Ukukhuluphala ngokweqileYigama elinikezwe isimo sokunqwabelana kwamafutha ngokweqile nokungajwayelekile emzimbeni okubangela ukuwohloka kwempilo. Ukuze kubalwe isimo sokukhuluphala ngokweqile, ukuhlolwa kwenkomba yesisindo somzimba kwenziwa phezu kwamanani obude nesisindo. Ekubalweni kwe-body mass index, inqubo yenziwa ngokuhlukanisa isisindo ngamakhilogremu ngesikwele sobude ngamamitha. Inani lokubala lenkomba yesisindo somzimba elingaphezu kuka-30 lisho ukuthi abantu bakhuluphele. Uma leli nani lingaphezu kuka-40, kusho ukuthi abantu bakhuluphele ngokweqile.
Izicubu zamafutha zifihla inani lezinto zamahomoni namakhemikhali ezithinta zonke izinhlelo. Ezinye izimfihlo zenza abantu bavuleke futhi imikhawulo yokugcwala idonselwe emazingeni aphezulu kanye nokukhuluphala ukuze kuthuthuke. Kubangelwa yizizathu eziningi isifo sokukhuluphala Kuthinta izitho eziningi emzimbeni womuntu. Ngenxa yalesi sizathu, ukwelapha lesi sifo, indawo lapho igatsha elingaphezu kwelilodwa lisebenza ngokuvumelana kufanele lihlelwe futhi izinqubo kufanele zenziwe.
ukwelashwa ukukhuluphala Okokuqala, ukuhlolwa kwenziwa i-endocrinologist, psychiatrist, i-nutritionist kanye nomelaphi womzimba ezigulini ezifaka isicelo sokuhlinzwa. Uma kunesidingo, iziguli kufanele zelashwe ochwepheshe benhliziyo nezifo zesifuba. Ukwengeza, kubalulekile ukuthi iziguli ezifanele zibonwe odokotela abahlinzayo abanolwazi lokuhlinzwa kwe-bariatric.
Zonke iziguli ezifaka isicelo zihlolwa ngokuningiliziwe mayelana nezici ezibangela inkinga yokukhuluphala ngokweqile, izinkinga ezingokwengqondo, imikhuba yokudla, nezimo zempilo. Njengomphumela wokuhlolwa okwenziwa ngokulandela izivivinyo, izinhlelo zokwelapha ezifanele iziguli ziyalungiswa. Izinhlelo zokwelapha zingase zihlanganise ukwelashwa noma izinketho zokuhlinzwa, kuye ngezici zeziguli, kanye nokudla okunempilo nokuzivocavoca umzimba.
Siyini Isifo Sokukhuluphala?
ukukhuluphala ngokweqile Iphakathi kwezinkinga zempilo ezibalulekile emhlabeni wonke, ikakhulukazi emazweni asethuthukile. Uma kubhekwa imininingwane yeWorld Health Organisation, kuyabonakala ukuthi abantu abayizigidi eziyizinkulungwane ezingu-1,9 emhlabeni bakhuluphele ngokweqile kanti abangu-600 million kubo bakhuluphele.
Ukukhuluphala, osekuvame ukwanda emhlabeni wonke, kuthinta kakhulu izinga kanye nobude bempilo yeziguli. Kodwa ukukhuluphala ngokweqile kuyelapheka. Ukwelashwa kwezifo zokukhuluphala Kulokhu, ukuzivocavoca futhi, uma kunesidingo, izindlela zokuhlinza zisetshenziswa kanye nokudla. Izifo ezinjengenhliziyo, i-apnea, umfutho wegazi ophakeme, umdlavuza wamathumbu, umdlavuza webele, umdlavuza wendlala yesinye zingaxazululeka ezigulini ezinqoba inkinga yokukhuluphala ngokweqile. Ngale ndlela, iziguli zingathatha isinyathelo esiholela empilweni enempilo kakhulu.
Ukukhuluphala yisifo esenzeka lapho abantu bedla ama-kilojoule amaningi kunalawo abangawadla futhi kubangela ukuba amafutha amaningi agcinwe emzimbeni kunokujwayelekile. Ukukhuluphala ngokweqile kubangela izifo ezibulalayo futhi kunciphise ukuphila komuntu. Inkomba yesisindo somzimba engaphezu kuka-40 ibizwa ngokuthi i-morbid obesity.
Ubani Ongenza Ukuhlinzwa Ukukhuluphala?
Abantu abanenkomba yesisindo somzimba phakathi kwama-35-40, kanye nalabo abanesifo sikashukela sohlobo 2 ngenxa yokukhuluphala, i-apnea yokulala, kanye nomfutho wegazi ophakeme babhekwa njengokukhuluphala ngokweqile ngokokuhlinzwa kwe-bariatric. Kungenzeka ukuhlinzwa ngisho nasezigulini ezinesifo sikashukela sohlobo 2 olusha kanye nokuphazamiseka kwemetabolism ngenxa yokukhuluphala futhi inkomba yazo yesisindo somzimba iphakathi kuka-30-35.
Ukudla kukhethwa njengendlela yokuqala yokwelashwa kubantu abaneziguli ezikhuluphele ngokweqile. Kodwa-ke, uma ukudla okuhlala isikhathi esingaphansi kwezinyanga ezingu-6 futhi kusetshenziswe okungenani kabili kungaphumeleli, ukwelapha ngokudla akuqhubeki. Kulokhu, inketho yokwelapha ephumelelayo kungaba ukuhlinzwa. Ukuhlinzwa kufanele kwenziwe ngokushesha ngangokunokwenzeka.
Yiziphi Izingozi Zokukhuluphala ngokweqile?
Ngokwezitatimende ezenziwe izinhlangano zezempilo emhlabeni, ukukhuluphala kuphakathi kwezifo eziwu-10 eziyingozi kakhulu. Namuhla, ukukhuluphala kuphakathi kwezifo ezingagwemeka ngemva kokubhema. Ngenkathi ihlushwa ukukhuluphala, iziguli kudingeka zishintshe indlela ezidla ngayo nendlela yokuphila. Izingozi zokukhuluphala ngokweqile Kubaluleke kakhulu ukuthi abantu baqaphele.
Izici Zemvelo
Namuhla, izici zomzimba zilinganiselwe kakhulu ezinganeni ezihlala emadolobheni amakhulu. Izingane zingakwazi ukuhlanganyela emisebenzini engokwenyama kuphela emakilasini okufunda ngokomzimba esikoleni. Ngenxa yalesi sizathu, ukuqondisa izingane kwezemidlalo zisencane kubalulekile mayelana nokuvimbela ukukhuluphala.
Enye yezinto okufanele ibhekwe mayelana nobungozi bemvelo ukusetshenziswa kwamakhompyutha nomabonakude. Lezi zimo zenza izingane zisebenzise amandla amancane kakhulu futhi zigcine amandla amaningi phakathi nosuku. Ngaphezu kwalokho, ukudla okungenamsoco phambi kukamabonakude noma ikhompuyutha nakho kuvula indlela yokukhuluphala.
Ukudla okunomsoco
Ngisho noma izingane ezikhuluphele ngokweqile zingadli ngaphezu kontanga yazo, zingase zikhuluphale ngoba zihamba kancane. Ukusetshenziswa kwamandla okuphansi kwezingane kudonsela ukunaka njengesinye sezici eziyingozi zokuzuza isisindo.
Ukuntuleka kwezikhathi zokudla ezinganeni, ukudla kanye noma kabili ngosuku, nokudla ukudla okunekhalori ephezulu njengama-carbohydrate noma amafrimu anamafutha kungenye yezinto ezibalulekile zokuzuza isisindo ezinganeni.
Izakhi Zofuzo
Bangu-80% ubungozi bokukhuluphala enganeni ezozalwa ngenxa yokukhuluphala kwabazali. Uma umzali oyedwa kuphela ekhuluphele ngokweqile, ingozi yehla ibe ngu-40%. Enye yezimbangela ezinkulu zokukhuluphala akukhona ukuthi iziguli zidla kakhulu, kodwa lawo mandla awasetshenziswa kakhulu njengoba edliwa. Kuyabonakala ukuthi imindeni yezingane ezinenkinga yokukhuluphala ayizibandakanyi kangako nezinto ezithinta umzimba.
Amahomoni
Izingane ezinezinkinga zokukhuluphala kufanele nakanjani zihlolwe ochwepheshe bezifo zama-hormone. Ezinye izingane ezinezinkinga zokukhuluphala zingase zibe nendlala yegilo kanye nezifo zezindlala ze-adrenal. Ngaphezu kwalokho, izinkinga zesifo sikashukela zingabonwa kulezi zingane.
Ziyini Izimbangela Zezifo Zokukhuluphala?
Ukudla okunomsoco okungajwayelekile nokungalingani, ukusetshenziswa kokudla okusheshayo, ukungenzi imidlalo kubangela izinkinga zokuzuza isisindo kanye nezinkinga zokugcoba kwezinye izitho ezibalulekile. Ukusetshenziswa kokudla okungalawuleki ezimeni zendlala yesikhathi eside, ukusetshenziswa kokudla okunama-carbohydrate nokudla okunoshukela kuphakathi kwamaphutha okudla okunempilo adala izinkinga zokukhuluphala.
Ukukhuluphala ngokweqile kubazali bobabili kwandisa amathuba okukhuluphala ezinganeni. Izifo ze-thyroid, isifo sikashukela, isifo se-adrenal gland ziphakathi kwezinkinga zokukhuluphala. Ukuze uvimbele izinkinga zokugcoba, ukwamukela ukudla okunempilo kanye nendlela yokuphila esebenzayo kusukela ebuntwaneni kuphakathi kwezindaba ezibalulekile.
Ayini Amabanga Okukhuluphala ngokweqile?
Abantu abanenkomba yesisindo somzimba engama-35-40, kanye nalabo abanesifo sikashukela sohlobo 2, i-apnea yokulala, nomfutho wegazi ophakeme ngenxa yokukhuluphala, babhekwa njengokukhuluphala ngokweqile ngokokuhlinzwa kwe-bariatric. Ukuhlinzwa kungase futhi kucatshangelwe ezigulini ezinesifo sikashukela sohlobo 2 olusha kanye nokuphazamiseka kwemetabolism ngenxa yokukhuluphala futhi inkomba yazo yesisindo somzimba iphakathi kuka-30-35. ukuhlinzwa kwe-gastric bypass Ingenye yezinhlobo ezikhethwa kakhulu zokuhlinzwa.
Ezibalweni zenkomba yesisindo somzimba, izigaba zokukhuluphala kwe-World Health Organization ziyahlolwa. Lapho abantu behlukanisa isisindo sabo ngesikwele sobude babo, umphumela uzobonisa ukuthi bakhuluphele noma cha.
· Labo abangaphansi kuka-18,5 kg/m babuthakathaka
· Abantu abanesisindo esijwayelekile esingu-18,5-24,9 kg/m
· Labo abaphakathi kuka-25-29,9 kg/mXNUMX bakhuluphele ngokweqile
· Labo abaphakathi kuka-30-39,9 kg/m bakhuluphele
· Labo abangaphezu kuka-40 kg/m bathathwa njengabakhuluphele kakhulu (abakhuluphele ngokweqile).
Ubudlelwano Phakathi Kwesifo Sikashukela Nokukhuluphala
Isifo sikashukela kanye nokukhuluphala kuhlobene. Njengoba abantu bekhuluphala, kuba nokwanda kokumelana ne-insulin. Ngenxa yalokho, iziguli zingase zibe nesifo sikashukela. Ngaphezu kwalokho, abantu bangase futhi bakhuluphale ngenxa yesifo sikashukela. Iziguli ezinesifo sikashukela sohlobo 2 zingase zithole isisindo ngenxa yokusebenzisa kwazo i-insulin.
Lesi simo asivamile uma kunesifo sikashukela sohlobo loku-1. Isizathu esenza ukuthi kubonakale kakhulu kuhlobo lwesifo sikashukela sohlobo 2 ukwanda kwenani le-insulin ekhiqizwa umzimba kanye nokusetshenziswa kwezidakamizwa ngenxa yokwanda kokumelana kwabantu. I-bypass encane yesisu Ngenye yezindlela ezisetshenziswa ekuhlinzeni i-bariatric.
Yiziphi Izindlela Zokwelapha I-Morbid Obesity Treatment?
Ukwanda kokukhuluphala ngokweqile nokuguquguqukayo kusanda kukhula kakhulu ngenxa yokushintsha kwendlela yokuphila kanye nemikhuba yokudla yeziguli. Ingxenye eyodwa kwezintathu yabantu bamazwe athuthukile, ikakhulukazi i-USA ne-England, inezinkinga zokukhuluphala ngokweqile. i-bypass yesisu Ivame ukusetshenziswa ekwelapheni ukukhuluphala.
Ukukhuluphala ngokweqile, ngokuphambene nenkolelo evamile, akusho nje ukukhuluphala ngokweqile. Ikakhulukazi ukukhuluphala ngokweqile kungase kubangele izinkinga ezengeziwe zomtholampilo ezinjengezifo zenhliziyo nemithambo yegazi, uhlobo lwesifo sikashukela sohlobo 2, i-apnea yokulala, izinkinga zamalunga, izinkinga zesikhumba, izinkinga zengqondo. Ezigulini zokukhuluphala ngokweqile, ukwanda okukhulu akwenzeki kuphela kuzicubu ze-adipose ngaphansi kwesikhumba. Cishe kuzo zonke izitho, kukhona ukwanda kokugcoba kanye nezicubu ezinamafutha ezizungezile.
Nakuba kungaziwa kabanzi emphakathini, ukukhuluphala ngokweqile kwandisa ingozi yokuba nomdlavuza. Olunye ucwaningo luye lwabonisa ukuthi abesifazane abakhulelwe abakhuluphele ngokweqile banezinkinga eziningi kumama nengane kunomama ababuthaka futhi bakhulelwa ngemva kokuhlinzwa kwe-bariatric.
Iziphi Iziguli Okwenziwa Ukuhlinzwa Ukukhuluphala?
Izindlela zokuhlinza zingakhethwa ezigulini ezinokukhuluphala ngokweqile okungenzeka zibe nezinkinga ezinkulu. Gcwalisa i-bypass yesisu Ngalokhu, abantu bangaqeda isifo sokukhuluphala. Ukwelashwa ngokuhlinzwa kuyizindlela zokwelapha eziqinile ezinikeza imiphumela engcono kakhulu ezimeni zanamuhla. Ngisho noma iziguli ezikhuluphele ngokweqile zehlisa isisindo okwesikhashana ngezinhlelo zokudla nezokuzivocavoca, izinga lazo lempumelelo liphansi kakhulu. Ngaphezu kwalokho, ingozi yokuba iziguli zithole isisindo futhi iphezulu kakhulu.
Njengoba i-metabolism ishintsha ezigulini ezithola ukwelashwa, kuba nokulahlekelwa okukhulu kwesifiso sokudla, ikakhulukazi ngemva kokuhlinzwa kwe-sleeve gastrectomy. Njengoba umthamo wesisu uncishisiwe, ukudla kuzokhawulelwa ezigulini. Ngenxa yalesi sizathu, ngeke kube okulungile ukuqhathanisa izindlela zokuhlinza kanye nezindlela zokwelapha mayelana nempumelelo. Nokho, kuseyinqubo yokuhlinzwa ngenxa yalezi zicelo. Ngaphezu kwalokho, kubaluleke kakhulu ukucabangela ukuthi kuyisinqumo esibucayi. Ukuhlinzwa okuncane kwe-gastric bypass Ngemva kwalokho, iziguli ziqala ukuncipha kalula.
Ezigulini ezinesifo sokukhuluphala ngokweqile, ukuhlinzwa kufanele kwenziwe ngezindlela ezihlukene. Iziguli kufanele zihlolwe ochwepheshe be-endocrinology, i-dietitian futhi, uma kunesidingo, isazi sokusebenza kwengqondo. Ngaphambi kokuhlinzwa, iziguli kufanele zihlolwe yi-endocrinologist ukuthi zinezinkinga zamahomoni nokuthi zikulungele yini ukuhlinzwa.
Ngaphambi kokuhlinzwa, kufanele kuqashelwe ukwenza i-endoscopy ukuze kutholwe enye i-pathology engenzeka esiswini. Iziguli kufanele zaziswe ngokuningiliziwe ongoti bokudla ngendlela yokudla ngaphambi nangemuva kokuhlinzwa. Ikakhulukazi ezinyangeni ezimbalwa zokuqala, ukulandelela kubaluleke kakhulu mayelana nokujwayela ukudla kanye ne-metabolism esimweni esisha. Ngaphezu kwalokho, iziguli kufanele zihlolwe ngokwesimo sazo esingokwengqondo ngaphambi kokuhlinzwa. Akulungile kubantu abanesifo sengqondo esibi kakhulu, abayimilutha yotshwala noma yezidakamizwa, kanye neziguli ezikhuluphele ngokweqile ezingakwazi ukuqonda imininingwane yokuhlinzwa ukuze zihlinzwe. Ukuhlinzwa kwe-gastric bypass yomjovo owodwa Uma kungenzeka, abantu abazozalwa kufanele bathole ukwesekwa komndeni okuphelele.
Ukugqugquzeleka nokugunyazwa komndeni kuzo zonke izigaba ze-oda lokudla ekhaya kuze kube inqubo yokuhlinzwa ibaluleke njengezinqumo zeziguli. Ukuhlinzwa kokukhuluphala ngokweqile ngokuvamile kuyizinhlelo ezinemingcele. Izicelo zokumuncwa okukhubazekile noma inhlanganisela yakho kokubili zingenziwa. Uma kungekho esinye isithiyo, ukuhlinzwa kungenziwa nge-laparoscopically, okungukuthi, ivaliwe.
Izicelo Zokuhlinzwa Ukukhuluphala
Ukuhlinzwa Kwesisu Kweshubhu
Ekuhlinzweni kwemikhono yesisu, cishe u-75-80% wesisu uyakhishwa. Njengoba isisu esisele ngemva kokuhlinzwa sibukeka njengeshubhu, isicelo siqanjwe kanje. Njengoba iningi lesisu likhishwa ngokuhlinzwa futhi kusele umthamo we-50-100 ml kuphela, inani lokudla elisetshenzisiwe lilinganiselwe. Ukuhlinzwa komkhono wesisu kunesici sokuba ukuhlinzwa okunemingcele. Kuyasiza ukunciphisa ukudla kanye nokulahlekelwa isisindo.
Njengoba i-hormone yesifiso sokudla ebizwa ngokuthi i-ghrelin, ekhishwa engxenyeni yesisu ekhishwa ekuhlinzweni kwe-sleeve gastrectomy, iyancipha ngemva kwenqubo, iziguli ziba nokuncipha okukhulu kwesifiso sokudla. Kuyinzuzo enyusa izinga lempumelelo ukuthi iziguli zingabuyeli ezifisweni zazo zakudala ngemva kokuhlinzwa.
Imiphumela yokuhlinzwa kwemikhono yesisu kushukela kanye nomfutho wegazi ophezulu iphezulu kakhulu. Ikakhulukazi, ukwelapha ngezidakamizwa ngomlomo kuphela ngokuvamile akudingekile emithini esetshenziswa iziguli ezinesifo sikashukela kanye neziguli ezinomfutho wegazi ophakeme. Le miphumela emihle izoqala ngokushesha ngemva kokuhlinzwa.
I-Gastric Bypass
i-bypass yesisu Ekufakweni komminzo, ingxenye encane ngemva nje kokuba umminzo ishiywe, futhi ingxenye enkulu iyadlula. Kule nqubo, ukuhlinzwa kwenziwa ngokuletha amathumbu amancane engxenyeni yesisu futhi ahlobise ngokuhambisana nenqubo. Ngenxa yalesi sizathu, kokubili umthamo wesisu uyancipha futhi ingxenye yamathumbu ikhutshaziwe. Ngale ndlela, kokubili inani lokudla okudliwe lizoba lincane futhi ukumuncwa kuzothinteka. Ngale ndlela, ukulawula ushukela wegazi kwabanesifo sikashukela abathembele ku-insulin kwenziwa ngempumelelo kakhulu.
Kunqunywa Kanjani Iyiphi Indlela Ezokhethwa?
Namuhla, awukho umehluko omkhulu wezobuchwepheshe phakathi kwale misebenzi emibili. Njengoba ukuhlinzwa kwe-sleeve gastrectomy kungokomzimba kakhulu, kunamazinga aphansi ezinkinga nokufa okuhlobene nokusebenza. Ukuhlinzwa kwemikhono yesisu kwenziwa ngesikhathi esifushane kakhulu. Kulula futhi ukufaka isicelo ngokuhlinzwa. Umkhono wesisu noma ukuhlinzwa kwe-bypass Odokotela banquma ukuthi yikuphi ukwelashwa okufanele.
Ngemuva kwalezi zindlela zombili, iziguli zingaphinda zithole isisindo phakathi neminyaka engu-3-4. Uma ukuhlinzwa kwe-sleeve gastrectomy kukhethwa ngokobuchwepheshe, i-resleeve noma i-gastric bypass ingasetshenziswa kulezi ziguli. Uma iziguli zike zaba ne-gastric bypass ngaphambilini, azinalo ithuba lokwelashwa kokuhlinzwa okwesibili uma kwenzeka ziphinde zazuza isisindo. Okufanele kwaziwe lapha ukuthi indlela yokuhlinza ekhethwayo kufanele inqunywe ngokukhethekile ezigulini ngenxa yokuhlolwa nokuhlolwa okufanele kwenziwe ngudokotela.
Inkinga ebaluleke kakhulu ku-sleeve gastrectomy kanye nokuhlinzwa kwe-gastric bypass ukuvuza noma izinkinga zokopha. Ngokuthuthuka kwamasu nesipiliyoni sesimanje, lezi zinkinga zehliswe kakhulu. Izindlela ezihlasela kancane ziyakhethwa kuzo zombili lezi zindlela. Ngale ndlela, kulula kakhulu ukuthi iziguli zibuyele empilweni yazo evamile ngemva kokuhlinzwa.
Ukuhlinzwa Ukukhuluphala ETurkey
Njengoba ukuhlinzwa ukukhuluphala kwenziwa ngempumelelo eTurkey, kudume kakhulu kwezokuvakasha kwezempilo. Ngaphezu kwalokho, ngenxa yokuhwebelana okuphezulu kwangaphandle eTurkey, iziguli ezivela phesheya zingahlinzwa ngamanani angabizi kakhulu. Izintengo zokuhlinzwa kwe-Bariatric eTurkey Ungaxhumana nathi ukuze uthole imininingwane eyengeziwe ngakho.
Shiya Amazwana