Zakudya za impso hemodialysis: malamulo zakudya

Hemodialysis Ndi chithandizo kwa odwala omwe ali ndi vuto lathanzi kulephera kwa aimpso, chomwe tanthauzo lake ndi kugwiritsa ntchito njira zamagetsi kuyeretsa thupi la wodwalayo ku zinthu zapoizoni ndikupangitsa madzi kukhala opanda mchere (adakonza hemodialysis/peritoneal dialysis) Tsoka ilo, kuphatikizira kwa hemodialysis sikusintha ntchito ya impso, komwe kumathandiza kusunga zovuta zingapo kagayidweKhalidwe la odwala aakulu aimpso kulephera.

Kuphatikiza apo, pa dialysis, pamakhala zotsatirapo zomwe zimayambitsa kuchepa kwa michere yambiri ya chakudya komanso kukula kwa kuchepa kwa mphamvu ya protein. Chifukwa chake, mkhalidwe wa odwala omwe ali ndi hemodialysis umatsimikiziridwa makamaka ndi chithandizo choyenera cha zakudya. Zakudya za odwala oterowo zimatengera zinthu zingapo: kufupika / kutalika kwa njira, kuchuluka ndi chikhalidwe cha kusintha kwa kagayidwe kazinthu, mawonekedwe a mayankho a dialysis ndi kupezeka / kuuma kwa zovuta. Chifukwa chake, zakudya pa hemodialysis ndi lingaliro lamphamvu lomwe limafuna munthu kusankha chakudya.

Kuphatikiza pa kukhalabe ndi thanzi labwino la wodwalayo, chithandizo chamankhwala chothandizira ndikuchepetsa kuchepa kwa matenda amitsempha yama mtima komanso kusintha kwa mtima, kupewa michere ndi mafupa a minyewa komanso kukonza ma metabolic chifukwa cha kuledzera kwa uremic, ndipo nthawi zambiri kuyimba kwa impso. Panthawi imodzimodziyo, ngakhale pakufunika kuti munthu athe kupeza njira zothandizira odwala omwe akudwala hemodialysis nthawi zonse, pali mfundo zambiri za zakudya zoperekedwa pansipa.

Zakudya kwa aimpso hemodialysis zachokera kuchipatala Gawo No. 7 G malinga ndi Pevzner, omwe mwanjira zina amasiyana ndi zakudya zamankhwala nthawi ya pre-hemodialysis isanachitike. Chakudyacho chimayang'aniridwa moyenera kudya macro / micronutrients ambiri, poganizira za umunthu wa kagayidwe ndi mpumulo wa zovuta za hemodialysis.

Chakudyacho chimapatsa mphamvu kuchuluka kwa mapuloteni mpaka 1.0-1.2 g / kg thupi / tsiku (60-75 g), omwe amayamba chifukwa cha kuchepa kwa mapuloteni panthawi ya hemodialysis, kuchepa kwa kugaya kwake komanso kuwonjezeka kwa kuwonongeka kwake. Ndili ndi kuchuluka kwa mapuloteni awa komwe thupi limadzuka albin ndikukhalabe ndi nitrogen wabwino / wopanda mbali. Komanso, kudya mapuloteni pamlingo uwu sikumapangitsa uremic kuledzera.

Zoperewera zama protein osakwanira mu chakudya zimapangitsa kuti pakhale kuperewera kwa mphamvu zama protein (kuchepa kwa chindapusa cha kulemera kwa thupi, milingo prealbumin, albin, cholesterol) ndikuwonjezera mwayi wakufa. Kuchuluka kwa mapuloteni omwe amapezeka muzakudya kumathandizira kuwonjezeka kwa magazi a zinyansi za nayitrogeni komanso kukula kwa uremia. Mapuloteni amayenera kuchokera ku nyama zomwe zimachokera, zomwe zimatha kukhala nyama yofiira, kalulu, nkhuku, nsomba zonenepa pang'ono, mazira a nkhuku, tchizi yaku kanyumba, mkaka ndi zakumwa zo mkaka wowawasa.

Mtengo wamagetsi wazakudya za tsiku ndi tsiku amawerengedwa kuchokera pa chiwerengero cha 35-40 kcal / kg / tsiku (2800-2900 kcal / tsiku). Nthawi yomweyo, mphamvu zopanda malire zimatheka ndikudya 35 kcal / kg / tsiku. Okalamba kapena omwe akugona pakama amaloledwa kuti achepetse kuchuluka kwa mphamvu zamagetsi mpaka 2400-2500 Kcal / tsiku.

Ndikofunikira kuphatikiza mafuta a masamba komanso mafuta am'madzi mu zakudya, zomwe ndi mafuta achilengedwe a polyunsaturated. Ndi kusadya bwino komanso zizindikiro hypoglycemia kuwonjezeka kovomerezeka m'zakudya zomanga thupi zopezeka mosavuta (confectionery, uchi, jamu, jelly, mousse). Komabe, ngati zilipo matenda ashuga, chakudya chamagulu m'zakudya ndizochepa.

Malo apadera m'zakudya za odwala hemodialysis ali ndi zomwe sodium mankhwala enaake ndi madzimadzi aulere. Chiwerengero chawo chimatsimikiziridwa payekha kutengera kuchuluka kwa kuthamanga kwa magazi komanso kuchuluka kwa madzi mthupi. Panthawi ya hemodialysis, monga lamulo, kuchuluka kwa mkodzo kumafufutikira mosalekeza, komwe kumayambitsa kusungidwa kwa sodium mthupi, ndipo ngakhale kuwonjezeka pang'ono kumagwiritsidwa ntchito kumawonjezera ludzu ndikukulitsa kugwiritsa ntchito kwaulere kwamadzi, komwe kumathandizira kukulitsa ochepa matenda oopsa, edema.

Kuphatikiza apo, kudya mchere wambiri mwa odwala pa hemodialysis kumabweretsa kuwonjezeka kwa thupi pakati pamagawo a hemodialysis, myocardial hypertrophy, chitukuko kulephera kwa mtima. Chifukwa chake, zomwe zimakhala mu sodium muzakudya ndizochepa kwa 2.0-2.8 g / tsiku (4-5 g la mchere wa tebulo). Samakhala mchere wamchere. Pakupezeka kwa edema ndi kuthamanga kwa magazi, 2-3 g yamchere imakhala yovomerezeka m'zakudya kuti pakhale mchere wamafuta omwe adapangidwa kale, ndipo ngati akupezeka, mchere umasiyidwa kwathunthu kuchokera pachakudyacho, ndipo zakudya zamchere - zophatikizidwa, zakudya zamzitini, nyama zotsekemera ndi maapulo - zimasiyidwa.

Kuchuluka kwa madzimadzi aulere omwe amagwiritsidwa ntchito amawerengedwa kuchokera pazowerengera: 600 ml + voliyumu ya diureis tsiku ndi tsiku + zowonjezera zam'mimba. Pafupifupi - 800-1000 ml yamadzimadzi. Kuthana ndi kuchuluka kwa madzimadzi, kuyeza mkodzo tsiku lililonse ndikutsimikiza kwa mkodzo tsiku lathalo ndikofunikira. Kuwonjezeka kwa kulemera kwa thupi pakati pa magawo a dialysis sikuyenera kupitirira 1.5-2 kg. Ndi kudya kwambiri kwamadzimadzi aulere kumathandizira kutopa kwambiriakupanga hyponatremiakutupa kumawonekera.

Kuti ulipire kuchuluka kwa mavitamini omwe amakhala ndi hemodialysis wokhazikika, tikulimbikitsidwa kuti tidye zakudya zathu ndi kukonzekera kwa multivitamin (gulu B, C, E,) mapiritsi 1-2 patsiku ndi kumwa vitamini Dmomwe odwala amakuliraD-hypovitaminosis. Kulandila kowonjezera beta carotene ndi Vitamini A zosafunika.

Zizindikiro zakumwa phosphorous, potaziyamu ndi calcium zimatsimikiziridwa makamaka ndi ma labotale ndi ma dalili a matenda. Odwala hemodialysis Hyperkalemia ogwirizana ndi chiopsezo chachikulu cha imfa. Chifukwa chake, kuchuluka kwa potaziyamu omwe amadwala odwala dialysis sayenera kupitirira 3 g ya potaziyamu / tsiku. Potaziyamu amapezeka makamaka mu zipatso / zipatso zouma (zoumba, zipatso, ma apricots, nkhuyu), nthochi, mtedza (bowa, walnuts, pistachios, hazelnuts), mphutsi, bowa, zitsamba zam'munda (sipinachi, parsley, katsabola), mpunga, buledi kuchokera ku ufa wowuma, broths zamasamba, chokoleti, misuzi ya zipatso, ketchup, khofi wapapo, cocoa. Masana, wodwala sangadye mopitilira 1 masamba ndi 1 chipatso (mulimonse). Nthawi yomweyo, masamba osaphika ndi zipatso ayenera kupendedwa, kutsukidwa ndi madzi ndikusiyidwa kwa maola atatu ndimadzi, popeza potaziyamu amasungunuka bwino m'madzi.

Kufunika kwa magnesium mwa odwala hemodialysis ndi 200-300 mg / tsiku. Hypermagnesemia chifukwa cha zochepa zomwe zimapezeka mu magnesium mu chakudya komanso mayamwidwe ochepa a m'matumbo (40-50%), Hyperkalemia sichachilendo, komabe, kuwunika kayendetsedwe ka mankhwala omwe ali ndi magnesium ndikofunikira (magnesium sulfate, ma antacid), chifukwa zimatha kuyambitsa mawonekedwe oopsa a hypermagnesemia omwe ali ndi kupuma, ma mitsempha.

Kufunika kwa calcium kwa odwala pa hemodialysis ndi 1.5 g / tsiku. Zakudya zama calcium zochulukirapo zimachitika chifukwa chogwiritsa ntchito zinthu zomwe zimakhala ndi calcium zomwe zimapangidwa kuti zimangirire phosphates (calcium acetate, calcium carbonate, calcium gluconate) Kuchuluka kwa calcium wowonjezera kumabweretsa hypercalcemia, komanso mtima / minyewa.Ngati palibe chifukwa chowongolera phosphorous yokhala ndi kashiamu wokhala ndi calcium, tikulimbikitsidwa kuti muchepetse kudya kwa calcium mpaka 900-1000 mg / tsiku.

Kufunika kwa phosphorous mu chakudya chamunthu wathanzi ndi 1600-1700 mg / tsiku. Pa njira imodzi ya hemodialysis, pafupifupi 250 mg ya phosphorous imachotsedwa. Ndiye kuti, hemodialysis sikutsimikizira kuchotsedwa kwa phosphorous kuchokera mthupi mu kuchuluka komwe kumafunikira ndikuletsa chitukuko hyperphosphatemia sindingathe. Popeza kuchuluka kwambiri kwa phosphorous kumawonjezera ngozi myocardial infaration ndi chitukuko cha matenda amtima, kugwiritsa ntchito phosphorous pa dialysis kuyenera kukhala kochepa. Popeza phosphorous ndiye organic ambiri opezeka paliponse, zopangidwa kuchokera ku nyama zimayenera kukhala zokhazokha pazogulitsa nyama zomwe zimakhala ndizambiri komanso zochepa, zogulitsa zomera.

Poganizira kuti mapuloteni ndiye gwero lalikulu la phosphorous, zikuwoneka kuti ndi zofunika kuti muphatikize m'zakudya zomwe muli ndi phosphorous wambiri phula - dzira loyera, nsomba zam'nyanja, chidole cha nkhuku, ng'ombe, turlet filimu, nkhumba, cod ndi malire a zinthu monga tchizi, mkaka, granola, chinangwa, buledi wa tirigu wathunthu, nyemba, koko, chimanga, tchizi chanyumba, mtedza. Ngati ndizosatheka kusintha mtundu wa phosphorous, makonzedwe amkati a calcium omwe amakhala ndi calcium.

Zakudya za aimpso hemodialysis zimapereka kupatula kwa zinthu zingapo pazakudya. Mndandanda wazinthu zoletsedwa kugwiritsidwa ntchito pa dialysis: msuzi wokhazikika pa nyama / nsomba / bowa, nyama yamafuta ndi nyama ndi mafoni am'madzi, masamba a nyemba (kupatula mapuloteni a soya), masoseji, nyama zosuta, chiwindi, ubongo, impso, zokhazikika zamkati, zolimba / zosanjidwa tchizi, zakudya zamchere zopatsa mchere / zamasamba zomwe zimakhala ndi oxalic acid, mazira owiritsa owuma, mafuta onga nyama, margarine, chokoleti, mapichesi, apricots, mphesa, yamatcheri, nkhuyu, currants zakuda, nthochi, zipatso zouma, tsabola, sinamoni, horseradish, mpiru .

Kusiyanitsa zakudya komanso kukonza zakudya zopanda mchere, njira zosiyanasiyana zophikira zimagwiritsidwa ntchito, kuphatikizapo kukazinga ndi kuwonjezera, kuwonjezera zonunkhira, viniga wachilengedwe, citric acid, komanso kugwiritsa ntchito masuzi opangira tokha.

Kupititsa patsogolo chidwi cha kukhumudwa, mndandanda wazinthu ungathe kukulitsa kuphatikizapo zakumwa zoledzeretsa (ngati palibe zotsutsana) - vinyo wamphesa kapena theka lauma, vermouth, sherry kapena zakumwa zoledzeretsa zam'mimba, kumwa komwe (malinga ndi ethyl mowa) kwa akazi sikuyenera kupitirira 20 g / tsiku ndi 40 g / tsiku kwa amuna. Ndikofunika kuti muzitha kudya zakudya zazing'onozing'ono zazing'ono 5-6 patsiku.

Zinthu Zololedwa

Zakudya za odwala hemodialysis zimaphatikizapo kugwiritsa ntchito mkate wopanda mchere ndi soups zamasamba ndi kuwonjezera kwa masamba ndi mbewu monga chimanga, komanso msuzi kabichi, beetroot, ndi borsch. Maphunziro achiwiri, mitundu yopanda mafuta ya nyama yofiira (ng'ombe, ng'ombe), nkhuku, nkhuku, kalulu, yomwe imaphikidwa yophika, imalimbikitsa. Kuwotcha nyama koyambirira ndikofunikira, chifukwa pakuphika chakudya chochuluka m'madzi, zinthu za nayitrogeni zimachotsedwa muzinthuzo.

Pambuyo kuwira, nyamayo ikhoza kuphikanso. Kuchokera ku nsomba, nsomba zam'madzi zopanda mafuta kapena nsomba za mumtsinje (pollock, pike, hake, pike perch, cod), zomwe zimakonzedwa mwanjira yomweyo, zimalimbikitsidwa.

Kukongoletsa amaloledwa ndiwo zamasamba ndi zitsamba zakumunda (phwetekere, kaloti, katsabola, letesi, nkhaka za masamba, parsley, kolifulawa, tomato, anyezi wobiriwira, mbatata), zomwe zimaphikidwa kapena kuperewera. Mazira a nkhuku amaloledwa kuti azidyedwa mthupi la zidutswa za 2-4 pamlungu ngati mawonekedwe amamu a protein kapena owiritsa. Popanda zoletsa, amaloledwa kuphatikiza mkaka wa zakudya ndi mkaka mu 200-300 g patsiku.

Analoleza zoyera zodziphika pa kirimu wowawasa / mkaka, vinaigrette kuchokera masamba osasamba, saladi ochokera masamba / zipatso. Monga mafuta, batala wopanda mafuta, mafuta osiyanasiyana azamasamba amalimbikitsidwa. Zipatso / zipatso zimatha kudyedwa munjira zosiyanasiyana, poganizira zomwe zili potaziyamu, ngati zoletsa zake zimakhudzidwa ndi wodwalayo. Mwa zakumwa zomwe mutha kumwa kulowetsedwa kwa rosehip, tiyi wofooka ndi khofi, zipatso zatsopano zomwe amapanga.

Masamba ndi amadyera

zukini0,60,34,624 kolifulawa2,50,35,430 mbatata2,00,418,180 kaloti1,30,16,932 tomato0,60,24,220 dzungu1,30,37,728 chivwende0,60,15,825 vwende0,60,37,433 maapulo0,40,49,847 sitiroberi0,80,47,541

Mphesa ndi chimanga

bulowheat groats (kernel)12,63,362,1313 oatmeal11,97,269,3366 mpunga woyera6,70,778,9344 sago1,00,785,0350

Confectionery

kupanikizana0,30,263,0263 odzola2,70,017,979 maswiti amkaka2,74,382,3364 maswiti2,24,683,6369 pastille0,50,080,8310

Zida zoyipa ndi zokometsera

sinamoni3,93,279,8261 wokondedwa0,80,081,5329 parsley wouma22,44,421,2276 shuga0,00,099,7398 msuzi wamkaka2,07,15,284 msuzi wowawasa1,95,75,278 mbewu za caraway19,814,611,9333

Zinthu zamkaka

mkaka3,23,64,864 kefir3,42,04,751 zonona2,820,03,7205 wowawasa zonona2,820,03,2206 yogati2,92,54,153 acidophilus2,83,23,857 yogati4,32,06,260

Zinthu zopangidwa ndi nyama

nkhumba16,021,60,0259 ng'ombe yophika25,816,80,0254 lilime la ng'ombe yophika23,915,00,0231 nyama yamphongo yophika30,70,90,0131 kalulu21,08,00,0156 nkhuku yophika25,27,40,0170 nkhuku19,20,70,084 mazira a nkhuku12,710,90,7157

Zofunikira pakudya

Odwala ena, pokhala hemodialysis impso, amanyalanyaza zochizira zakudya, poganiza kuti ndi reinsurance komanso zopeka za madokotala.

Mfundo zotsatirazi zikuthandizira kuthetsa malingaliro olakwika awa:

• Zisonyezo za njirayi ndi pyeloectasia (kukulira kwa pelvis) ndi kulephera kwa aimpso. Ndi matenda awa, impso sizitha kuthana ndi ntchito zawo, zomwe zimapangitsa kuti pakhale kuchuluka kwa poizoni komanso kupha thupi. Kulephera kudya kumapangitsanso njirayi, kumayambitsa kusokonezeka kwa metabolic.
• Impso za munthu wathanzi zimagwira ntchito mosatalikirana, osangoyima kwa sekondi m'miyoyo yawo yonse, komanso zina zochita kupanga - katatu kokha pa sabata kwa maola 5. Chifukwa chake, ndikofunikira kuonetsetsa kuti timadzi tating'onoting'ono ndi zinthu zakupha sizilowa mthupi mkati mwa nthawi yapakati yoyimba.

Kuphatikiza apo, pa hemodialysis ya impso, kutayika kwa zinthu zofunika kwa thupi komanso kukula kwa kuperewera kwa thanzi (BEN) kumachitika. Zonsezi zimatha kudzetsa zovuta komanso kudya kwa anorexia.

Chifukwa chake, mankhwala othandizira pa hemodialysis amapulumutsa ku mtima, kusokonekera kwa mitsempha yokhala ndi vuto la mitsempha, kumalepheretsa kusokonezeka kwa mphaka wam'matumbo komanso kukula kwa uricemia.

Chakudya chama impso chamadongosolo chimadalira tebulo la zamankhwala No. 7 ndi mitundu yake. Kuphatikiza pa mfundo zachakudya, zakudya zimasankhidwa kwa wodwala aliyense, zomwe zimatengera mawonekedwe a kagayidwe, kulemera ndi zovuta zokhudzana ndi matendawa.

Zinthu Zoletsedwa Komanso Zoletsedwa

Zinthu zambiri sizimachotsedwa pakudya pa hemodialysis. Choyambirira, izi ndi mbale zilizonse zokazinga, zamchere ndi zososedwa. Sizoletsedwa kudya nyama zokhazikika, msuzi ndi msuzi wa nsomba, masoseji, zinthu zosiyanasiyana zomalizidwa ndi zakudya zomwe zimapezeka pompopompo. Zonsezi zimakhala ndi mitundu yayikulu yosungirako komanso zowonjezera zonunkhira zomwe zimayambitsa ludzu kwambiri ndikupweteka thupi.

Zinthu zina zoletsedwa za hemodialysis:

• nyemba
• sauerkraut,
• anyezi wobiriwira komanso watsopano,
• ankasuta nyama
• radish, turnip, radish, tomato, horseradish, udzu winawake, adyo, sorelo, sipinachi, rhubarb,
• yamapichesi, yamatcheri, timadzi tokoma, nthochi, ma apricots,
• bowa
• mapira, barele, ngale, semolina,
• pasitala
• zokometsera zokometsera ndi zonunkhira,
• chokoleti
• nyama ndi mafuta ophikira, mafuta,
• mowa
• khofi wakuda ndi tiyi, msuzi wa phwetekere.

Ino si mndandanda wathunthu wa zoletsa. Ndizosatheka kutchula onsewo. Chachikulu ndichakuti wodwalayo ayenera kumvetsetsa mfundo za chakudya - zakudya zomwe zingayambitse ludzu ndizoletsedwa.

Zakudya zomwe zimakhala ndi potaziyamu yambiri ndi phosphorous zimadyedwa zochepa. Izi zimaphatikizapo njere ndi mtedza, zipatso zouma, masamba ndi zipatso zamasamba, chinangwa, chokoleti, mazira, tchizi chanyumba ndi madzi a sodium.

Kuchepa kwa impso mu shuga

Chiwalo chophatikizidwa chimakhala ndi "glomeruli" yopitilira 100,000 - zosefera zapadera zomwe zimatulutsa magazi kuchokera ku zinthu za metabolic ndi poizoni zosiyanasiyana.

Magazi akamadutsa m'mitsempha yaying'ono ya zoseferaizi, zinthu zovulaza zimatumizidwa kuchokera ku impso kupita ku chikhodzodzo, ndipo timadziti ndi zofunikira zimabwezeretsanso kuthambo. Kenako, mothandizidwa ndi urethra, zinyalala zonse zimachotsedwa m'thupi.

Popeza matenda ashuga amadziwika ndi kuchuluka kwa glucose, katundu pazolo lolocha limakulitsidwa kwambiri. Kuti muchotse shuga owonjezera m'thupi, impso zimafunikira madzi ambiri, chifukwa, kukakamira kulikonse kumawonjezeka.

Njira zoterezi pakapita nthawi zimayambitsa kuchepa kwa kuchuluka kwa mafayilo omwe amagwira ntchito, omwe mwachindunji amakhala ndi vuto pakudziyeretsa magazi.

Ndi nthawi yayitali ya "matenda okoma", impso zimatha kotero kuti kulephera kwa impso kumayamba. Zofunikira zake ndi:

• kupweteka mutu komanso kutopa
• kutsegula m'mimba ndi kusanza.
• kupuma pang'ono ngakhale zolimbitsa thupi pang'ono,
• Khungu
• kulawa kwazitsulo
• kukokana ndi malo otsika a m'munsi, kuyipa kwambiri usiku,
• mpweya wabwino
• kukomoka komanso kukomoka.

Vutoli limayamba pambuyo pa zaka 15 mpaka 20 zosathandiza odwala matenda ashuga. Kuti awone momwe impso zimagwirira ntchito, dokotala atha kuwongolera mkodzo kapena kuyesa magazi kwa creatinine kapena kuyesa kwamkodzo kwa albumin kapena microalbumin.

Potsimikizira za matendawa, dokotalayo angakupatseni njira yoyeretsera magazi. Akatswiri ambiri amavomereza kuti hemodialysis ya matenda ashuga imafunikira chithandizo chapadera. Chifukwa chake, odwala ayenera kusinthana ndi regimen yapadera ya mankhwala a insulini - jakisoni ndi ma insulin a anthu. Chofunika cha mankhwalawa ndikuletsa jakisoni wa mahomoni nthawi yayitali m'mawa.

Kuphatikiza apo, tisaiwale za kuyang'anira glycemia pafupipafupi kuti tipewe zovuta zina.

Zovomerezeka ndi Zovomerezeka

Izi sizikutanthauza kuti kudya kwa odwala omwe ali ndi hemodialysis kwa impso ndi kodetsa ndipo kumapangitsa munthu kuti akhale ndi moyo wopanda moyo. Pali mbale zambiri zomwe zimaloledwa kudya nthawi ya mankhwala. Kuphatikiza apo, chakudyacho chimakupatsani mwayi kuti mumwe zakumwa 2040 g zouma zouma kapena zouma pang'ono patsiku kuti mukhale ndi chidwi chokwanira chokwanira komanso muzitha kupeza mphamvu.

Mndandanda wazinthu zomwe zimaloledwa ku hemodialysis ya impso:

• masamba (dzungu, nkhaka, kaloti, mbatata, kabichi, zukini),
• maapulo, chivwende, vwende,
• mpunga woyera, buckwheat, oatmeal, sago,
• maswiti, kupanikizana, uchi, pastille, marshmallows, shuga,
• kefir, yogurt, kirimu wowawasa, kirimu, yogurt,
• nyama yokonda, nkhuku, kalulu, nkhuku,
• ng'ombe ndi masamba,
• tiyi wokhala ndi mkaka.

Poyamba, tikulimbikitsidwa kuti tizigwiritsa ntchito supu zamasamba ndi chimanga, msuzi wa kabichi, borsch, beetroot. Chakudya chachiwiri chimakhala ndi nyama yophika kapena nsomba yokhala ndi mbale yam'mbali. Mazira amaloledwa kuti azidyedwa mwa mawonekedwe a omelet, osapitirira zidutswa 4 pa sabata. Ngati lactose yolekeredwa bwino, 200- 300 g yophika mkaka wonse patsiku iyenera kuphatikizidwa ndi zakudya.

Zosankha zamasabata

Kwa odwala omwe akudwala hemodialysis, kudya zakudya kwambiri ndikofunikira. Chifukwa chake, ndizofunikira kwambiri kuti sizimayambitsa kunyansidwa, ndipo chakudya chake ndi chabwino komanso chokwanira. Zakudya zosiyanasiyana komanso kugwiritsa ntchito zitsamba zonunkhira, msuzi wololedwa ndi chinangwa zimakuthandizani kuti muzolowere zakudya zopanda mchere.

Otsatirawa ndi mawonekedwe mndandanda wamasabata, womwe ungatengedwe ngati maziko pokonza zakudya.

Lolemba:

Chakudya cham'mawa	Omelet, masamba saladi, odzola oatmeal
Zakudya	Squirrel anaphika apulo
Chakudya chamadzulo	Msuzi wa kabichi wamasamba, nkhuku yophika, mbatata yofewa wowawasa zonona, chakumwa cha zipatso
Tiyi yapamwamba	Mabisiketi, kulowetsedwa kwa rosehip
Chakudya chamadzulo	Kabichi zrazy ndi minced nyama ndi anyezi, tiyi mkaka
Asanagone	Galasi la kefir
Tsiku lonse	Mkate wopanda mchere - 200 g, shuga - 50 g, kupanikizana kapena uchi - 40 g, batala la ng'ombe -20 g.

Lachiwiri:

Chakudya cham'mawa	Karoti casserole ndi maapulo, zikondamoyo, msuzi
Zakudya	Zipatso ndi mabulosi saladi
Chakudya chamadzulo	Msuzi wa mpunga ndi masamba, nsomba yophika, mbatata yosenda, zakudya
Tiyi yapamwamba	Batala bun, rosehip kulowetsedwa
Chakudya chamadzulo	Chipatso cha Pilaf, 100 ml wowawasa kirimu tiyi wokhala ndi mkaka
Asanagone	Galasi la yogati
Tsiku lonse	Monga pa monday

Lachitatu:

Chakudya cham'mawa	Grated karoti saladi ndi shuga, zikondamoyo, msuzi
Zakudya	Zipatso
Chakudya chamadzulo	Masamba borsch ndi wowawasa kirimu wowuma, Buckwheat, zakudya
Tiyi yapamwamba	Cupcake, rosehip msuzi
Chakudya chamadzulo	Zodulidwa kabichi, Zakudyazi ndi kanyumba tchizi, tiyi
Asanagone	Kapu ya yogati
Tsiku lonse	Monga pa monday

Lachinayi:

Chakudya cham'mawa	Souffle kuchokera mpunga, coleslaw, oatmeal odzola
Zakudya	Zipatso
Chakudya chamadzulo	Msuzi-puree kuchokera kumasamba ophatikizidwa kale, nyama yophika ndi mbatata, compote
Tiyi yapamwamba	Kabichi chitumbuwa, rosehip msuzi
Chakudya chamadzulo	Tsabola wopaka wowawasa zonona, tchizi chatsopano
Asanagone	Galasi la kefir
Tsiku lonse	Monga pa monday

Lachisanu:

Chakudya cham'mawa	Omelet, vinaigrette, odzola oatmeal
Zakudya	Saladi wazipatso
Chakudya chamadzulo	Msuzi wa noodle wamkaka, nkhuku yokoma, mpunga, zipatso zotere
Tiyi yapamwamba	Carrot cutlets, rosehip kulowetsedwa
Chakudya chamadzulo	Mbatata casserole ndi nyama, kirimu wowawasa, tiyi
Asanagone	Galasi la yogati
Tsiku lonse	Monga pa monday

Loweruka:

Chakudya cham'mawa	Zipatso za pilaf, zikondamoyo, msuzi
Zakudya	Kissel oat
Chakudya chamadzulo	Msuzi wa Buckwheat ndi msuzi wa masamba, nsomba yophika, mbatata yosenda, compote
Tiyi yapamwamba	Kanyumba tchizi Steam Pudding
Chakudya chamadzulo	Zakudya za masamba ndi nkhuku, tiyi ndi mkaka
Asanagone	Galasi lamkaka ophika mkaka
Tsiku lonse	Monga pa monday

Lamlungu:

Chakudya cham'mawa	Saladi wa zipatso ndi kirimu wowawasa, tchizi chachi Dutch, odzola oatmeal
Zakudya	Coleslaw
Chakudya chamadzulo	Kutupa msuzi, pilaf ndi nkhuku, compote
Tiyi yapamwamba	Mbatata zrazy, rosehip kulowetsedwa
Chakudya chamadzulo	Zucchini chokhazikika, chitumbuwa cha apulosi, tiyi
Asanagone	Galasi la kefir
Tsiku lonse	Monga pa monday

Zakudya pamwambapa siziri zomaliza. Mitengo ya mbale imatha kusinthidwa mwakufuna kwanu, osachokapo mndandanda wazomwe zololedwa ndi zoletsedwa.

Zofunikira pakudya ndi hemodialysis wa impso zimatha kukhala zosiyana kwambiri. Nthawi zambiri, posankha zakudya zoyenera, ndikofunikira kuti azitsogozedwa osavomerezeka ndi kusintha kwa wodwalayo, kulemera kwake komanso msinkhu wake, kuthamanga kwa magazi, komanso kuchuluka kwa mapuloteni mumkodzo. Chifukwa chake, ndikofunikira kuti wodwala azidyetsa zakudya kuti azisungira bukuli, pomwe tsiku lililonse amalemba zakudya zomwe amadya ndikuwona momwe thanzi liliri.

Zakudya zoyenera panthawi ya dialysis ya impso

Maziko a chakudya choyenera pakulephera kwa impso ndi njira yapadera. Zakudya za impso dialysis zimapangidwa poganizira kuchuluka kwa kagayidwe kachakudya ka wodwalayo komanso pafupipafupi kuyeretsa magazi. Chowonadi ndi chakuti chifukwa cha peritoneal process kapena hemodialysis, osati poizoni amachotsedwa m'thupi, komanso zinthu zofunikira: amino acid, mavitamini.

Mndandanda wa mankhwala mankhwala kwa odwala pa dialysis

Pali miyeso yovomerezeka yamakalori yomwe imatsimikizira kulandila kwakanthawi kofunikira pa zinthu zofunika (35-40 kcal pa kilogalamu ya kulemera kwa wodwala, ndi mode kunama - 30).

Zakudya za dialysis zimadziwika ndi miyambo ina ya kapangidwe kazomwe amapangira chakudya, zomwe zalembedwa patebulopo.

Zinthu za chakudya	Mlingo wa Tsiku ndi Tsiku (magalamu)	Zogwiritsa
Agologolo	60	Zambiri sizoyambira nyama.
Mafuta	100	25-30% ndizomera zachilengedwe.
Zakudya zomanga thupi	350	Opitilira theka - zotsekemera (osati ufa) chakudya ndi uchi.
Tsatani zinthu (K, Na, Ca)	2,4	Kukweza mulingo woyenera sikulimbikitsidwa.
Mafuta	1000	Kugwiririra ntchito koletsedwa.
Mchere	4-5	Ndikofunika kuti musagwiritse ntchito konse, popeza NaCl imadzetsa ludzu.

Malangizo pazakudya zopatsa thanzi komanso zakudya za hemodialysis

Kulephera kwa impso kumapangitsa hemodialysis.Njirayi ndizovuta kuchita ndipo imachitika mu dipatimenti yapadera ya chipatala. Zakudya za hemodialysis zimapangidwa kuti muchepetse nkhawa pa impso, potero kusintha zotsatira za chithandizo.

Zakudya ndi malamulo ophika

Madokotala amalimbikitsa kudya pafupipafupi zakudya zamagulu panthawi ya dialysis (5-6 zakudya patsiku). Njira yolinganiza kudya kwakanthawi kumachepetsa katundu pazakudya ndi njira yowonekera. Kuphika - kusalira, ndi kuteteza kwakukulu kwa michere. Kuti mupeze kuchuluka kwa chakudya, muyenera chofunikira kwambiri kukhitchini. Wophatikizira wotereyu amakupatsani mwayi kuti muwone bwino kulemera kwa ntchito imodzi. Kuti mumve zambiri pazomwe zimapangidwira, pali pulogalamu yapadera yomwe imayikidwa pafoni. Mochulukitsa, kuchuluka kwa mapuloteni, mafuta, ndi chakudya chamagulu mu chakudya kumapezeka pa intaneti.

Mawonekedwe Amphamvu

Chifukwa cha matenda oopsa a impso, zakudya zama protein ochepa zimalimbikitsidwa, popeza mapuloteniwo amayamba kusungidwa bwino mu creatinine, ammonia, bilirubin, ndi urea.

Koma ngati hemodialysis imaperekedwa kwa wodwala, puloteniyo amawola mwachangu, ndiye momwemonso zakudya muzochita zosiyanasiyana. Zakudya zamankhwala pa hemodialysis zidapangidwa zaka zopitilira 30 zapitazo, koma sizinatayike.

Ndi gawo lofunikira la mankhwalawa kwa anthu omwe ali ndi vuto loti aimpso amalephera.

Chakudya chiyenera kukhala choyenera. Imapangidwa ndi katswiri payekhapayekha, poganizira momwe matendawo amayendera, pafupipafupi komanso “zokumana nazo” zam'mimba, komanso zolozera zamankhwala a impso. Zinthu zambiri zomwe hemodialysis zimachotsa zimalowa m'thupi ndi chakudya. Ntchito yayikulu ndikukhathamiritsa magwiridwe antchito ndikuwonetsetsa kuti ntchito zonse za thupi zili pamlingo woyenera.

Zakudya zoyenera kudya

Mndandanda wazakudya zopangidwa ndi hemodialization ya impso ndizosiyanasiyana. Kupanga menyu yoyenera ndikotheka kwa wodwala aliyense. Timapereka mndandanda wazakudya panthawi yomwe dialysis:

• Zogulitsa zam'madzi zimatha kudyedwa, koma zochepa (mpaka 170 g patsiku). Amaloledwa kuphatikiza mkate wa rye muzakudya. Akatswiri amalimbikitsa kuti apange zinthu zophikidwa panyumba ndi mchere wochepa kwambiri.
• Masamba omasamba ndi ma broth. Zomwe zimachitika tsiku lililonse sizoposa 250 magalamu.
• Zakudya zamafuta ndi nsomba (mitundu yopendekera, 100 g kwa maola 24). Nkhuku, ng'ombe, kalulu - amazisenda kapena kuwiritsa. Ndiye mutha kupepuka mwachangu mu mafuta a masamba. Nsomba ziyenera kusankhidwa ndi mafuta otsika kwambiri: pollock, perch, and whiting whiting.
• Zogulitsa zamkaka zimakhala ndi zoletsa zowonjezereka: 150 g patsiku - pazokwanira mkaka, womwe umawonjezeredwa ndi mbale zopangidwa ndi okonzeka, 140 g - kirimu wowawasa, tchizi tchizi - 30 g.
• 200 magalamu ndiye kuchuluka kwa phala. Ndikwabwino kutengera zokonda za mpunga ndi sago. Mbale sizingaphatikizidwe ndi mbale za nyama.
• Zipatso ndi zipatso zimatha kudyedwa mwanjira iliyonse, kupatula mitundu yoletsedwa, yomwe tikukambirana pansipa.
• Masamba amasankhidwa pokonza menyu ndi asing'anga, potengera nambala yolola ya zinthu. Nthawi zambiri mumatha kudya: mbatata (250 g), nkhaka, tomato. Zothandiza kwambiri: saladi, mitundu yonse ya kabichi, amadyera, kaloti.
• Maswiti: mousse, zakudya, shuga, uchi. (Odwala matenda ashuga sawerengera).
• Suzi, zovala za saladi zakonzedwa pamaziko a kirimu wowawasa, batala, tomato. Kuchokera pa zonunkhira amaloledwa kuwonjezera citric acid ndi vanila.
• Zakumwa: tiyi wakuda ndi mankhwala azitsamba, khofi wofooka, misuzi yosiyanasiyana.
• Mafuta: mafuta a masamba (60 g), batala (30 g).

Mfundo zachikhalidwe

Lamulo lofunikira lazakudya ndikugwiritsa ntchito mapuloteni okwanira.

Ngati anthu omwe ali ndi vuto la impso amakhala ndi mapuloteni ochepa kwambiri asanakhale hemodialysis, ndiye kuti munthawi yomwe akufunika amapeza zofunika kudya kuposa munthu wathanzi.

Pa dialysis, odwala amataya ma amino acid onse, ndipo ayenera kuyambiranso. Puloteni ambiri pafupifupi 1,2 g / kg thupi patsiku.

Mafuta ndi zakudya zamafuta zimadyedwanso pamlingo woyenera, pokhapokha, wodwalayo ayenera kuchepetsa thupi, kapena alibe matenda ashuga. Mfundo zina zofunika zaumoyo:

1. Potaziyamu poletsa. Asanafike dialysis mwa munthu wolephera aimpso, vuto lomwe lingakhale lowopsa, hyperkalemia, n`zotheka. Mukamaliza njira, kuchuluka kwa potaziyamu kumachepa, koma pakati pa magawo kusanthula kumawonetseranso chowonjezera. Chifukwa chake, zinthu zomwe zimakhala ndi chinthu ziyenera kukhala zochepa chabe (zipatso zina, zipatso zouma).
2. Kuwongolera phosphorous ndi calcium metabolism. Anthu ambiri pa hemodialysis amakumana ndi mafupa, ntchito ya parathyroid imalephera. Ndikulimbikitsidwa kuti muthe kukonzekera calcium ndi vitamini D3, komanso kuchepetsa zakudya zomwe zimakhala ndi phosphorous - mankhwala a mkaka, nyemba, mkate, chimanga.
3. Matenda a mtundu wa zotayidwa. Izi zimapweteketsa impso, zomwe zimayambitsa zovuta zingapo kuchokera m'mafupa, zamanjenje, komanso m'mafupa. Odwala sayenera kupatula kuphika mu zotayira za aluminium, komanso osadya zakudya zomwe zili ndi pistachios, nandolo, kiwi).
4. Ulamuliro wapadera wamadzi. Excretion wa mkodzo mu dialysis odwala ndi mkhutu, chifukwa aimpso kulephera. Kuchepetsa kudya kwamadzi ndikofunikira, makamaka ngati pali matenda oopsa kapena mtima. Pali lamulo: kuyambira gawo limodzi, kumwa madzi osaposa 4% ya kulemera kwa thupi.
5. Chosiyana ndi zakudya zamchere. Tchipisi tonse, ma boti, nsomba zamchere ndi zinthu zina zimatunga madzi ndipo sitiyenera kuzisankha.

Katundu Woletsedwa

Dongosolo lazakudya la hemodialysis limaletsa kugwiritsa ntchito zinthu zina menyu. Mwachitsanzo, zomwe zimakhala ndi potaziyamu, phosphorous. Zinthu izi sizifufuzidwa bwino ndi impso. Mlingo wokwera wa K ukhoza kukhala wakupha. Ndi kulephera kwa aimpso, pali zinthu zingapo zomwe siziyenera kudyedwa:

• nyama sopo ndi decoctions,
• soseji, masoseji, nyama zosuta, nsomba zamchere,
• tchizi (ili ndi mchere wambiri ndi mapuloteni),
• zipatso: mphesa, ma apulo, nthochi ndi mapichesi,
• zipatso: ma cherries, currants,
• masamba: nyemba, zopakidwa, sipinachi, bowa,
• mchere: chokoleti, zipatso zouma, muffin wokoma,
• cocoa
• nyama zamafuta (mafuta).

Oxalic acid ndi chinthu chosasangalatsa mu mbale ya hemodialysis wodwala. Kuti abwezeretse zinthu zomwe zikusowapo, dokotala atha kukulemberani mankhwala apadera. Mankhwala osavomerezeka ndi osayenera kwambiri.

Kumwa Mgwirizano

Impso zakhudzidwa sizingatheke kuthiramo kuchuluka kwamadzi, motero odwala omwe ali ndi dialysis amawunika kuchuluka kwake. Madzi akumwa, komanso msuzi, zakumwa zololedwa siziyenera kupitirira 1 lita imodzi. Akatswiri amalimbikitsa kuthetsa ludzu ndi madzi oyera.

Maphikidwe azakudya zabwino komanso zathanzi panthawi ya dialysis

Kwa anthu ambiri, menyu wazakudya amatanthauza kudya zakudya zatsopano, zopanda pake (koma zopatsa thanzi). Uku ndi malingaliro olakwika.

Tikukufotokozerani zitsanzo zitatu zapamwamba za maphikidwe kuchokera ku malingaliro pamisonkhano yamitu:

• "Buckwheat mumayendedwe amalonda." Nkhuku yophika, mwachangu mwachangu mu masamba a masamba mpaka utakhazikika. Ndiye muzitsuka grits, calcine mu poto. Kenako, muyenera kudya mbale zokhala ndi makoma obowola (makamaka kolifulawa), ikani zosakaniza zonse, kuthira madzi ndi simmer. Mutha kuwonjezera tomato wosankhidwa, kapena kirimu wowawasa.
• "Idyani mkate mu uvuni." Flour (1 chikho) amasakanikirana ndi zonunkhira (zokometsera zokha zomwe dokotala amagwiritsa ntchito). Turmeric, chitowe, basil, coriander ndi zonunkhira zina ziyenera kutsanulidwa kuti zilawe komanso popanda kuwononga thanzi. Sungitsani dzira muzosakaniza ndi kuwonjezera mafuta pang'ono masamba. Sakanizani zonse bwino. Kuchokera pa mtanda timaphika makeke ndi kuphika kwa theka la ola.
• Saladi "Hrum-hrum". Kaloti ndi zigoli zazitali zimadulidwa mzere. Adyo wophwanyika amawonjezeredwa ndikumapanikizidwa pang'ono ndi Press.Mbatata zimadulidwa chimodzimodzi monga masamba ena, kenako ndikutsukidwa m'madzi ambiri (2 maola). Pambuyo akuwuka kwa nthawi yayitali, muzu wa mbeu uyenera kukazunguliridwa mpaka golide wa bulauni. Kusakaniza konse kumawonjezera dontho la mchere ndi mayonesi.

Maphikidwe oterewa sangasiye aliyense wopanda chidwi. Zakudya zomwe zalembedwera zimatha kuperekedwa kwa alendo, sitingayerekeze kuti adathandizidwa ndi "zokhwasula-khwasula" zapadera.

Zosankha zingapo zamasiku onse

Kupanga zakudya zapadera ndi bizinesi yabwino. Pali zitsanzo zakonzedwa zopangidwa ndimankhwala a dialysis zakudya. Timapereka mndandanda wamatchuthi otchuka kwambiri tsiku lililonse la sabata:

kadzutsa	chosakasa	nkhomaliro	tiyi wamadzulo	chakudya chamadzulo
1. Phala la mpunga ndi mkaka (50 g), tiyi wakuda, wopanda mphamvu (200 g).	1. Zipatso zamalonda ndi kirimu wowawasa (150 g).	1. Msuzi wamasamba (250 g), buledi wowiritsa (50 g), mkate wa rye (150 g), saladi wamasamba (160 g).	1. Zipatso zonona (100 g).	1. Mbatata zophika (zotentha), 250 g, bere la nkhuku yophika ndi msuzi wowawasa wowawasa (75 g), saladi watsopano wamasamba (150 g), mankhwala a zitsamba (200 g).
2. Lilime la ng'ombe (100 g), vinaigrette ndi mafuta a masamba (150 g), khofi wofooka (200 g).	2. Mtundu wowotcha (100 g).	2. Msuzi wa Beetroot ndi kirimu wowawasa (125 g), nyama stroganoff ku nyama yophika (55/100 g), mbatata zosenda (180 g), chitumbuwa cha cherry (150 g).	2. Msuzi wa duwa lakutchire (100 g).	2. Yophika kabichi schnitzel (200 g), Zakudyazi ndi tchizi tchizi (1 2 servings a b / s 110 g), Zakumwa za Cranberry (150 g).
3. Mapulogalamu obwera kwa protein (110 g), masamba abwino, (170 g) - tiyi (200 g).	3. Madzi a Plum (200 g).	3. Msuzi wa barele wa Pearl ndi masamba (250 g), nyama chakudya (55/260 g), msuzi wa zipatso (chilichonse, 200 g).	3. Malalanje.	3. Zojambula zophika (200 g), apayi mkate (150 g), odzola (150 g).

Kupewetsa matenda kumimba

Kuti thupi lisapereke "zolephera" zazikulu, kuyezetsa kuchipatala sikuyenera kunyalanyazidwa. Impso zanu zimakusangalatsani ndi thanzi labwino, ngati mumatsatira malamulo osavuta:

• Mphamvu yamphamvu. Mapuloteni, zakudya zamafuta ziyenera kuchepetsedwa.
• Kukana mchere ndi mowa.
• Zakumwa zoledzera: 30-40 ml / kg pa kulemera. (Chizolowezi ndi cha munthu wamkulu wathanzi, kwa mwana ziwerengero ndizosiyana pang'ono).
• Thanzi labwino (pewani kudzimbidwa).
• Kutentha moyenera komanso kulimbitsa chitetezo chokwanira. (Tetezani ku hypothermia).

Yothandiza kwambiri yoga, kuvina kummawa. Koma kuchita masewera olimbitsa thupi kwambiri kumatha kuvulaza.

Pomaliza

"Impso za impso, zoperewera ndi miyala" - imayimbidwa mu nyimbo imodzi yoseketsa. Inde, ndipamene matenda oopsa amachitika, munthu sakhala nthabwala. Chifukwa chake, thanzi liyenera kutetezedwa "kwa achichepere." Kwa iwo omwe ali kale ndi matenda a ziwalo zophatikizika, ndikofunikira kutsatira malangizo a dokotala komanso zakudya zapadera.

Mafuta ndi Mafuta

batala la amphaka opanda nkhawa1,072,51,4662 mafuta a chimanga0,099,90,0899 mafuta a azitona0,099,80,0898 mafuta a mpendadzuwa0,099,90,0899 ghee0,299,00,0892

Chinsinsi cha njira ya hemodialysis

Hemodialysis ndi njira yowonjezera yoyeretsera magazi.

Chipangizo chapadera chimasefa magazi a wodwalayo kudzera mu umwini, ndikuyeretsa poizoni ndi madzi osiyanasiyana. Chifukwa chake, zida zamtunduwu nthawi zambiri zimatchedwa "impso yokumba."

Mfundo zoyendetsera chipangizochi ndi motere. Magazi ochokera mu mtsempha amalowa mkati mwake, ndipo machitidwe oyeretsa ake amayamba.

Kumbali imodzi ya nembanemba yapadera, magazi amayenda, ndipo mbali inayo, dialysate (yankho). Muli zinthu zomwe zimakopa madzi ochulukirapo komanso mitundu yambiri ya poizoni. Kuphatikizika kwake kumasankhidwa kwa wodwala aliyense payekhapayekha.

"Impso yokumba" ili ndi zinthu zotsatirazi:

1. Amachotsa zinthu zowola. Tiyenera kudziwa kuti m'magazi a munthu wodwala matenda ashuga omwe amalephera kupweteka kwa impso, kuchuluka kwambiri kwa poizoni, mapuloteni, urea ndi zinthu zina kumawonedwa. Komabe, palibe zinthu zotere mu dialysate. Malinga ndi malamulo a mayamwidwe, zonse zomwe zimachokera ku zakumwa zomwe zili ndizambiri zimasunthira zakumwa zomwe zimakhala ndizochepa.
2. Amachotsa madzi owonjezera. Izi zimachitika ndi ultrafiltration. Chifukwa cha pampu, magaziwo amadutsa mu fyuluta mutapanikizika, ndipo mu chubu chomwe muli dialysate, kukakamiza kumakhala kotsika. Popeza kusiyana kwa kukakamira kumakhala kwakukulu kwambiri, madzi owonjezera amadutsa mu dialysis solution.Njirayi imalepheretsa kutukusira kwa mapapu, ubongo ndi mafupa, komanso imachotsa madzimadzi omwe amasonkhana mozungulira mtima.
3. Matendawa pH. Kuti kukhazikika kwa acid-base usawa, gawo lapadera la sodium bicarbonate lilipo mu dialysis solution. Imalowa mu plasma, kenako m'magazi ofiira, ndikupangitsa magaziwo kukhala ndi besi.
4. Amasinthasintha misinkhu yama electrolyte. Pofuna kuti asachotse magazi pazinthu zofunikira monga Mg, K, Na ndi Cl, zimapezeka zofanana mgulu la dialysate. Chifukwa chake, zochulukirapo zamagetsi zimadutsa mu yankho, ndipo zomwe zili mkati mwake zimakhazikitsidwa.
5. Zimalepheretsa kukula kwa embolism ya mpweya. Kuchita izi kumayesedwa ndi kukhalapo kwa "msampha wamlengalenga" pa chubu, yomwe imabwezeretsa magazi m'mitsempha. Ndi kudutsa kwa magazi, kupanikizika koipa kumapangidwa (kuchokera 500 mpaka 600 mm Hg). Chipangizocho chimatenga thovu ndipo chimawalepheretsa kulowa m'magazi.

Kuphatikiza apo, kugwiritsa ntchito impso yochita kupanga kumalepheretsa mapangidwe magazi.

Chifukwa cha heparin, chomwe chimayendetsedwa pogwiritsa ntchito pampu, kuphatikizika kwa magazi sikuchitika.

Hemodialysis: Zizindikiro ndi ma contraindication

Ndondomeko ikuchitika katatu mu masiku 7.

Pambuyo pakuchitika hemodialysis, kuchuluka kwa kusefera kwa magazi, kapena m'malo mwake, kutsitsa ndende ya urea, kutsimikiza.

Mchitidwewo ukachitika katatu pa sabata, ndiye kuti chizindikirochi chikuyenera kukhala 65%. Ngati hemodialysis ikuchitika kawiri pa sabata, ndiye kuti kuchuluka kwa kuyeretsa kumayenera kukhala pafupifupi 90%.

Mankhwala a hematodialysis ayenera kuchitika pokhapokha atazindikira dokotala komanso mgwirizano wa dokotala. Njira yoyeretsera magazi imafotokozedwa motere:

• pachimake aimpso kulephera chifukwa pachimake glomerulonephritis, pyelonephritis ndi kutsekeka kwa kwamikodzo thirakiti,
• kulephera kwa aimpso,
• ndi poyizoni wa mankhwala osokoneza bongo (maantibayotiki, sulfonamides, mapiritsi ogona, sedative, ndi ena),
• ndi kuledzera ndi ziphe (toadstool or arsenic),
• kuledzera ndi methyl mowa kapena ethylene glycol muli mowa,
• ndi Hyperhydrate (madzi ochulukirapo m'thupi),
• ndi kuledzera ndi mankhwala osokoneza bongo a morcine kapena heroin,
• vuto la kukanika mu electrolyte okhutira chifukwa cha kutsekeka kwamatumbo, cystic fibrosis, kuchepa madzi m'thupi, kutentha, Peritonitis kapena kutentha kwamphamvu kwa thupi.

Komabe, kugwiritsa ntchito "impso yakupanga" ngakhale mutakhala ndi imodzi mwazomwezi sikufunika. Munthu wodwala matenda ashuga kapena wodwala yemwe ali ndi shuga wokwanira amakhala ndi hemodialysis ngati:

Kwa magulu ena a odwala, hemodialysis ikhoza kukhala yotsutsana. Siloledwa kugwiritsa ntchito chipangizo chosulira magazi pazinthu zotsatirazi:

• mukakhala ndi matenda
• ndi chitukuko cha malingaliro a m'matumbo amtundu (schizophrenia, psychosis kapena khunyu),
• ndi kuchuluka kwamphamvu kwa kuthamanga kwa magazi,
• pambuyo stroko kapena myocardial infaration,
• Ndi zotupa zoyipa,
• ndi kulephera kwa mtima
• ndi chifuwa chachikulu komanso shuga,
• ndi magazi am'magazi (leukemia ndi aplastic anemia),

Kuphatikiza apo, hemodialysis sikugwiritsidwa ntchito pazaka zopitilira 80.

Zakudya nambala 7 za hemodialysis

Zakudya zotere za anthu odwala matenda ashuga omwe amadalira insulin amagwiritsidwa ntchito hemodialysis kuti azitha kudya zakudya zabwino komanso kupewa kutulutsa zotsatira zoyipa chifukwa cha kusefera kwa magazi.

Nthawi zambiri, chakudya 7 chimatchedwa "aimpso."

Chofunikira chake ndikuchepetsa kudya kwa potaziyamu tsiku ndi tsiku, ndi madzi.

Pali mitundu ingapo ya zakudya, koma onse sapatula kugwiritsa ntchito zakudya, kuphatikizapo potaziyamu, ndi mbale zomwe zimakhala ndi mchere wambiri. Komabe, zonunkhira zina ndi msuzi zimaloledwa kulipirira kuchepa kwa mchere.

Malinga ndi chakudya No. 7, zakudya ndi mbale zotsatirazi ndizololedwa:

• supu zamasamba ndi masamba ndi mbatata, katsabola, parsley, batala, anyezi (owiritsa kapena stewed),
• buledi, zikondamoyo ndi zikondamoyo zopanda mchere,
• ng'ombe yokhala ndi mafuta ochepa, nkhumba yosenda, nkhumba, kalulu, nkhuku, (ingaphike kapena kuwiritsa),
• nsomba yokhala ndi mafuta ochepa, ndiye kuti mutha kuwaza kapena kuphika,
• vinaigrette yopanda mchere, saladi ochokera ku zipatso zatsopano ndi ndiwo zamasamba,
• saus ndi zonunkhira - phwetekere, mkaka, zipatso ndi msuzi wamasamba, sinamoni, viniga,
• mazira otentha owiritsa kawiri patsiku, ma mawonekedwe a omeleta, yolks popanga mbale,
• zipatso zosaphatikizika monga pichesi, lalanje, ndimu, maapulo wobiriwira,
• chimanga - barele, chimanga,
• mkaka, kirimu, kirimu wowawasa, tchizi tchizi, mbale zokhotakhota, mkaka wowotchera, kefir ndi yogati,
• tiyi wopanda shuga, timadziti tosatulutsa, mankhwala opaka m'chiuno,
• mafuta a masamba.

Kuphatikiza pa kuwonera zakudya zapadera, ndikofunikira kuti musinthe ntchito ndi kupumula kwabwino. Kupsinjika m'maganizo kumathandizanso kwambiri pakugwira ntchito ya impso ndi shuga m'magazi.

Pakudya, odwala ayenera kutsatira malingaliro onse a dokotala kuti apewe zovuta zingapo. Pankhaniyi, kudzipereka pakokha ndi koletsedwa, chifukwa wodwalayo amangodzivulaza.

Kanemayo munkhaniyi akufotokoza ntchito ya impso mu matenda ashuga.

Zakudya

Kwa odwala, kudya No. 7g ndi kuwongolera kwamunthu kumakhala koyenera. Amadziwika ndi kudya mapuloteni okwanira, kuletsa kwa potaziyamu, sodium chloride, ndi kuchepa kwa madzi. Ma acino ofunikira amalowa m'thupi ndi nyama, mazira, ocheperako ndi nsomba. Zakudya zamkaka zimadyedwa pang'ono.

Zakudya za wodwalayo zizikhala pa kutentha wamba. Zakudya - 5 pa tsiku. Kapangidwe kazakudya kameneka ndizotsatira (ziwerengero zimaperekedwa):

• mapuloteni - 60 g, omwe 70% ndi mapuloteni a nyama,
• mafuta - 100 g, pomwe 30% ndi masamba,
• chakudya - 450 g
• potaziyamu - zosakwana 2,5 g
• madzi - mpaka malita 0,8,
• zopatsa mphamvu - 2900 kcal,
• mchere - 2-6 g (malingana ndi kuopsa kwa matendawa).

Zakololedwa ndi zoletsedwa

Gwiritsani ntchito ziyenera kukhala zinthu ngati izi:

1. Nyama, nsomba. Ng'ombe zokonda, kalulu, nkhuku, nkhuku, kuchokera ku nsomba zamakola - nsomba zamkati, pinki. Ndikofunikira kudya nyama yophika, yophika, yamafuta.
2. Zakudya zamkaka. M'miyeso yaying'ono (mpaka 100 g) mkaka, tchizi chokoleti, kirimu wowawasa amaloledwa.
3. Mkate Mutha kokha rye, tirigu wopanda mchere (patsiku - mpaka 150 g).
4. Supu Mutha kudya supu zamasamba ndi ndiwo zamasamba, zomwe sizimakhazikitsidwa pang'ono monga chimanga, mkaka. Nthawi zambiri msuzi patsiku ndi 300 g.
5. Mazira. Kufikira mazira 2-3 patsiku sizivulaza wodwala.
6. Mbale. Ndikwabwino kungodya mpunga, sago, osaphatikiza ndi nyama (mpaka 200 g patsiku).
7. Zamasamba. Chovomerezeka kudya 300 g ya mbatata, ndi masamba otsala - osakwana 400 g (kabichi, nkhaka, kaloti, beets, tomato, amadyera).
8. Zipatso, zipatso. Mutha kudya chilichonse kupatula ma blackcurrants, ma cherries, mphesa, mapichesi, apricots, nkhuyu, nthochi.
9. Maswiti. Amaloledwa kudya mousse, zakudya, zakudya, shuga pang'ono, uchi.
10. Zonunkhira. Ndikofunikira kupaka mbale ndi citric acid, nthangala za caraway, ochepa kwambiri omwe amadya tsabola, horseradish, mpiru, ketchup.
11. Mafuta. Imwani 65 g mafuta a masamba, 35 g a batala.

• mafuta msuzi
• msuzi uliwonse
• maapulo
• chakudya zamzitini
• soseji
• ankasuta nyama
• tchizi
• nyemba
• bowa
• sipinachi
• sorelo
• marinade
• rhubarb
• makeke okoma
• chokoleti
• zipatso zouma
• cocoa.

Zosintha zachitsanzo

1. Chakudya cham'mawa: phala la mpunga, uchi, tiyi wakuda.
2. Chakudya cham'mawa chachiwiri: saladi wa apulo ndi mandimu, 25 g a tchizi chanyumba.
3. Chakudya chamadzulo: msuzi wamasamba, ng'ombe yophika ndi mbatata yosenda, saladi wa nkhaka, chidutswa cha mkate, tiyi ya zitsamba.
4. Tiyi yapamwamba: cranberry odzola.
5. Chakudya chamadzulo: mbatata zothimbirira, chidutswa cha nsomba yophika, saladi wa phwetekere, chakumwa chilichonse.

Medical Journal Mankhwala Otchuka

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Owerenga athu amalimbikitsa

Owerenga athu pafupipafupi amachotsa mavuto a impso ndi njira yothandiza. Anadziyesa yekha - zotsatira zake ndi 100% - kupumula kwathunthu ku zowawa ndi mavuto pokodza. Uwu ndi mankhwala achilengedwe ochizira zitsamba. Tinaona njirayi ndikuganiza kuti tikulangizeni. Zotsatira zake zimakhala zachangu.

Impso dialysis imayikidwa ngati pali matenda akulu. Nthawi zambiri, matenda a impso amayamba ndi matenda ashuga. Poizoni wa poizoni amatithandizanso kugwira ntchito kwa chiwalo chophatikizira.

Zakudya ndi zakudya pa nthawi ya dialysis ya impso zimathandiza kuthetsa matenda komanso kukonza thanzi.

Hemodialysis imachitika pogwiritsa ntchito zida zapadera: magazi amayeretsedwa ndipo zinthu zapoizoni zomwe zimapezeka panthawi ya metabolism zimachotsedwa. Mchitidwewo amatulutsa magawo a madzi ndi ma elekitirodi.

Kodi kudya dialysis ndikofunikira?

Pakukonzekera kwa matenda a impso, thupi la munthu limataya zinthu zambiri zofunika. Chifukwa chake, muyenera kukhala osamala ndi zakudya zomwe zimadyedwa.

Kapangidwe ka mafupa ndi minofu yamunthu aliyense payekha kumakhudzana ndi kufunsa katswiri wa zamankhwala posankha zakudya zopangira dialysis.

Nkhani za thanzi zimakambidwa ndi omwe amakupatsani chithandizo chaumoyo kapena wondipatsa zakudya.

Mlingo wa kusokonezeka kwa metabolic umatsimikiziridwa panthawi yophunzira. Kutengera ndi zotsatira za kusanthula, katswiri wazachipatala amamanga mndandanda wazakudya za odwala. Koma muyenera kukumbukira kuti mumenyu iliyonse mukamayimba pali zofunika kwa onse.

Malangizo azaumoyo wathanzi

Impso ndi ma impso enieni zimasiyana momwe amagwirira ntchito. Woyamba kuyeretsa magazi amayenda katatu pa sabata m'maola ochepa chabe, ndipo lachiwiri limagwira ntchito nthawi yonseyo. Magawo a hemodialysis amasinthasintha amakakamiza wodwala kuwona zomwe amadya. Chisamaliro chachikulu chimaperekedwa ku kuchuluka kwa madzi ndi poizoni.

Mlingo wa mphamvu zamagetsi ukuwonjezeka munjira iliyonse, njira ya katyuliki imakulirakulira. Njira yosefera imangokhala ndi gawo lama protein okha. Anthu omwe ali ndi vuto la impso ayenera kutsatira malamulo oyamba azakudya:

• Kuchepetsa kudya.
• Chepetsani kuchuluka kwa mchere.
• Phatikizaninso zakudya za mapuloteni muzakudya zanu.
• Kuchulukitsa chakudya chama calorie.
• Chepetsani kugwiritsa ntchito zakudya zomwe zimakhala ndi phosphorous ndi potaziyamu.

Zakudya za hemodialysis zimaphatikizapo zakudya zomanga thupi kwambiri. Kunyalanyaza izi m'zakudya kumakulitsa mkhalidwe wa wodwalayo: minofu imachepa ndipo thupi limatha. Mapuloteni oyenera omwe amafunikira kuti adye tsiku limodzi ndi gramu imodzi pa 1 makilogalamu.

Kwenikweni, akatswiri azakudya amafotokozera kuchuluka kwa mapuloteni a nyama, chifukwa ali ndi mitundu ya ma amino acid. Izi zimatha kupezeka pazogulitsa:

• nyama ya ng'ombe yokhala ndi mafuta ochepa,
• nkhuku yophika
• nkhuku
• kalulu wophika.

Chakudya chamapuloteni ambiri chimayendetsedwa, ndipo nthawi yomweyo chimakhala ndi phosphorous yambiri. Mulinso:

Nthawi zonse mkaka kwa wodwala panthawi ya dialysis ndi kapu imodzi. Mlingo wovomerezeka wogwiritsa ntchito kirimu wowawasa ndi mpaka magalamu 150. Mazira amayenera kudya zidutswa 4 mkati mwa sabata yophika. Nyama ndi nsomba zimaphika.

Mafuta ndi chakudya

Mafuta amayenera kutengedwa pamlingo wina panthawi ya dialysis process. Akatswiri amalangizidwa kudya gawo limodzi la batala (20-25 magalamu) ndi mkate patsiku. Mpendadzuwa ndi mafuta a azitona, omwe amafunikira pakuphika zokha, samachotsedwa pakudya. Amasinthasintha cholesterol m'mwazi wa anthu.

Zakudya zopatsa mphamvu zimayeneranso kutsata mlingo wololedwa. Kuchepa thupi kumachotsedwa pakudya chakudya chamafuta ambiri. Izi zitha kukhala izi:

Kuletsa kumakhazikitsidwa pambale ya pasitala. Ndikofunika kuwonjezera tirigu muzakudya:

Anthu omwe apezeka ndi matenda osokoneza bongo amayenera kuwongolera kudya kwawo kwamankhwala okhala ndi mankhwala okhala ndi insulin panthawi ya dialysis moyang'aniridwa ndi achipatala mosamala.

Mchere ndi zonunkhira

Ngati munthu adwala mchere wambiri patebulo, ndiye kuti amawonjezera kuchepa kwa madzi m'thupi. Chifukwa chake, ziyenera kuchepetsedwa kapena kuchotsedwa kwathunthu kuzakudya zomwe zimadyedwa. M'malo mwake mchere umalimbikitsidwa ndi zonunkhira zotsatirazi:

Kuphika nsomba sikokwanira popanda mchere. Pankhaniyi, mutha kuyimitsa ndi cloves ndi tsabola. Basil imawonjezedwa ku mphodza. Mbatata zosenda owazidwa anyezi ndi adyo. Parsley ndi tsabola zimayikidwa m'mbale zokhala ndi zosakaniza zotentha.

Wodwala sayenera kudya maapulo, nyama zosuta ndi zakudya zina zomwe zimakonzedwa pogwiritsa ntchito mchere. Komabe zochepa zimatha kuwonjezeredwa. Mlingo watsiku ndi tsiku sayenera kupitilira supuni imodzi.

Njira yakumwa

Wopatsa zakudya ayenera kuwunika kuchuluka kwa madzimadzi omwe amamwa odwala. Popita nthawi, hemodialysis amachepetsa kugwira ntchito kwa impso. Madzi amachotsedwa m'thupi pang'onopang'ono.

Zikakhala zowopsa, wodwalayo nthawi zambiri amasiya kuyamwa. Kusamala kwamadzi ndikwabwino ngati mkodzo umasungidwa mokwanira.

Impso zikasiya kumwa madzi, wodwalayo amakhala ochepa madzi.

Miyezo yamadzi pochiza matenda a impso imasinthidwa payekhapayekha. Ntchito yamadzi katulutsidwe amazimiririka kapena imapitirira kutengera zovuta za matendawa. Matenda a shuga ndi glomerulonephritis amalimbikitsa kutha kwa ntchito za genitourinary system, ndi pyelonephritis ndi polycystic kuwasunga. Koma malamulowa amagwira ntchito: pakati pa hemodialysis magawo, wodwalayo sayenera kupitirira 5% ya madzi.

Pogwiritsa ntchito impso yochita kupanga, zinthu zapoizoni ndi madzi owonjezera amachotsedwa m'thupi. Nthawi zambiri pambuyo pa njira ya dialysis, wodwalayo amatha kumva bwino ndikuyamba kulephera mtima chifukwa chomwa mowa kwambiri.

Zopatsa mphamvu

Odwala omwe akukhudzidwa ndi dialysis impso ayenera kudya zakudya zopatsa mphamvu kwambiri. Zochita zolimbitsa thupi zimakhudza kukonzekera kwa zopatsa mphamvu za tsiku ndi tsiku. Zakudya za dialysis ya impso zimalimbikitsa kugwiritsa ntchito 35 kcal pa 1 kg imodzi ya thupi.

Mafuta ndi chakudya chamafuta ndi koyamba mndandanda wama calori. Wiritsani nyamayo, kenako phula poto. Zonunkhira zokometsera ndi misuzi yotsekemera zimawonjezera chidwi cha wodwala. Madokotala amalola kumwa mowa. Wodwala amaloledwa kumwa kapu yofiira kapena kapu ya brandy, koma osatinso.

Potaziyamu, calcium, Phosphorous

Nutritionists amaletsa zoletsa za potaziyamu. Thupi laumunthu limamverera kuwonjezeka kwa milingo ya potaziyamu. Ndi matenda a impso, ntchito yawo imalephera, motero potaziyamu amachotsedwa m'thupi movutikira. Kugwiritsa ntchito kwambiri zinthu zomwe zili ndi chinthuchi kumakwiyitsa wodwala. Izi zimatsogolera kuimfa. Zinthu zomwe zimadzaza ndi izi:

Potaziyamu wocheperako amapezeka munyama. Zakudya zovomerezeka zimakhazikitsidwa ndi adokotala.

Mlingo wa phosphorous ndi calcium m'magazi umasokonezeka nthawi ya hemodialysis. Dokotala ayenera kuyang'anitsitsa kuchuluka kwa calcium ndi phosphorous m'magazi. Mulingo wokwera umakonzedwa ndi mankhwala: binders phosphate ndi vitamini D3. Nthawi yomweyo, zinthu zamkaka zokhala ndi phosphorous yambiri ndizochepa.

Odwala omwe ali ndi dialysis ya impso amayenera kuchepetsa kudya kwa Vitamini A. Ma cell ofiira am'magazi amawonongeka ngati wodwala atenga vitamini B wotsutsana. Chifukwa chake, mulingo wazinthu zofunika kuti thupi likula, ndipo zosafunikira zimachotsedwa.

Kukonzekera kwa multivitamin, komwe kungagulidwe ku malo ogulitsa mankhwala, ndikulimbikitsidwa. Mavitaminiwo amabwezeretsanso zosunga zina zofunikira mthupi la munthu.

Malangizo Ophika

Zinthu zophika buledi pa dialysis, wodwala ayenera kudya zochuluka. Zakudya zawo siziyenera kupitirira 200 magalamu patsiku. Ndikulimbikitsidwa kudya mkate watsopano kapena wopanga nokha. Njira yabwino ndi rye.

Masamba ophika masamba Ndikulimbikitsidwa kudya m'malo mwa nyama. Simalimbikitsidwa kudya msuzi pa msuzi wa nyama. Chifukwa cha kapangidwe kake, msuzi wamasamba umatchedwa masamba. Kulandila kwa chakudya choterocho sikuyenera kupitirira 250 magalamu.

Nyama ndi nsomba mbale ikhoza kumatha kumwa pafupifupi magalamu 100. Komanso, ayenera kukhala okhwima. Nsomba zamafuta ndizoletsedwa. Ndikwabwino kudya nyama yophika kapena nsomba. Mutha kuphika msuzi wa nsomba.

Palibe chifukwa choti muyenera kuwaza nyama ndi nsomba. Choyamba muyenera kuphika zinthuzo, kenako pang'onopang'ono mwachangu kapena mphodza ndi kuphatikiza pang'ono mafuta a masamba. Zonunkhira zina zimatha kuwonjezeredwa ndi mbale.

Simungadye masosi mafuta ndi soseji zotsika mtengo: zimakhala ndi mchere wambiri.

Zinthu zamkaka ndibwino kusaphatikiza zakudya. Madokotala amaloledwa kumwa kapu imodzi ya mkaka - magalamu 150 patsiku. Muthanso kudya kirimu wowawasa mu magalamu 150, koma muyenera kusamala ndi tchizi chokoleti - kugwiritsa ntchito kwake kuyenera kuchepetsedwa mpaka magalamu 30 patsiku ndipo osatinso.Tchizi ndizoletsedwa mwamtundu uliwonse.

Mbale siziyenera kuzunzidwanso.. Pafupifupi magalamu 300 amaloledwa patsiku. Magawo ampunga amayesedwa oyenera. Nayo mutha kuphika phala ndi soup. Saloledwa kudya mpunga ndi ng'ombe, kalulu ndi nkhuku.

Mutha kuphatikiza mu zakudya zipatso ndi zipatso. Koma mphesa, apricot ndi zakudya zina zonona kwambiri siziyenera kuphatikizidwa pamndandanda uno. Ndi bwino kuphika zakudya zamafuta komanso zinthu zina zotsekemera. Zipatso zimalimbikitsidwa kudya popanda shuga wowonjezera.

Ngati wodwala akuvutika ndi hemodialysis, ndiye malinga ndi mndandanda wazogulitsa, mutha kugwiritsa ntchito masamba. Kufikira magalamu 250 a mbatata mwa mtundu uliwonse akhoza kuphatikizidwa muzakudya. Zotsalazo zimaloledwa kudya mpaka magalamu 400 patsiku. Popanda malire, madokotala amalimbikitsa kuphatikiza ndi parsley, katsabola ndi anyezi m'zakudya. Ndiowopsa kudya bowa ndi sipinachi.

Zakudya zokoma itha kugwiritsidwa ntchito ngati mousse. Ndikofunika kuwonjezera uchi ku khofi kapena tiyi. Zakudya zoletsedwa zimaphatikizapo makeke ndi chokoleti. Zakudya zimaloledwa kusakaniza ndi msuzi wa phwetekere ndi batala. Osachepera, ndikofunikira kuchepetsa kugwiritsa ntchito tsabola wotentha.

Pa dialysis, ndikofunikira kusamalira osati zokhudzana ndi malonda okha, komanso zakumwa. Amathandizidwanso. Kwa kagayidwe ndi mankhwala tiyi wazitsamba. Khofi wa diuretic ndi tiyi wakuda amagwiritsidwanso ntchito pankhaniyi.

Mafuta nawonso samachotsedwa pakudya. Mafuta ophikira ikhoza kudyedwa mu kuchuluka kwa magalamu 60, ndipo zonona - 30 magalamu.

Zitsanzo Zamasiku onse

Malangizo pa menyu watsiku ndi tsiku pa dialysis:

1. Chakudya cham'mawa: phala la buckwheat ndi madzi a shuga ndi kuwonjezera mkaka kapena yogati, pambuyo pake mumatha kumwa tiyi wakuda.
2. Zosakhazikika: saladi wa zipatso, wosankhidwa bwino, wokometsedwa ndi kirimu wowawasa kapena yogurt yachilengedwe.
3. Chakudya chamasana: msuzi wamasamba kapena filimu yankhuku yophika ndi zokometsera, kagawo ka mkate wa rye, saladi yamasamba yokonzedwa ndi masamba kapena mafuta a azitona.
4. Zosakhazikika: zipatso zonona kapena mafuta ochepa kefir.
5. Chakudya chamadzulo: mbatata yosenda ndi nkhuku yophika, yothira limodzi ndi msuzi wowawasa wa kirimu, ndi radish saladi. Musanagone, muyenera kusamba, kenako kumwa tiyi wobiriwira wobiriwira.

Ngati zizindikiro zotsatirazi mukuzidziwa nokha:

• kulimbikira kupweteka kumbuyo
• kukodza pokodza
• kuphwanya magazi.

Njira yokhayo yakuchita opaleshoni? Yembekezani, ndipo musachite zinthu mosinthasintha. Matendawa amatha kuchiritsidwa! Tsatirani ulalo ndikuwona momwe Katswiri amalimbikitsira kuchitira ...

Kodi hemodialysis imayikidwa liti ndipo shuga imachitika bwanji?

Kugwiritsa ntchito hemodialysis, amatsuka magazi a poizoni, poizoni ndi zinthu zina za metabolic. Mu shuga mellitus, njirayi imagwiritsidwa ntchito nthawi zambiri, popeza matenda amtunduwu amakhala ndi zovuta zambiri komanso kuchuluka kwa zinthu za metabolic, zomwe thupi lokha silingathe kuzichotsa. Ndondomeko iyenera kuchitidwa molingana ndi algorithm inayake.

Zisonyezo za hemodialysis mu shuga

Masiku ano, mu 30% yokhudza kufunika kwa hemodialysis, odwala ndi odwala matenda ashuga. Izi zimagwirizanitsidwa ndi chakuti nthawi zambiri amakhala ndi matenda ashuga, omwe amachititsa kuti matenda a impso alephere. Hemodialysis imachitidwa malinga ndi zisonyezo zina:

• kuledzera kwa thupi komwe kumachitika chifukwa cha kuchuluka kwa zinthu zoipa.
• kufooka thupi,
• chilolezo cha creatine chatsikira mpaka 10-15ml / mphindi (mtengowo umatengera kulemera),
• bongo wa mankhwala osokoneza bongo
• kulephera kapena kupweteka kwa impso,
• pyelonephritis,
• pachimake glomerulonephritis,
• Hyperhydrate (madzi ochulukirapo m'thupi), ngati sangathe kuyimitsidwa ndi njira ina,
• poyizoni ndi zakumwa zoziziritsa kukhosi (zothetsera),
• kudziunjikira kwamadzi, komwe kumawopseza kutupika kwa ubongo kapena mapapu
• kupatuka kwazomwe zimayambira (monga protein, urea, glucose, uric acid, creatinine) pakuwunika magazi ndi mkodzo.

Kodi amathandizira bwanji?

Njira ya hemodialysis imatenga maola angapo. Kutalika kwake kumatengera mawonekedwe amilanduyo. Kukula kwa njirayi kumapangidwanso payekhapayekha. Mu kuperewera kwa impso, hemodialysis imachitika tsiku lililonse la 4-7, mawonekedwe - kamodzi pakapita masiku atatu.

Ndondomeko ikuchitika motere:

1. Wodwalayo amakhala pampando wapadera kapena pabedi.
2. Pali kulumikizana kwa chipangizocho (dialyzer), chomwe chimatchedwanso impso yochita kupanga.
3. Njira yoyeretsa magazi imayamba. Pampu yapadera imatulutsa magazi kuchokera mthupi kudzera mu mtsempha. Pazida, amadziwika ndi yankho la dialysis lomwe limayeretsa. Magazi oyeretsedwa amabwerera mthupi kudzera mu mtsempha wina.

Njira yotsuka magazi imatchedwa dialysate. Amayeretsedwa madzi ndi yankho la mchere ndi ma asidi. Potaziyamu, shuga, magnesium, calcium, chlorine, bicarbonate angagwiritsidwe ntchito, koma sodium ndiwothandiza kwambiri.

Hemodialysis imafuna chakudya. Izi ndizofunikira kuti chitetezo chithandizire. Malamulowa ayenera kutsatiridwa:

• Pewani mafuta odzaza komanso chakudya chamafuta ochepa. Simungadye nyama yamafuta, nsomba zonona, maswiti, chokoleti, zophika. Ndikofunikira kusiya masoseji, zakudya zamzitini, nyama zosuta.
• Onjezani kuchuluka kwa mapuloteni muzakudya. Kuchulukitsa kwawo kuyenera kuwerengedwa potengera kulemera kwamthupi la wodwalayo. Pa kilogalamu iliyonse muyenera 1.2 g ya mapuloteni. Pamaso dialysis, kuwerengetsa kwa protein yonse ndizosiyana - 0,5 magalamu pa kilogalamu ya kulemera.
• Kuletsa mchere. Tsiku zosaposa 5 magalamu.

• Ma calorie a tsiku ndi tsiku sayenera kupitirira 2500 kcal. Kuletsa kumeneku ndikofunikira kuti thupi likhale loyenera komanso kuti lizitha kuyamwa.
• Onani makhwala akumwa. Ndi hemodialysis pakati pa njira, kugwiritsa ntchito madzimadzi saloledwa zosaposa 5% mwa kulemera kwa wodwalayo.
• Phatikizaponso masamba atsopano komanso zakudya zopanda thanzi mu zakudya: buckwheat, barele la ngale, oat (oatmeal).
• Sankhani zamasamba ambiri mu oxalic acid. Muyenera kusiya sipinachi, radish, biringanya, anyezi wobiriwira, udzu winawake, rhubarb.
• Muchepetse zakudya zokhala ndi calcium yambiri, phosphorous, ndi potaziyamu.

Glycemic control

Panthawi ya hemodialysis ya matenda a shuga, ndikofunikira kuwongolera glycemia wodwalayo. Imatha kukhala yosakhazikika masana.

Kutengera kupezeka hyperglycemia Pa ntchito dialysis, anuria ndikutheka (palibe mkodzo mu chikhodzodzo), pamene glucose owonjezera sasiya thupi. Izi zimatha kukhala ndi vuto la hyperosmolar lomwe limayambitsa chiwopsezo cha moyo ndipo limafunikira thandizo mwachangu.

Hemodialysis ndiyowopsa hypoglycemiapamene kuchuluka kwa shuga kuli pansi 3.3 mmol / L. Pankhaniyi, kusokonezeka kwa hemodynamic, ma neural process, ndi zigawo zamkati za magazi ndizotheka.

Kwa odwala matenda ashuga pa hemodialysis, mndandanda wamankhwala ochepetsa shuga ndi ochepa. Nthawi zambiri mumayambira kuyambitsa kufupikitsa kwa glipizide, koma osapitirira 10 mg patsiku. Ndikulimbikitsidwa kukana meglitinides (owongolera prandial), chifukwa kudya kwawo kumawonjezera chiopsezo cha hypoglycemia. Metformin imatsimikiziridwa mwamtheradi mu hemodialysis.

Anthu odwala matenda ashuga a hemodialysis amalimbikitsidwa kuti azichita kwambiri ndi mankhwala a insulin. Patsiku la ndondomeko, mlingo wa insulini uyenera kuchepetsedwa - muyeso uwu ndi kupewa intradialysis hypoglycemia. Kwa insulin yochepa, ndikokwanira kuti muchepetse mankhwalawo nthawi isanachitike, nthawi zina iyenera kuti kuthetsedweratu gawo lisanayambe.

Hemodialysis imagwiritsidwa ntchito kuyeretsa magazi pomwe impso zimalephera kugwira ntchito iyi. Ndondomeko iyenera kuchitika moyang'aniridwa ndi katswiri.Pa chithandizo chotere, ndikofunikira kutsatira zakudya zinazake ndikuwongolera glycemia, popeza kusintha kwa insulin kapena mankhwala a hypoglycemic kungakhale kofunikira (m'malo mwake ndikotheka).

Zakudya za Impso

Njira yovuta yophatikizana ndi vuto laimpso ndi kufa kwa seloyo imatchedwa kuti aimpso kulephera.

Nthawi zambiri, kukula kwa matendawa kumayambitsa matenda a impso, mwachitsanzo, pyelonephritis, glomerulonephritis, mapangidwe a calculi mu impso, amyloidosis, etc.

Mu 75% ya milandu, kuperewera kwa impso ndi zotsatira za matenda a shuga, glomerulonephritis (nthenda ya autoimmune yokhudza impso glomeruli) komanso matenda oopsa.

Odwala omwe kukula kwa matenda atalowa gawo lomaliza akuwonetsedwa pafupipafupi hemodialysis. Iyi ndi njira yaukadaulo yophatikizira kuyeretsa kwina kwa magazi a zinthu zopangidwa ndi poizoni. Pa hemodialysis, matenda a madzi ndi kusalinganika kwa electrolyte kumachitika.

Kufunika kwa dialysis kumachitika osati mu pachimake komanso matenda aimpso kulephera, komanso vuto la poizoni ndi mankhwala osokoneza bongo, poyizoni, ziphe. Hyperhydration yoopsa m'moyo (mwachitsanzo, edema kapena pulmonary edema) ndi chisonyezero cha kuyeretsa magazi kochokera muukadaulo.

Chifukwa chake zakudya ndizofunikira

Zotsatira zoyipa za njirayi ndiyo kutayika kwa zinthu zingapo zofunikira, kotero zakudya zimathandiza kwambiri kuyendetsa impso. Malingaliro a mankhwala azakudya akuyenera kuvomerezana ndi adokotala omwe amapezeka (kufunsana ndi katswiri wazakudya ndi nephrologist ndikofunikira), popeza

thupi la munthu aliyense payekha. Chikhalidwe komanso kuchuluka kwa zovuta zama metabolic, pafupipafupi komanso kutalika kwa kuyeretsa magazi, komanso kapangidwe ka dialysis njira zimakhudzira thanzi.

Komabe, kwa odwala onse omwe amachita njirayi nthawi zonse, mfundo zoyambira zaukadaulo zakonzedwa.

Zambiri pazoletsa

Munthu wa hemodialysis sayenera kulandira zopitilira 6 g za sodium patsiku. Zoyenera, ngati wodwalayo akukana mchere wa pagome. Zakudya za anthu omwe ali ndi matenda oopsa sayenera kukhala wopanda mchere.

Mutha kusintha kukoma kwa mbale powonjezera zonunkhira zosiyanasiyana, zokometsera, mpiru wosenda, njira yofooka yaviniga. Kupatula - horseradish, tsabola ndi sinamoni

Matenda a munthu yemwe akudwala matenda aimpso amalephera kuchotsa potaziyamu. Chuma chowonjezera chimachotsedwa pa dialysis. Kuchuluka kwa potaziyamu pakati pa magawo ndi kowopsa kwambiri ndipo kungayambitse kumangidwa kwamtima. Kumbukirani kuti chizindikiro choyamba cha matenda oopsa ndi kutopa kwambiri komanso kufooka kwa miyendo.

Odwala omwe amayeretsedwa magazi, phosphorous-calcium metabolism nthawi zambiri imalephera. Kusagwirizana kungapezeke kokha ndi katswiri popereka kuwunika komwe kumawonetsa kuchuluka kwa calcium ndi phosphorous m'magazi. Impso zomwe zakhudzidwa sizingathe kuthana ndi kuchotsedwa kwa phosphorous, yomwe imayatsidwa ndi le calcium kuchokera m'mafupa. Izi zimabweretsa kufooka ndi kusokonekera kwa mafupa, komanso zovuta zina.

Kuwongolera kumachitika ndikuchepetsa menyu a mkaka ndi zinthu zina zambiri za phosphorous. Kuphatikiza apo, adotolo amasankha kukonzekera kwa calcium ndi mankhwala okhala ndi D3. Nthawi zambiri, omwe amamangirira phosphate amathandizidwanso kuti asokoneze kuyamwa kwa phosphorous, mwachitsanzo, almagel kapena wamba. Kuti mupeze kufunika kwa mankhwalawa, ayenera kumwedwa mogwirizana ndi malangizo.

Kwa wodwala matenda a impso, aluminiyamu imamuvulaza kwambiri. Kukonzekera komwe kuli nako kungayambitse kuwonongeka kwakuthupi, mwachitsanzo, kungayambitse magazi kwambiri, kuwonongeka kwa minofu yam'mafupa, ndikuwonetsa kuwonongeka kwamitsempha yama neva - aluminium dementia.

Odwala sayenera kusankha pawokha ma multivitamin omwe ali ndi zowonjezera mchere

Mndandanda wazinthu zomwe zimaletsa panthawi ya hemodialysis zimaphatikizapo:

• zipatso zouma za potaziyamu - zoumba zouma ndi ma apricots zouma,
• Zipatso za zipatso, mphesa ndi nthochi,
• mtedza ndi nyemba
• nyama ndi msuzi wa bowa,
• offal, mwachitsanzo, impso, mtima, chiwindi,
• masamba (tomato ndi mbatata yophika),
• amadyera (sorelo ndi sipinachi),
• mankhwala apamwamba a phosphorous,
• wosuta ndi mchere wamchere ndi caviar,
• Zakumwa za Isotonic
• cocoa
• dzira yolk
• zakudya zamzitini, masoseji ndi masoseji,
• Zinthu zophika buledi
• chimanga (kupatula - mpunga).

Ngati wodwalayo akuwonetsedwa aimpso, sizoletsedwa kugwiritsa ntchito ziwiya za aluminium panthawi yophika.

Nyama ndi nsomba ziyenera kuyamba kuwiritsa. Odwala omwe akuchipatala samaloledwa kudya msuzi. Kuphika kwinanso ndi nkhani ya kukoma. Nyama ndi nsomba zimatha kukazinga kapena kuphika powonjezera zonunkhira.

Kutalika kwa nthawi yayitali (kwa maola 6 mpaka 10) masamba ophika bwino kumathandiza kuchepetsa kuchuluka kwa sodium ndi potaziyamu muzakudya. Mukuchita izi, ndikofunikira kusintha madzi kangapo (ngati chakudyacho chili ndi potaziyamu kwambiri, madziwo amasinthidwa nthawi 10, ndipo nthawi yowukitsa imachulukitsidwa mpaka maola 24)

Zogulitsa kwathunthu kapena pang'ono

Zakudya za odwala omwe ali ndi hemodialysis zimapereka mwayi kwa kusiyanitsidwa ndi zakudya zama nyama / nsomba / msuzi wa bowa, mafuta osiyanasiyana othandizira nyama, nyama yamafuta, zakudya zamchere zambiri (zakudya zamzitini, tchizi wowuma, tchipisi, ma msuzi a msuzi, mtedza wowotchera, masoseji, soseji, marinade, ketchups, mchere, margarine, masamba okazinga), ma legamu, chiwindi, ubongo, impso, nyama zosuta, mazira owiritsa kwambiri, chimanga ndi pasitala, zinthu zamkaka.

Chepetsa kugwiritsa ntchito zakudya zomwe zili ndi potaziyamu yambiri - curry, bowa, khofi, mkaka, zipatso zamasamba, sorelo, nthochi, nsomba zam'madzi, nthangala, nthangala za sesame, mtedza, soya, chocolate , ketchup, sipinachi, beets, mowa, avocado, misuzi yazipatso, msuzi wa phwetekere, ma apricots, molasses, mphesa, yamatcheri, nkhuyu, mphodza.

Zinthu zopangidwa ndi phosphorous zimayikidwa zoletsedwa: chinangwa, mtedza, mkate wathunthu, chimanga, mkaka wa koko, tchizi, mazira, nyemba, maesili, tchizi choko. Tiyi yamphamvu / khofi, cocoa, madzi amchere a sodium samayikidwa pazakumwa.

Nsomba ndi nsomba zam'nyanja

nsomba17,54,60,0139 ankasuta nsomba26,89,90,0196 caviar wakuda28,09,70,0203 granular nsomba caviar32,015,00,0263 nsomba zamzitini17,52,00,088

Madzi ndi ma compotes

dzungu dzungu0,00,09,038

* Zambiri zili pa 100 g yazogulitsa

Zogulitsa kwathunthu kapena pang'ono

Zakudya za odwala omwe ali ndi hemodialysis zimapereka mwayi kwa kusiyanitsidwa ndi zakudya zama nyama / nsomba / msuzi wa bowa, mafuta osiyanasiyana othandizira nyama, nyama yamafuta, zakudya zamchere zambiri (zakudya zamzitini, tchizi wowuma, tchipisi, ma msuzi a msuzi, mtedza wowotchera, masoseji, soseji, marinade, ketchups, mchere, margarine, masamba okazinga), ma legamu, chiwindi, ubongo, impso, nyama zosuta, mazira owiritsa kwambiri, chimanga ndi pasitala, zinthu zamkaka.

Chepetsa kugwiritsa ntchito zakudya zomwe zili ndi potaziyamu yambiri - curry, bowa, khofi, mkaka, zipatso zamasamba, sorelo, nthochi, nsomba zam'madzi, nthangala, nthangala za sesame, mtedza, soya, chocolate , ketchup, sipinachi, beets, mowa, avocado, misuzi yazipatso, msuzi wa phwetekere, ma apricots, molasses, mphesa, yamatcheri, nkhuyu, mphodza.

Zinthu zopangidwa ndi phosphorous zimayikidwa zoletsedwa: chinangwa, mtedza, mkate wathunthu, chimanga, mkaka wa koko, tchizi, mazira, nyemba, maesili, tchizi choko. Tiyi yamphamvu / khofi, cocoa, madzi amchere a sodium samayikidwa pazakumwa.

Zoletsa Zogulitsa Zapamwamba

Masamba ndi amadyera

Mapuloteni, g	Mafuta, g	Zakudya zomanga thupi, g	Zopatsa mphamvu, kcal
nyemba zamasamba	9,1	1,6	27,0	168
sauerkraut	1,8	0,1	4,4	19
anyezi wobiriwira	1,3	0,0	4,6	19
anyezi	1,4	0,0	10,4	41
nkhaka zamzitini	2,8	0,0	1,3	16
nkhaka zosemedwa	0,8	0,1	1,7	11
radishi	1,2	0,1	3,4	19
radish yoyera	1,4	0,0	4,1	21
mpiru	1,5	0,1	6,2	30
udzu winawake	0,9	0,1	2,1	12
phala zamzitini	1,1	0,1	3,5	20
nsapato	3,2	0,4	10,5	56
adyo	6,5	0,5	29,9	143
sipinachi	2,9	0,3	2,0	22
sorelo	1,5	0,3	2,9	19
ma apricots	0,9	0,1	10,8	41
nthochi	1,5	0,2	21,8	95
nectarine	0,9	0,2	11,8	48
mapichesi	0,9	0,1	11,3	46
bowa	3,5	2,0	2,5	30
bowa wowaza	2,2	0,4	0,0	20
Mphesa ndi chimanga
semolina	10,3	1,0	73,3	328
chimanga cha chimanga	8,3	1,2	75,0	337
ngale barele	9,3	1,1	73,7	320
mapira akudya	11,5	3,3	69,3	348
Mafuta ndi Pasitala
pasitala	10,4	1,1	69,7	337
chokoleti	5,4	35,3	56,5	544
Zida zoyipa ndi zokometsera
mpiru	5,7	6,4	22,0	162
ginger	1,8	0,8	15,8	80
ketchup	1,8	1,0	22,2	93
mayonesi	2,4	67,0	3,9	627
tsabola wakuda pansi	10,4	3,3	38,7	251
msuzi wa phwetekere	1,7	7,8	4,5	80
Tchizi ndi tchizi tchizi
tchizi tchizi	17,2	5,0	1,8	121
Zinthu zopangidwa ndi nyama
mafuta	2,4	89,0	0,0	797
wosuta nkhuku	27,5	8,2	0,0	184
bakha	16,5	61,2	0,0	346
bakha wosuta	19,0	28,4	0,0	337
tsekwe	16,1	33,3	0,0	364
Nsomba ndi nsomba zam'nyanja
nsomba	17,5	4,6	0,0	139
ankasuta nsomba	26,8	9,9	0,0	196
caviar wakuda	28,0	9,7	0,0	203
granular nsomba caviar	32,0	15,0	0,0	263
nsomba zamzitini	17,5	2,0	0,0	88
Mafuta ndi Mafuta
mafuta a nyama	0,0	99,7	0,0	897
mafuta ophikira	0,0	99,7	0,0	897
Madzi ndi ma compotes
msuzi wa phwetekere	1,1	0,2	3,8	21

* Zambiri zili pa 100 g yazogulitsa

Ubwino ndi kuipa

Ubwino	Chidwi
Imachepetsa azotemia, imachepetsa kuthamanga kwa magazi, imachepetsa edema, imachotsa zosokoneza mu phosphorous-calcium metabolism. Osati okwera ndalama.	Chakudya chokhazikika pamankhwala onse.

Ndemanga ndi Zotsatira

Chakudya chokhwima kwa odwala pa hemodialysis ndikofunikira kwambiri, makamaka kwa odwala omwe ali ndi kuthamanga kwa magazi, kupezeka kwa edema ndi matenda a calcium-phosphorous. Malinga ndi odwala, ndizovuta kuzolowera zakudya zopanda mchere kapena mchere wochepa, mbale sizikhala zopanda pake, koma palibe chosankha.

• «... Pambuyo pakuwonongeka kwa impso ndikukula kwa matenda a impso, adalembedwa hemodialysis. Panali mayeso osakwanira, kuwonjezeka kwa kuthamanga kwa magazi, kutupa. Anayambitsa zochizira wopanda mchere mchere. Zinali zovuta kwambiri kuzolowera zakudya zopanda mafuta nthawi yomweyo. Madyera am'minda (parsley, katsabola, adyo, anyezi, parsnips) anathandizanso, ndipo anakonzanso sosi yozizira mkaka ndi zonona. Ndidayenera kuyang'anira kwambiri chakudya changa. Ndimaphika chilichonse mumafuta a masamba. Ngakhale zakudya zimasamalidwa bwino, ndipo palibe poti mupite, muyenera kusintha ngati mukufuna kukhala ndi moyo».

Dialysis Impso Zakudya Zam'magazi

Odwala omwe ali ndi matenda ashuga omwe amayamba kulephera a impso mu gawo lotsiriza amathandizira miyoyo yawo kudzera mu njira za dialysis. Munthawi izi, zinyalala zomwe zimakhala ndi nayitrogeni zimachotsedwa m'mwazi.

Kutsetsereka ndi njira yodula komanso yosasangalatsa, yokhala ndi chiwopsezo chachikulu chotenga kachilomboka. Kuti achepetse kuchuluka kwake, odwala amalimbikitsidwa kuti achepetse kuchuluka kwa mapuloteni ndi madzi.

Pakadali pano kulephera kwa impso, chakudya chamafuta ochepa, zama protein ambiri sizabwino. Nthawi zambiri, mapuloteni azakudya amakalowa chakudya.

Madera ena a Western dialysis tsopano amalimbikitsa kuti odwala awo odwala matenda ashuga azitha kuthira mafuta a azitona m'malo mwa chakudya. Ili ndi mafuta ambiri athanzi.

GI mu zakudya mankhwala a matenda a impso

Zakudya za impso zamagulu a shuga ziyenera kukhala zochepa-carb ndipo zimakhala ndi mapuloteni ochepa a nyama. Zakudya zoterezi sizichulukitsa shuga wamagazi, motero kukhazikitsa komanso nthawi yomweyo osalemetsa ntchito ya impso.

Matenda a shuga enieni amakakamiza munthu moyo wake wonse kuti azitsatira chithandizo chamankhwala malinga ndi kusankha kwa mankhwala a GI. Chizindikiritso ichi mu digito chimawonetsa mphamvu ya chinthu chomwe chimapangidwa mu chakudya m'magazi a glucose pambuyo pake.

Mtundu wachiwiri wa shuga, chakudyacho chimakhala ngati chithandizo chachikulu, ndipo mwa mtundu wodalira insulin, ndiye chithandizo chofanana chomwe chimakwaniritsa insulin.

GI imagawidwa m'magulu angapo:

1. 0 - 50 PIECES - chizindikiro chotsika,
2. 50 - 69 PIECES - pafupifupi,
3. Mayunitsi 70 ndi pamwambapa ndi chizindikiro chachikulu.

Munthu akakhala ndi shuga wambiri, ndiye kuti kukana kwathunthu zakudya zomwe zili ndi GI yayikulu. Chakudya chachikulu chimapangidwa ndi zinthu zomwe zimakhala ndi GI yotsika, chakudya chomwe chimakhala ndi zolembera zingapo chimaloledwa kuphatikizidwa mumenyu monga kusiyapo kangapo pa sabata.

Ndi zakudya zosayenera, wodwala akamadya chakudya chamafuta othamanga, sikuti shuga yokha imangokulitsidwa, komanso mitsempha ya magazi imatha kutsekeka, chifukwa chakudya chotere chimakhala ndi cholesterol yoyipa.

Wodwala akapezeka kuti ali ndi vuto laimpso ndipo magazi ake amawonjezereka pafupipafupi, ndikofunikira kugwiritsa ntchito zakudya zomwe zili ndi index yotsika ya glycemic.

Zisonyezo za hemodialysis wokhazikika

Odwala onse omwe ali ndi matenda a "matenda a impso kulephera" (CRF) amawonetsedwa njira yoyeretsa magazi kudzera mu zida "zochitira impso"

Ngati wowerenga akufuna kudya chakudya chopangira dialysis ya impso, ndiye kuti mukufunikiranso kumvetsetsa komwe mikhalidwe yovuta yoyeretsera ana imagwiritsidwa ntchito. Popeza pathological aimpso mikhalidwe komanso zakudya zoyenera limodzi nawo ndizofunikira kwambiri pakulimbikitsa kwachangu komwe kumakulitsa moyo wa wodwala wokhala ndi vuto laimpso.

Chifukwa chake, pa hemodialysis, odwala omwe amalephera kupezeka aimpso ayenera kukhala otere:

• Kuchuluka kwa madzimadzi m'thupi la wodwalayo, zomwe zingayambitse matenda a m'mapapo.
• Kutsika kwakukulu mu kusefera kwa impso glomeruli (pansipa 15-20 ml / min).
• Kuchulukitsa kwa kuchuluka kwa creatine m'magazi (kuchokera ku 600 μmol / L kapena kuposa).
• Kuwonekera kwa zizindikiro za kutopa kambiri pamasamba azothermia.
• Kuledzera kwambiri kwa thupi la wodwalayo ndi zinthu zomwe zimasokoneza mapuloteni komanso njira za metabolic zapitazo.

Chofunikira: kuti musabweretse wodwalayo pamavuto osaneneka, ndikofunikira kuti ayambitse hemodialysis koyamba kwa iwo. Ndipo njirayo ikafunsidwa, mwayi wopitilira moyo wa wodwalayo.

M'pofunika kudziwa kuti hemodialysis sichingachotse ntchito ya impso yathanzi. Wodwala yemwe akuyeretsa magazi owoneka, mwina, pakapita nthawi, amakhala ndi metabolism yosokonekera, komanso kutayika kwa kufufuza zinthu, mchere wofunikira, ndi zina zambiri.

Ichi ndichifukwa chake ndikofunikira kumvetsetsa kuti chakudya cholondola cha hemodialysis ndichinsinsi cha mkhalidwe wabwinobwino wamthupi ndi wamaganizidwe a odwala omwe ali ndi vuto laimpso. Ndikofunikanso kudziwa kuti chithandizo chamankhwala pachokha chimatengera kuchuluka kwa njirayi, nthawi yake pagawo limodzi, mtundu wa mayankho a dialysis ndi machitidwe a thupi la wodwalayo.

Ichi ndichifukwa chake ndikofunikira kukambirana za zakudya zanu ndi akatswiri azakudya zofunikira musanafike hemodialysis. Mfundo zoyambirira za zakudya zoyenera za odwala a dialysis adzapatsidwa pansipa.

Zakudya zama protein, mafuta, michere ndi mchere

Panthawi yochizira matenda a impso popanda hemodialysis, kuchuluka kwa mapuloteni omwe amadyedwa ndi ochepa - osapitirira 0,5 g pa kilogalamu ya wodwala patsiku. Zomwezi zimagwiranso mchere - 5 g kapena kuchepera patsiku. Ngati nthendayo imayendera limodzi ndi kuchuluka kwa kukakamizidwa, ndiye kuti mchere sukulimbikitsidwa kuti udyedwe konse - zake zachilengedwe mu zakudya ndizokwanira.

Ndi hemodialysis, m'malo mwake, kuchuluka kwa mapuloteni okwanira kumalimbikitsidwa. Ichi ndi chifukwa cha kuchepa kwakukulu kwa michere munjira: kufufuza zinthu, ma amino acid, mavitamini ndi oligopeptides. Zakudya za protein tsiku lililonse zimayenera kukhala pafupifupi magalamu 1.2 pa kilogalamu iliyonse.

Kudya kwamafuta ndi chakudya chamagulu amakhalanso ayenera kukhala okwanira, pokhapokha ngati vuto la impso limayambitsa matenda a shuga. Kuchuluka kwa chakudya chamafuta mu nkhani iyi ndizochepa.

Madzi akumwa

Mu wodwala akudwala hemodialysis, aimpso ntchito amachepetsa kwambiri, zomwe zimakhudza kuchuluka kwa mkodzo wothira. Nthawi zina, kukodza kumakhala kovuta kwambiri kapenanso kusakhalapo, ngakhale izi ndizochitika zathupi zathupi zomwe zimakupatsani mwayi wolamulira madzi mthupi.

Chifukwa chake, odwala, makamaka okhala ndi vuto la mtima komanso matenda oopsa, ayenera kuchepetsedwa kuchuluka kwa madzi omwe amamwe. Madzi kulowa thupi ndi kusabweranso mulingo woyenera kumatha kubweretsa mawonekedwe a edema, komanso kudumphadumpha kowopsa m'magazi.

Komabe, nthawi zina, zoletsa izi ndizosavomerezeka.Chifukwa chake, ndi polycystic kapena pyelonephritis, mavuto pokodza amatha kusakhalapo, ndipo ndi matenda ashuga, tsiku lililonse diuresis imatha kukhala yochulukirapo.

Kuzungulira kwa mankhwala a nitrogenous m'magazi kungakhalenso koopsa. Komabe, chifukwa chamadzimadzi olowa mthupi, chidwi chawo chitha kuchepetsedwa, kukonza mkhalidwe wa wodwalayo. Chifukwa chake, kuletsa kwa zakumwa zakumwa panthawi ya hemodialysis kumatha kuchitika mosiyanasiyana monga momwe zikuwonekera komanso pambuyo pofunsira kwa dokotala.

Kudya micronutrient

Impso hemodialysis ndi njira yoyeretsera thupi la zinthu zingapo pochitika kuti impso zaumunthu sizitha kuthana ndi ntchitoyi payokha. Malangizo ake atha kukhala motere: - Kulephera kapena kupweteka kwa impso.

- Poizoni. - Mankhwala osokoneza bongo.

- Kumwa mowa mwauchidakwa. - Madzi ochulukirapo mu minofu ndi ziwalo.

Pogwiritsa ntchito dialysis, zotsatirazi zimachotsedwa m'thupi: - Extin creatinine (chomaliza chomaliza cha kuphwanya mapuloteni). - Urea.

- mankhwala a Boric acid. - Salicylates.

- Sulfanilamides. - Mowa wa ethyl ndi methyl.

- Madzi ochulukirapo. - Ma electrolyte a potaziyamu, sodium, calcium.

- Zoyipa zosiyanasiyana. Zambiri mwa zinthuzi zimalowa m'thupi ndi chakudya.

Kuchitapo kanthu kwakanthawi komanso kolemetsa sikuthandiza kwenikweni ngati wodwala sasintha kadyedwe kake.

Zakudya za hemodialysis a impso zimatanthauzanso njira zopatsa thanzi zomwe zidapangidwa m'zaka zapitazi. Madotolo amutcha tebulo nambala 7.

Adapangidwa kuti aziganizira kagayidwe kamunthu panthawi yakuyeretsa magazi kudzera mu impso yochita kupanga. Amawonedwa panjira ya mankhwalawo pakokha ndipo patapita kanthawi itatha.

Kuphatikiza poti palibe mapuloteni ochulukirapo pamenyu, ambiri ayenera kulowa m'thupi limodzi ndi zakudya zamasamba. Mapuloteni ochokera kwa nyama ndi ochepa ndipo amayenera kulandira chithandizo cha kutentha.

Zakudya zamafuta zimapezekanso. Impso za munthu amene akudwala hemodialysis sangathe kulimbana ndi katundu wotere.

Pafupifupi, madokotala amalimbikitsa kumwa osaposa 1 lita imodzi yamadzi patsiku, ndi madzi ambiri wamba oyeretsedwa. Mbale zonse zimakonzedwa popanda mchere.

Zonunkhira zochepa zimatha kuloledwa ndi dokotala, koma izi sizoposa 2-3 g patsiku. Ndikwabwino mchere mchere musanadye.

Zogulitsa zomwe zili ndi potaziyamu yambiri, calcium, sodium, oxalic acid zimachotsedwa kwathunthu kapena zochepa. Ndikulimbikitsidwa kudya chakudya cha sing'anga kutentha.

Zakudya zisanu ndi imodzi patsiku zimayikidwa. Nthawi zambiri, odwala sayenera kupanga okha menyu.

Ndi hem hemalal ya impso, ambiri amathandizidwa ndi odwala ndipo amayang'aniridwa ndi madokotala. Zakudya zawo zimapangidwa mosiyanasiyana.

Komabe, pali zida zosiyanasiyana za hemodialysis impso kunyumba. Omwe akulandila chithandizo chamtunduwu adzapindula ndi malangizo owonjezereka a zakudya.

Zakudya za hememalalization zimafunikira chakudya chopangidwa payekha kapena chosankhidwa bwino. zomwe zimatengera zinthu zambiri, kuphatikiza kukhalapo kapena kusowa kwa zovuta, nthawi yayitali ya chithandizo, ndi zina zambiri. Ichi ndichifukwa chake amalimbikitsidwa kutsatira malangizo onse a dotolo, yemwe amadziwa mawonekedwe a thupi la wodwala, komanso machitidwe a chithandizo chake.

Ngati mwaphunzira pulogalamu yothana ndi matenda a shuga 1 kapena pulogalamu yachiwiri ya matenda ashuga ndikuyesetsa kutsatira malingaliro ake, ndiye kuti mukudziwa kuti kudya zakudya zamagulu ochepa kumakupatsani mwayi wochepetsa shuga wamagazi kuti ukhale wabwinobwino komanso wosakhalitsa, monga momwe zimakhalira ndi anthu athanzi popanda matenda ashuga.

Werengani mwatsatanetsatane njira yanji yazotupa yaying'ono. Mudadzionera nokha kuti kudya "moyenera", komanso kudya pang'ono kwama protein komanso ochepa mafuta, musalole kuti shuga asinthe.

Amadzaza ndi chakudya, motero shuga m'magazi omwe amadwala matenda a shuga amalumpha ndipo mavuto amakula msanga.

Komabe, madokotala akupitiliza kulimbikitsa chakudya chochepa chama protein a odwala matenda ashuga kuti achepetse kukula kwa kulephera kwa impso ndikachedwa kuyambiranso. Pazakudya izi, zochuluka za mapuloteni azakudya zimasinthidwa ndi chakudya.

Amakhulupirira kuti njirayi imachepetsa nkhawa pa impso, ngakhale kuti sizilola shuga kukhala ndi shuga wabwinobwino. Kodi mungasankhe bwanji zakudya zabwino kwambiri kwa impso? Ndi zakudya ziti zomwe zili bwino - mapuloteni ochepa kapena ochepa mafuta? Yankho: zimatengera gawo lomwe matenda anu a matenda ashuga ali nawo.

Pali mfundo yoti palibe kubwerera. Ngati mungadutse, glomeruli imakhala yowonongeka kwambiri kotero kuti shuga mumagazi silimakupatsaninso mwayi wobwezeretsa kapena kukonza impso.

Dr. Bernstein akuwonetsa kuti mfundo iyi yobwererayi ndi kuchuluka kwa impso pafupifupi 40 ml / min. Ngati kuchuluka kwa kusefera kwa m'munsi kumatsika, ndiye kuti chakudya chamafuta ochepa chokhala ndi mapuloteni sichingathandizenso, koma kungathandizire kuyambika kwa gawo loti matendawa alephere.

Ngati kuchuluka kwa kusefera kwa glomerular ndi 40-60 ml / min, ndiye kuti kukula kwa shuga m'magazi ochepetsa chakudya chamthupi kumathandizira kukhazikika kwa impso kwa nthawi yayitali. Pomaliza, ngati kuchuluka kwa kusefedwa kwa glomerular kupitirira 60 ml / min, ndiye, motsogozedwa ndi chakudya chamafuta ochepa, impso zimabwezeretsedwa mokwanira ndikugwira ntchito, monga momwe zimakhalira ndi anthu athanzi.

Dziwani momwe mungawerengere kuchuluka kwako kwa kusefera kuno.

Kumbukirani kuti chakudya chamafuta ochepa sichimagwira impso. Mosakayikira, zimathandizira kukhala ndi shuga wabwinobwino m'magazi a shuga.

Amaganiziridwa kuti chifukwa cha izi, ntchito ya impso imabwezeretseka ngati mfundo yoti palibe kubwerera siyidaperekedwe. Kuti mukhale ndi shuga wabwinobwino, ngakhale pakudya chamafuta ochepa, muyenera kutsatira boma mosamalitsa.

Muyenera kukhala osalolera zakudya zosavomerezeka monga Asilamu okhulupirika ali oleza nkhumba ndi mizimu. Pangani shuga ndi glucometer osachepera 5 pa tsiku, khalani mu boma la kudziletsa kwathunthu la shuga.

Khama lomwe mukufunikira kuti lipindule nthawi zambiri ngati muonetsetsa kuti shuga yanu ikhazikika. Pakatha miyezi yochepa, mayeso amawonetsa kuti ntchito ya impso ndiyokhazikika kapena ikusintha.

Mavuto ena a matenda ashuga adzathanso.