqubo kufuneka zinciphise ukuphulukiswa.
Ngoxa i-incision iyaphilisa, i-bandage eneqabunga kuyo ifakwe kwi-tube. Oku kunceda ukufumana naluphi na umbane oza kuvuza kwindawo. Ukuba i-drainage ikhona kwaye ikhubaza isikhumba, i-ovenment barrier ingasetyenziselwa ukukhusela. Ukuhlambulula kakuhle isayithi kunye nesepha kunye namanzi kunye nokuhlambulula isephaphu eseleyo kuloo ndawo ngokuqhelekileyo kukho konke ukunakekelwa kwesiza kufuneka.
Kwixesha elide, izigulane ezininzi azifuneki mafutha okanye i-gauze kwisayithi, kodwa ezinye zikhetha ukugqoka xa kukho umjelo wokukhusela isikhumba okanye iingubo zokungcola.
Ukususwa kweThutyana yeThutyana
Ukususwa kwebhanki yokutya eyethutyana ihamba ngokukhawuleza kwaye kulula. Kungase kuthukuthele kwiisisu ezinobuhlungu zomlomo, umphimbo, kunye neempumlo, kodwa oku kuncinci. Ukuze ususe ityhubhu, ityhubhu iyahlulwa kokutya kunye namanzi, kunye ne-syringe enkulu eyenzelwe ukusebenzisa ityhubhu yokutya. Emva koko kukhishwe ngenyameko, kuthatha imizuzwana 3-5 ukuya kususwa ngokukhawuleza. Ukuba iphoyinti yebhubhu ihambelane, ibonisa ukuba yonke ibhubhu isuswe ngempumelelo, iphoswe kude.
Ukususwa kweThutyana okusisigxina
Ukuba uphinda uphinde ukwazi ukutya nokusela kakuhle, kunokwenzeka ukuba ususe ityhubhu "yokusisigxina". Okumangalisa kukuba, le nkqubo inokukhawuleza, kwaye nangona kukho intlungu, ngokuqhelekileyo imodareyitha kwaye imfutshane. Abadluli bahluke kwiimfuno zabo zokuba i-tube isuswe; ezinye zifuna ukuba ugcine ubunzima bakho ubuncinane inyanga ngelixa uthabatha konke ukutya kunye nolwandle ngokusebenzisa i-tube-G, ngelixa abanye bangadinga ixesha elide.
Xa sele kwenziwe isigqibo sokususa ityhubhu, ityhubhu ingasuswa, kodwa oku kufuna ukuba kusetyenziswe umlinganiselo othile wamandla. Isigulane ngokuqhelekileyo sinesilonda esilahlakeleyo esigcinwe kufuphi nesiza, kwaye umboneleli uyayibamba ngokucacileyo ityhubhu aze ayibambe ngokukhawuleza kodwa ngokuqinisekileyo ukususa kwisayithi. Ukuba kukho ibhaluni ngaphakathi kwisisu, ihlaselwe ngaphambi kokususa ityhubhu, kodwa ezininzi iintlobo zineflethi kunokuba ibhaluni kwaye ayimfuneko.
Inkqubo ngokuqhelekileyo ibetha, kwaye kukho inani elincinci legazi kwezinye iimeko, kodwa intlungu ihamba ngokukhawuleza. Unokulindela ukuba ukufakwa kweso sihlanjululwe, kodwa oku akuyimfuneko, kwaye ukugqoka okucocekileyo kunokwaneleyo ukugcina iigulane zihlambuluke kwiintsuku ezilandelayo ukuba kukho nawuphi na umjelo. Isibhengezo sivame ukuvala ngaphakathi kweveki yebhubhu isuswa.
ILizwi
Isigqibo sokubeka ityhubhu yokutya ayilona nto yokuthatha into encinane, kubalulekile ukuxoxa ngoluphi uhlobo lwexesha elide elinokulindela wena okanye wakho othandekayo. Kwezinye izigulane, ityhubhu kulindeleke ukuba ibe yesikhashana ngelixa iphola kwisifo. Kwezinye izigulane, ityhubhu yokutya ingalindelwa ukuba ihlale kwindawo yabo bonke ubomi babo.
Ingaba okanye akusiyo oku kulungele wena okanye wakho umthandayo ngumbuzo oyintloko. Ukuba ungumlondolozi kwimeko enokufuna ityhubhu yokutya, uyathandwa ngumntu onokuthi ube neengcamango ezinamandla kwi sihloko, okanye abazange bakhulume ngeemfuno zabo zonyango lwexesha elide. Ukuba awuqinisekanga ngezimvo zabo, usebenzisa isigwebo sakho-kunye nemibono yeqela elibonelela ngononophelo kunye neengcebiso zabanye abathandayo-kuya kuba sisikhokelo sakho sokwenza izigqibo.
> Umthombo:
> Ukuqonda i-Endoscopic Gastrostomy (PEG) nganye. Umbutho waseMelika kwi-Endoscopy yesisu. https://www.asge.org/home/for-patients/patient-nformation/understanding-peg