Ntho e ngoe le e ngoe eo u lokelang ho e tseba ka Refeeding Syndrome

Litaba

• Refeeding syndrome ke eng?
• Hobaneng e etsahala?
• Matšoao
• Lisosa tsa kotsi
• Kalafo
• Pholiso
• Thibelo
• Ponahalo

Refeeding syndrome ke eng?

Ho fepa hape ke mokhoa oa ho kenya lijo bocha kamora phepo e fosahetseng kapa tlala. Refeeding syndrome ke boemo bo kotsi mme bo ka bolaeang bo ka hlahang nakong ea ts'ebetso. E bakoa ke ho fetoha ha tšohanyetso ho li-electrolyte tse thusang ’mele oa hao ho sila lijo.

Liketsahalo tsa refeeding syndrome li thata ho tseba, kaha ha ho na tlhaloso e tloaelehileng. Refeeding syndrome e ka ama mang kapa mang. Leha ho le joalo, hangata e latela nako ea:

• khaello ea phepo e nepahetseng
• ho itima lijo
• ho ja haholo
• tlala
• tlala

Maemo a mang a ka eketsa kotsi ea boemo bona, ho kenyelletsa:

• ho ipolaisa tlala
• bothata ba tšebeliso ea joala
• mofetše
• ho thatafalloa ke ho metsa (dysphagia)

Ho buuoa ho itseng ho ka eketsa kotsi ea hau.

Hobaneng e etsahala?

Ho haelloa ke lijo ho fetola tsela eo 'mele oa hao o silang limatlafatsi ka eona. Mohlala, insulin ke hormone e robang tsoekere (tsoekere) ho tsoa lik'habohaedreite. Ha ts'ebeliso ea lik'habohaedreite e fokotsehile haholo, insulin ea sekhahla e lieha.

Ha li-carbohydrate li le sieo, 'mele o fetohela mafura le liprotheine tse bolokiloeng e le mohloli oa matla. Ha nako e ntse e ea, phetoho ena e ka senya mabenkele a elektrolyte. Phosphate, elektrolyte e thusang lisele tsa hau ho fetola tsoekere hore e be matla, hangata e a ameha.

Ha lijo li khutlisetsoa hape, ho na le phetoho e sa lebelloang ho tloha metabolism ea mafura ho khutlela metabolism ea lik'habohaedreite. Sena se baka hore sephiri sa insulin se eketsehe.

Lisele li hloka li-electrolyte tse kang phosphate ho fetola tsoekere hore e be matla, empa phosphate e haella. Sena se lebisa boemong bo bong bo bitsoang hypophosphatemia (low phosphate).

Hypophosphatemia ke tšobotsi e tloaelehileng ea refeeding syndrome. Liphetoho tse ling tsa ts'ebetsong le tsona li ka hlaha. Tsena li kenyelletsa:

• maemo a sa tloaelehang a sodium le mokelikeli
• liphetoho mafura, tsoekere kapa metabolism ea protheine
• khaello ea thiamine
• hypomagnesemia (magnesium e tlase)
• hypokalemia (potasiamo e tlase)

Matšoao

Refeeding syndrome e ka baka mathata a tšohanyetso le a bolaeang. Matšoao a Refeeding syndrome a ka kenyelletsa:

• mokgathala
• bofokoli
• pherekano
• ho hloleha ho hema
• khatello e phahameng ea mali
• sethoathoa
• arrhythmias ea pelo
• ho hloleha ha pelo
• koma
• lefu

Matšoao ana a hlaha nakong ea matsatsi a mane ho qala ha ts'ebetso ea ts'ebetso. Le ha batho ba bang ba kotsing ba sa hlahise matšoao, ha ho na mokhoa oa ho tseba hore na ke mang ea tla ba le matšoao pele a qala kalafo. Ka lebaka leo, thibelo e bohlokoa.

Lisosa tsa kotsi

Ho na le lisosa tse hlakileng tsa kotsi ea "refeeding syndrome". U kanna oa ba kotsing haeba ngoe kapa ho feta ea lipolelo tse latelang e sebetsa ho uena:

• O na le index ea boima ba 'mele (BMI) tlasa 16.
• U theotse karolo e fetang 15 lekholong ea boima ba 'mele oa hau likhoeling tse 3 ho isa ho tse 6 tse fetileng.
• U jele lijo tse fokolang, kapa ka tlase ho likhalori tse hlokahalang ho boloka lits'ebetso tse tloaelehileng 'meleng, bakeng sa matsatsi a 10 kapa a fetang a latellanang.
• Teko ea mali e senotse maemo a hau a serum phosphate, potasiamo, kapa magnesium a tlase.

Le uena u ka ba kotsing haeba pedi kapa ho feta ea lipolelo tse latelang e sebetsa ho uena:

• U na le BMI tlasa 18.5.
• U theotse karolo e fetang 10 lekholong ea boima ba 'mele oa hau likhoeling tse 3 ho isa ho tse 6 tse fetileng.
• U nkile ho se hokae ho se na lijo bakeng sa matsatsi a 5 kapa a ho feta a latellanang.
• U na le nalane ea ts'ebeliso ea joala kapa tšebeliso ea meriana e itseng, joalo ka insulin, lithethefatsi tsa chemotherapy, diuretics kapa antacids.

Haeba u lumellana le maemo ana, u lokela ho batla tlhokomelo ea meriana ea tšohanyetso hanghang.

Lintlha tse ling le tsona li ka u beha kotsing e kholo ea ho ba le lefu la refeeding. U kanna oa ba kotsing haeba u:

• na le anorexia nervosa
• na le bothata ba ho sebelisa joala bo sa foleng
• ba le mofetše
• ba na le lefu la tsoekere le sa laoleheng
• ha ba na phepo e nepahetseng
• haufinyane o ile a etsoa opereishene
• na le nalane ea ho sebelisa li-antacids kapa diuretics

Kalafo

Refeeding syndrome ke boemo bo tebileng. Mathata a hlokang ho kenella hanghang a ka hlaha ka tšohanyetso. Ka lebaka leo, batho ba kotsing ba hloka tlhokomelo ea bongaka sepetlele kapa setsing se khethehileng. Sehlopha se nang le boiphihlelo ho gastroenterology le dietetics se lokela ho hlokomela kalafo.

Lipatlisiso li ntse li hlokahala ho fumana mokhoa o motle oa ho phekola lefu la refeeding. Kalafo hangata e kenyelletsa ho nkela li-electrolyte tsa bohlokoa sebaka le ho fokotsa ts'ebetso ea ts'ebetso.

Ho phethoa ha likhalori ho lokela ho ba butle mme hangata ho na le likhalori tse ka bang 20 ka kilograma ea boima ba 'mele ka karolelano, kapa likhalori tse ka bang 1000 ka letsatsi qalong.

Litekanyetso tsa Electrolyte li hlahlojoa ka liteko tsa khafetsa tsa mali. Ho kenella ka hare ho methapo (IV) ho latela boima ba 'mele hangata ho sebelisoa ho nkela li-electrolyte sebaka. Empa kalafo ena e kanna ea se tšoanele batho ba nang le:

• ho se sebetse hantle ha liphio
• hypocalcemia (calcium e tlase)
• hypercalcemia (calcium e phahameng)

Ho feta moo, maro a khutlisetsoa butle-butle. Phetolo ea sodium (letsoai) le eona e ka hlahlojoa ka hloko. Batho ba kotsing ea ho ba le mathata a amanang le pelo ba ka hloka ho hlahlojoa ke pelo.

Pholiso

Ho hlaphoheloa ho tsoa ho refeeding syndrome ho latela matla a khaello ea phepo e nepahetseng pele lijo li khutlisetsoa. Ho fepa hape ho ka nka matsatsi a 10, le ho beha leihlo kamora moo.

Ntle le moo, ho pheta-pheta hangata ho etsahala haufi le maemo a mang a tebileng a hlokang kalafo ka nako e le ngoe.

Thibelo

Thibelo e bohlokoa ho qoba mathata a sokelang bophelo a lefu la ts'oaetso.

Maemo a mantlha a bophelo bo eketsang kotsi ea ts'oaetso ea Refeeding ha a thibeloe kamehla. Litsebi tsa bophelo bo botle li ka thibela mathata a ho hlaseloa ke lefu ka:

• ho khetholla batho ba kotsing
• ho fetola mananeo a ntlafatso ho latela maemo
• ho hlokomela kalafo

Ponahalo

Refeeding syndrome e hlaha ha lijo li hlahisoa kapele haholo kamora nako ea khaello ea phepo e nepahetseng. Ho fetoha ha maemo a elektrolyte ho ka baka mathata a tebileng, ho kenyelletsa ho oela, ho hloleha ha pelo le ho koma. Maemong a mang, refeeding syndrome e ka bolaea.

Batho ba haelloang ke phepo e nepahetseng ba kotsing. Maemo a mang, a kang anorexia nervosa kapa boloetse bo sa foleng ba ts'ebeliso ea joala, a ka eketsa kotsi.

Mathata a refeeding syndrome a ka thibeloa ke infusions ea electrolyte le regimen ea ho fokotsa butle butle. Ha batho ba kotsing ba tsejoa kapele, kalafo e kanna ea atleha.

Ho eketsa tlhokomeliso le ho sebelisa mananeo a ho lekola ho khetholla ba kotsing ea ho ba le Refeeding syndrome ke mehato e latelang ea ho ntlafatsa chebahalo.