Ib qho tseem ceeb ntawm kev rov qab los ntawm kev noj zaub mov tsis zoo yog kev noj zaub mov zoo . Qhov no txhais tau hais tias haus cov calorie ntau ntau ntawm cov kev ua haujlwm kom tau raws li qhov xav tau ntawm lub cev thiab cia nws kho. Cov neeg ntawm txhua tus genders, hnub nyoog, duab, thiab ntau thiab tsawg muaj peev xwm noj zaub mov tsis zoo thiab tsis noj mov ; koj tuaj yeem tsis paub hais tias tus neeg ntawd puas noj qab nyob zoo lossis muaj mob xwb los ntawm kev saib xyuas lawv.
Hauv tsab ntawv no, peb yuav tham txog lub luag haujlwm ntawm kev pub noj haus ntxiv rau kev noj qab haus huv kev noj qab haus huv, los ntawm qhov ncauj noj haus zoo xws li Paub Kom Zoo los sis Txo Boost kom siv ntau hom kev pub mis.
Qee cov ntsiab lus tseem ceeb ntawm kev noj haus
Thawj zaug ntawm txhua yam, qhov kev noj haus zoo li cas, tseem hu ua refeeding, entail? Vim cov neeg mob uas noj zaub mov feem ntau tsis muaj kev noj qab nyob zoo- tsis hais txog lub cev qhov hnyav npaum li cas- yog ib qho kev xaiv ntawm tus kheej uas yuav tsum tau muaj nyob rau hauv cov kws kho mob cov kws kho mob, cov tswv yim zoo tshaj plaws hauv kev noj qab nyob zoo. Lub hom phiaj ua tau nce mus ntxiv, tsim muaj cov pluas noj thiab cov khoom noj txom ncauj uas zoo sib xws. Thaum ib tus neeg muaj mob tsis txaus ntseeg vim yog caloric deprivation (txwv tsis pub muaj caloric deprivation), cov khoom noj tsis zoo, los yog kev noj haus tsis muaj zog), lawv cov metabolism ua rau qeeb qeeb thiab tiv thaiv lub cev qhov hnyav.
Qhov no yog li cas peb dim kev tshaib kev nqhis ua ib hom kab.
Thaum cov neeg muaj kev noj qab nyob zoo pib rov ua haujlwm, nws yuav ua rau nws xav tias noj mov ntau tshaj li qhov tsawg tshaj plaws uas tau noj mov. Tom qab tag nrho, hais tias kev noj qab nyob zoo suab tau nrov, txhais tias, thiab xav tau heev. Txawm li cas los xij, peb lub cev yog cov miraculous thiab ntau smarter tshaj peb muab lawv credit rau.
Pib noj ntau calories-hais, 1600 los sis ntau tshaj ib hnub-puas muaj ib yam dab tsi: Nws ua rau tib neeg cov metabolism tsis ua rau hnyav nce. Koj nyeem hais tias txoj cai. Qhov no txhais tau hais tias thaum ib tus neeg tau txwv tsis pub calorie ntau ntau, thiab xav tias lawv qhov hnyav yuav tsis txo qis dua (thiab tej zaum hnov tob tob thiab nkees thiab nquam paj nquam nruas), pib noj tsawg kawg yog 1600 calories ib hnub twg, lawv qhov hnyav yuav nyob ruaj khov, thaum lawv cov metabolism hauv txoj kev nce mus.
Amazingly txaus, thaum yav dhau los malnourished neeg mus ntxiv los ntawm cov txheej txheem noj haus, lawv ua hypermetabolic . Ntawd yog, lawv yuav tsum haus 3000 lossis ntau calorie ntau ntau ib hnub xwb es rov qab 1-2 phaus ntawm lub cev hnyav ib lub lim tiam. Muaj kev txaus ntshai rau kev thim rov qab, nrog rau kev poob qis ntawm cov ntshav ntawm phosphorus, hu ua hypophosphatemia. Yav tag los, qhov kev pom zoo yog tias calorie ntau ntau yuav tsum tau pib qeeb heev, kom tsis txhob mob hypophosphatemia. Txawm li cas los xij, cov kev tshawb fawb tshiab tau qhia tau tias nws yeej zoo dua qub kom tau txais cov metabolism mus, tu lub cev thiab lub hlwb, thiab tsis pib qeeb-thiab phosphorus qib zoo xwb.
Yuav Ua Li Cas Thiaj Tau Txais Cov Caij Nyoog Hauv
Cov lus nug ces yog: Yuav ua li cas peb tau txais cov calories no? Feem ntau cov neeg muaj kev noj mov tuaj yeem noj zaub mov , thiab cov zaub mov tsis tu ncua tas li yog qhov zoo tshaj plaws uas yuav tau txais hauv ib qho calories thiab micronutrients.
Txawm li cas los xij, thaum qee qhov kev xav tau cov zaub mov tseem ceeb, nws nyuaj rau haus txhua yam khoom noj. Hauv cov rooj plaub no, ib qho khoom plig zoo xws li Ensure Plus (ntawm 355 kcal / lub raj mis) lossis Koob Phom (ntawm 290 calorie nyob rau hauv 4 ounces) yog yooj yim dua ntawm lub plab tas li ntawm cov calorie ntau ntau hauv cov zaub mov.
Qee cov dietitians xaiv xaiv zaub mov noj qhov chaw noj mov (noj pluas tshais, pluas su, thiab noj hmo) nyob li qub, tab sis cov khoom noj txom ncauj tau ntev dua, qee zaum siv cov ntawv ntxiv. Qhov no, thaum lub hom phiaj nyhav tau tiav lawm, cov tshuaj noj thiab qhov ntau ntau ntawm cov khoom noj txom ncauj hloov, tab sis lub ntsiab pluas noj nyob ntawm ib qho kev npaj kho, ua rau muaj kev txhawj xeeb tsawg dua.
Kuj, qee cov neeg mob yuav tsum tau "kho" lawv cov calories pib. Thaum noj mov ntau yam khoom noj txaus ntshai heev rau txoj kev noj mov, tsuas yog tau txais cov calorie ntau ntxiv los ntawm qhov ntxiv tau zoo kawg nkaus. Lub hom phiaj, tau kawg, yog ib txwm rov qab los noj mov ntau yam khoom noj. Rau cov neeg uas coj qhov teeb meem ntawm cov tshuaj ua cov zaub mov "tsawg dua" los yog ua haujlwm dhau los, peb yuav tau hais: Tsis muaj dab tsi ntau tshaj kev txwv. Yog li, yog hais tias ib qho ntxiv pab ib tug neeg tsiv los ntawm cov hnub nyoog thaum ntxov ntawm kev noj haus, qhov no yog qhov zoo tshaj qhov qub nrog lub plab mob plab.
Pub Hlab
Qee zaum, cov neeg mob uas noj tshuaj yuav tsum tau muab me me, ywj pheej ntxig rau hauv lub qhov ntswg, tawm hauv plab los yog hnyuv hnyuv. Cov nas qoob no (NG) los yog nasojejunal (NJ) plab yuav muab tau kev noj haus tas mus li los ntawm lawv tus kheej los yog ntxiv tau zaub mov noj thaum nruab hnub nrog rau cov khoom noj hmo ntuj. Rau cov neeg mob hauv tsev kho mob, ua ke ntawm NG feeds thiab noj cov zaub mov hauv nruab hnub tuaj yeem pab cov neeg mob noj calorie txaus los ua kom rov qab muaj nyhav dua, thiab yuav tsum tsis txhob muaj teeb meem xws li ntshav qab zib tsawg tsawg.
NG noj kuj tseem pab tau "kho" cov calorie ntau ntau thaum cov neeg mob xav ua kom zoo rov tuaj tab sis tseem tsis tau noj. Tsis tshua muaj neeg mob, cov neeg mob yuav siv cov NG leeg nyob hauv tsev. Qhov no tsis yog feem ntau pom zoo, vim tias muaj kev pheej hmoo siab ntawm cov neeg mob sab kev kho mob los ntawm kev xa tawm tube, tsis siv lawv zoo, los yog rub tawm lub raj. Yog tias tus neeg mob yog tus mob hauv lawv cov kab mob, feem ntau lawv muaj nyob rau hauv qib siab ntawm kev tu mob tshwj xeeb . Lub NG tube tuaj yeem nyob rau hauv qhov chaw kom txog li ntawm 6 lub lim tiam nrog kev kho mob zoo, tiam sis kev pheej hmoo ntawm kev siv muaj xws li sinusitis (mob plawv), mob plawv, ua pheromonia (thaum mob plab rov qab ua lub caj pas thiab hauv lub ntsws), thiab lub suab qaum voos lossis raug mob.
Kuj muaj ntau lub cev pub rau cov neeg uas noj zaub mov, xws li cov roj ntsha (percutaneous gastrostomy) (PEG) raj los yog cov hlab ntsha ntawm Percutaneous jejunostomy (PEJ). Cov no tuaj yeem tso tau los ntawm tus kws phais mob, tus kws kho mob GI, los yog cov kws kho mob cov teebmeem. Qhov taw qhia tseem ceeb tshaj plaws los ua ntawm no yog tias cov tub ntxhais PEG yuav tsum tsis txhob muab tso vim tias ib tug neeg muaj kev txwv tsis pub lawv ua. Feem ntau, cov kws kho mob tsis muaj peev xwm yuav hais txog tus neeg mob anorexia nervosa, "Cia li muab tso rau hauv ib lub PEG." Yog hais tias ib tus neeg txwv tsis pub calorie ntau ntau ntawm qhov ncauj, lawv yuav txwv tsis pub calories los ntawm lub raj!
Cov PEGs yuav tsum tseg rau cov xwm txheej uas tsuas yog ib tus neeg tau txais kev noj haus txaus los ntawm PEG. Cov teeb meem zoo li no muaj xws li mob tsis xeev ntuav, qhov PEJ pub rau noj hauv plab hauv plab uas nws tsis tuaj yeem ntuav tawm. Tsis tas li ntawd, nyob rau hauv lub siab me mesenteric artery syndrome, qhov uas cov hnyuv tau hle nruab nrab ntawm ob lub hlab ntsha hauv qhov chaw ntawm lub cev sai los yog ntau qhov hnyav, tus txheej txheem kev saib xyuas yog muab kev noj haus ua kua haus kom txog thaum muaj hnyav dua. Tsuas yog tias qhov kev ua rau sab nraud loj heev yuav tsum tau muab tso rau PEJ.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov hlab no raug mob ntau heev, thiab lawv qhov kev tso kawm yog feem ntau nyuaj los ntawm qhov mob, xeev siab, ua pa nyuaj, thiab teeb meem pib noj cov raj. Tshem lub raj ua ntej rau 6 lub lis piam tuaj yeem ua rau muaj mob loj heev hauv plab. Cov kev siv yuav tsum raug tshwj tseg rau cov neeg uas muaj kev txawj ntse.
> Cov chaw
> Garber AK, Sawyer SM, Golden NH, Guarda AS, Katzman DK, Kohn MR, Le Grange D, Madden S, Whitelaw M, Redgrave GW. Kev rov ntsuam xyuas ntawm cov kev xav mus rau hauv cov neeg mob uas muaj qhov mob anorexia. Int J noj zaub mov. 2016 Mar; 49 (3): 293-310
> Gaudiani JL, Mehler PS. Cov kev mob tshwm sim tsis tshua muaj kev txwv tsis pub hnav thiab ua kom zoo: "Zebras," tsis tuaj yeem kuaj mob, thiab cov kev coj ua zoo tshaj plaws. Int J noj zaub mov. 2016 Mar; 49 (3): 331-44
> Madden S, Miskovic-Wheatley J, Clarke S, Touyz S, Nyab P, Kohn MR. Cov txiaj ntsig ntawm kev ceev nrawm raws tu qauv hauv Cov Tub Ntxhais Hluas (Anorexia Nervosa). J Kev Noj Yeeb Yuam Noj. 2015 Mar 25; 3: 8
> Maginot TR, Kumar MM, Shiels J, Kaye W, Rhais KE. Cov txiaj ntsig tau los ntawm ib tus neeg pw hauv tsev kho mob rau cov hluas uas muaj qhov mob anorexia: Rady Children's Hospital San Diego / University of California, San Diego. J Kev Noj Yeeb Yuam Noj. 2017 Jan 3; 5: 1