Shiriti gastrik, i njohur gjer\u00ebsisht si shirit gastrik, \u00ebsht\u00eb nj\u00eb nga metodat kirurgjikale q\u00eb p\u00ebrdoret n\u00eb trajtimin e obezitetit morbid. Kjo metod\u00eb, e njohur edhe si banda gastrike; \u00cbsht\u00eb procesi i vendosjes s\u00eb nj\u00eb brezi rreth stomakut, af\u00ebrsisht 200 mm n\u00ebn kryq\u00ebzimin e ezofagut dhe stomakut.<\/p>\n\n\n\n
Shiriti i vendosur n\u00eb stomak fryhet hap pas hapi duke injektuar serum p\u00ebrmes nj\u00eb porti n\u00ebn l\u00ebkur\u00eb, 1 muaj pas operacionit. Avantazhi m\u00eb i madh i k\u00ebtij aplikacioni, si\u00e7 sugjeron edhe emri, \u00ebsht\u00eb se mund t\u00eb rregullohet pas operacionit. Shiriti i b\u00ebr\u00eb nga silikoni e ndan stomakun n\u00eb dy ndarje si nj\u00eb or\u00eb r\u00ebre. Mbushja e qeses s\u00eb sip\u00ebrme t\u00eb vog\u00ebl t\u00eb stomakut me ushqim ofron nj\u00eb ndjenj\u00eb t\u00eb ngopjes s\u00eb hershme. K\u00ebshtu, me nj\u00eb ndjenj\u00eb t\u00eb ngopjes, marrja e ushqimit zvog\u00eblohet drejtp\u00ebrdrejt.<\/p>\n\n\n\n
Parimi baz\u00eb i metod\u00ebs s\u00eb brezit gastrik \u00ebsht\u00eb ndryshimi i zakoneve t\u00eb sjelljes dhe stilit t\u00eb t\u00eb ushqyerit t\u00eb pacientit, si n\u00eb metodat e tjera kirurgjikale.<\/p>\n\n\n\n
Cilat jan\u00eb llojet e shiritave gastrik\u00eb?<\/p>\n\n\n\n
N\u00eb dit\u00ebt e sotme, ka shum\u00eb shirita gastrik\u00eb me miratime nga FDA dhe CE. Dallimet kryesore midis grupeve n\u00eb fjal\u00eb jan\u00eb sasit\u00eb e tyre t\u00eb mbushjes, disa dallime formale dhe strukturat portuale, ve\u00e7an\u00ebrisht mb\u00ebshtetja e tyre n\u00eb literatur\u00eb. Nd\u00ebrsa disa shirita kan\u00eb nj\u00eb v\u00ebllim mbushjeje maksimale prej 6 cc, disa mund t\u00eb arrijn\u00eb mbushjen 9 \u2013 11 cc. Gjer\u00ebsia e pjes\u00ebs s\u00eb brezit t\u00eb mb\u00ebshtjell\u00eb rreth stomakut ndryshojn\u00eb. Disa shirita kan\u00eb nj\u00eb tipar t\u00eb ‘kujtes\u00ebs s\u00eb form\u00ebs’ q\u00eb merr form\u00eb direkt kur kalohet pas stomakut.<\/p>\n\n\n\n
Shiritat e stomakut aktual q\u00eb p\u00ebrdoren n\u00eb vendin ton\u00eb;<\/p>\n\n\n\n
Lapband (Lap-Band\/ Bioenterics Corp, SHBA),<\/p>\n\n\n\n
Band\u00eb e rregullueshme suedeze (Allergan \u2013 Obtech Medical AG e Zvicr\u00ebs),<\/p>\n\n\n\n
Midband (Zhvillimi i Inovacionit Mjek\u00ebsor n\u00eb Lyon, Franc\u00eb)<\/p>\n\n\n\n
A.M.I Soft Gastric Band Premium (Agjencia A.M.I e Inovacionit Mjek\u00ebsor, Austri) dhe<\/p>\n\n\n\n
Heliogast Advanced (Helioscopie, Lyon, Franc\u00eb).<\/p>\n\n\n\n
Si t\u00eb vendosni nj\u00eb shirit gastrik?<\/p>\n\n\n\n
Metoda e brezit gastrik (clamp; shirit gastrik i rregulluesh\u00ebm; brezi gastrik i rregulluesh\u00ebm; brezi gastrik i rregulluesh\u00ebm laparoskopik: LAGB) aplikohet duke p\u00ebrdorur nd\u00ebrhyrje laparoskopike n\u00eb shum\u00eb pacient\u00eb. Kryerja e prerjeve shum\u00eb t\u00eb vogla gjat\u00eb operacionit i mund\u00ebson pacientit t\u00eb kthehet n\u00eb jet\u00ebn e p\u00ebrditshme n\u00eb nj\u00eb koh\u00eb t\u00eb shkurt\u00ebr. Pacienti humbet af\u00ebrsisht 60 deri n\u00eb 80 p\u00ebr qind t\u00eb pesh\u00ebs s\u00eb tij t\u00eb tep\u00ebrt n\u00eb 12 deri n\u00eb 24 muaj pas operacionit. N\u00ebse nuk ka problem me shiritin gastrik, k\u00ebta pacient\u00eb nuk kan\u00eb rrezik p\u00ebr t\u00eb shtuar pesh\u00eb.<\/p>\n\n\n\n
Si kryhet operacioni me kap\u00ebse gastrike?<\/p>\n\n\n\n
Kirurgjia e brezit gastrik \u00ebsht\u00eb metoda e vendosjes s\u00eb nj\u00eb brezi silikoni 3 deri n\u00eb 4 cm posht\u00eb pjes\u00ebs ku bashkohen ezofagu dhe stomaku. Duke qen\u00eb se pjesa e sip\u00ebrme e stomakut do t\u00eb jet\u00eb m\u00eb e vog\u00ebl, pacienti do t\u00eb ndihet i ngopur duke konsumuar m\u00eb pak ushqim.
Pozicioni i pacientit: Pasi pacienti vendoset n\u00eb shpin\u00eb n\u00eb tryez\u00ebn e operacionit, k\u00ebmb\u00ebt e tij jan\u00eb t\u00eb p\u00ebrkulura 300\u00b0 posht\u00eb. Operatori punon midis k\u00ebmb\u00ebve t\u00eb pacientit n\u00eb pozicionin e kund\u00ebrt Trendelenburg.<\/p>\n\n\n\n
Fryrja e barkut me gaz: Nj\u00eb gjilp\u00ebr\u00eb speciale e quajtur Verres futet p\u00ebrmes prerjes mbi k\u00ebrthiz\u00eb. Ose, n\u00ebse kirurgu ka p\u00ebrvoj\u00eb, nj\u00eb hyrje dhe inflacion m\u00eb i sigurt abdominal arrihet duke par\u00eb shtresat nj\u00eb nga nj\u00eb me nj\u00eb trokar optik (trokar vizual). Prerja e par\u00eb; Ajo kryhet af\u00ebrsisht 6 gishta posht\u00eb dhe n\u00eb pjes\u00ebn e mesme t\u00eb kock\u00ebs s\u00eb gjoksit. Kjo prerje, p\u00ebrmes s\u00eb cil\u00ebs do t\u00eb hyj\u00eb kamera optike, \u00ebsht\u00eb af\u00ebrsisht 10 mm e gjat\u00eb. Ai \u00ebsht\u00eb i mbushur me gaz dioksid karboni n\u00eb m\u00ebnyr\u00eb q\u00eb presioni intra-abdominal t\u00eb jet\u00eb 15 mmHg. Q\u00ebllimi i k\u00ebsaj \u00ebsht\u00eb t\u00eb shtyj\u00eb zorr\u00ebt dhe organet e barkut prapa dhe t\u00eb mbroj\u00eb organet nga l\u00ebndimet.<\/p>\n\n\n\n
Futja e trokareve dhe instrumenteve t\u00eb dor\u00ebs: Gjithsej 5 trokare (kanula n\u00ebp\u00ebr t\u00eb cilat do t\u00eb kalojn\u00eb instrumentet) futen p\u00ebrmes prerjeve ekzistuese.<\/p>\n\n\n\n
Diseksioni: Anesteziologu fut n\u00eb stomak nj\u00eb tub nazogastrik me nj\u00eb tullumbace t\u00eb fryr\u00eb n\u00eb fund. Baloni intragastrik fryhet me 2.5 cc serum dhe t\u00ebrhiqet. N\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb, baloni ngjitet n\u00eb kryq\u00ebzimin gastroezofageal. Kjo fryrje n\u00eb stomak gjithashtu i lejon kirurgut t\u00eb vendos\u00eb se ku t\u00eb filloj\u00eb diseksionin.<\/p>\n\n\n\n
Diseksioni i lakimit t\u00eb vog\u00ebl: Ky diseksion duhet t\u00eb kryhet sa m\u00eb af\u00ebr murit t\u00eb stomakut, me p\u00ebrpjekje maksimale p\u00ebr t\u00eb mos e d\u00ebmtuar at\u00eb dhe nervi laterjet duhet t\u00eb mbrohet.<\/p>\n\n\n\n
Diseksioni i ligamentit frenogastrik: Fundusi gastrik, dometh\u00ebn\u00eb pjesa e sip\u00ebrme e stomakut, kapet me nj\u00eb kap\u00ebse duke hyr\u00eb p\u00ebrmes trokarit m\u00eb t\u00eb jasht\u00ebm dhe t\u00ebrhiqet posht\u00eb. K\u00ebshtu, lidhja midis stomakut dhe diafragm\u00ebs, e quajtur ligament frenogastrik, shtrihet.<\/p>\n\n\n\n
Tuneli retrogastrik: Rotikulatori Endograsp ose Disektori Artikulues futet p\u00ebrmes trokarit n\u00eb kuadrantin e sip\u00ebrm t\u00eb djatht\u00eb dhe avancohet p\u00ebrmes tunelit retrogastrik n\u00ebn vizionin e drejtp\u00ebrdrejt\u00eb. M\u00eb pas, instrumenti \u00ebsht\u00eb i k\u00ebnduar n\u00eb m\u00ebnyr\u00eb q\u00eb ligamenti frenogastrik t\u00eb jet\u00eb i duksh\u00ebm n\u00eb zon\u00ebn e diseksionit, dometh\u00ebn\u00eb n\u00eb an\u00ebn e kund\u00ebrt.<\/p>\n\n\n\n
Futja dhe vendosja e brezit: N\u00eb p\u00ebrgjith\u00ebsi, pjesa e tubit t\u00eb brezit vendoset n\u00eb bark p\u00ebrmes trokarit m\u00eb t\u00eb jasht\u00ebm 10 mm. Ky fund \u00ebsht\u00eb i lidhur me nj\u00eb rrotullues endograsp dhe kalohet pas stomakut n\u00eb nivelin e zon\u00ebs s\u00eb disektimit. Pasi tubi i shiritit kalohet p\u00ebrmes mekanizmit t\u00eb ky\u00e7jes, brezi i silikonit vendoset rreth stomakut dhe shtr\u00ebngohet.<\/p>\n\n\n\n
Shiriti gastrik, i njohur gjer\u00ebsisht si shirit gastrik, \u00ebsht\u00eb nj\u00eb nga metodat kirurgjikale q\u00eb p\u00ebrdoret n\u00eb trajtimin e obezitetit morbid. Kjo metod\u00eb, e njohur edhe si banda gastrike; \u00cbsht\u00eb procesi i vendosjes s\u00eb nj\u00eb brezi rreth stomakut, af\u00ebrsisht 200 mm n\u00ebn kryq\u00ebzimin e ezofagut dhe stomakut.<\/p>\n\n\n\n
Shiriti i vendosur n\u00eb stomak fryhet hap pas hapi duke injektuar serum p\u00ebrmes nj\u00eb porti n\u00ebn l\u00ebkur\u00eb, 1 muaj pas operacionit. Avantazhi m\u00eb i madh i k\u00ebtij aplikacioni, si\u00e7 sugjeron edhe emri, \u00ebsht\u00eb se mund t\u00eb rregullohet pas operacionit. Shiriti i b\u00ebr\u00eb nga silikoni e ndan stomakun n\u00eb dy ndarje si nj\u00eb or\u00eb r\u00ebre. Mbushja e qeses s\u00eb sip\u00ebrme t\u00eb vog\u00ebl t\u00eb stomakut me ushqim ofron nj\u00eb ndjenj\u00eb t\u00eb ngopjes s\u00eb hershme. K\u00ebshtu, me nj\u00eb ndjenj\u00eb t\u00eb ngopjes, marrja e ushqimit zvog\u00eblohet drejtp\u00ebrdrejt.<\/p>\n\n\n\n
Parimi baz\u00eb i metod\u00ebs s\u00eb brezit gastrik \u00ebsht\u00eb ndryshimi i zakoneve t\u00eb sjelljes dhe stilit t\u00eb t\u00eb ushqyerit t\u00eb pacientit, si n\u00eb metodat e tjera kirurgjikale.<\/p>\n\n\n\n
Cilat jan\u00eb llojet e shiritave gastrik\u00eb?<\/p>\n\n\n\n
N\u00eb dit\u00ebt e sotme, ka shum\u00eb shirita gastrik\u00eb me miratime nga FDA dhe CE. Dallimet kryesore midis grupeve n\u00eb fjal\u00eb jan\u00eb sasit\u00eb e tyre t\u00eb mbushjes, disa dallime formale dhe strukturat portuale, ve\u00e7an\u00ebrisht mb\u00ebshtetja e tyre n\u00eb literatur\u00eb. Nd\u00ebrsa disa shirita kan\u00eb nj\u00eb v\u00ebllim mbushjeje maksimale prej 6 cc, disa mund t\u00eb arrijn\u00eb mbushjen 9 \u2013 11 cc. Gjer\u00ebsia e pjes\u00ebs s\u00eb brezit t\u00eb mb\u00ebshtjell\u00eb rreth stomakut ndryshojn\u00eb. Disa shirita kan\u00eb nj\u00eb tipar t\u00eb ‘kujtes\u00ebs s\u00eb form\u00ebs’ q\u00eb merr form\u00eb direkt kur kalohet pas stomakut.<\/p>\n\n\n\n
Shiritat e stomakut aktual q\u00eb p\u00ebrdoren n\u00eb vendin ton\u00eb;<\/p>\n\n\n\n
Lapband (Lap-Band\/ Bioenterics Corp, SHBA),<\/p>\n\n\n\n
Band\u00eb e rregullueshme suedeze (Allergan \u2013 Obtech Medical AG e Zvicr\u00ebs),<\/p>\n\n\n\n
Midband (Zhvillimi i Inovacionit Mjek\u00ebsor n\u00eb Lyon, Franc\u00eb)<\/p>\n\n\n\n
A.M.I Soft Gastric Band Premium (Agjencia A.M.I e Inovacionit Mjek\u00ebsor, Austri) dhe<\/p>\n\n\n\n
Heliogast Advanced (Helioscopie, Lyon, Franc\u00eb).<\/p>\n\n\n\n
Si t\u00eb vendosni nj\u00eb shirit gastrik?<\/p>\n\n\n\n
Metoda e brezit gastrik (clamp; shirit gastrik i rregulluesh\u00ebm; brezi gastrik i rregulluesh\u00ebm; brezi gastrik i rregulluesh\u00ebm laparoskopik: LAGB) aplikohet duke p\u00ebrdorur nd\u00ebrhyrje laparoskopike n\u00eb shum\u00eb pacient\u00eb. Kryerja e prerjeve shum\u00eb t\u00eb vogla gjat\u00eb operacionit i mund\u00ebson pacientit t\u00eb kthehet n\u00eb jet\u00ebn e p\u00ebrditshme n\u00eb nj\u00eb koh\u00eb t\u00eb shkurt\u00ebr. Pacienti humbet af\u00ebrsisht 60 deri n\u00eb 80 p\u00ebr qind t\u00eb pesh\u00ebs s\u00eb tij t\u00eb tep\u00ebrt n\u00eb 12 deri n\u00eb 24 muaj pas operacionit. N\u00ebse nuk ka problem me shiritin gastrik, k\u00ebta pacient\u00eb nuk kan\u00eb rrezik p\u00ebr t\u00eb shtuar pesh\u00eb.<\/p>\n\n\n\n
Si kryhet operacioni me kap\u00ebse gastrike?<\/p>\n\n\n\n
Kirurgjia e brezit gastrik \u00ebsht\u00eb metoda e vendosjes s\u00eb nj\u00eb brezi silikoni 3 deri n\u00eb 4 cm posht\u00eb pjes\u00ebs ku bashkohen ezofagu dhe stomaku. Duke qen\u00eb se pjesa e sip\u00ebrme e stomakut do t\u00eb jet\u00eb m\u00eb e vog\u00ebl, pacienti do t\u00eb ndihet i ngopur duke konsumuar m\u00eb pak ushqim.
Pozicioni i pacientit: Pasi pacienti vendoset n\u00eb shpin\u00eb n\u00eb tryez\u00ebn e operacionit, k\u00ebmb\u00ebt e tij jan\u00eb t\u00eb p\u00ebrkulura 300\u00b0 posht\u00eb. Operatori punon midis k\u00ebmb\u00ebve t\u00eb pacientit n\u00eb pozicionin e kund\u00ebrt Trendelenburg.<\/p>\n\n\n\n
Fryrja e barkut me gaz: Nj\u00eb gjilp\u00ebr\u00eb speciale e quajtur Verres futet p\u00ebrmes prerjes mbi k\u00ebrthiz\u00eb. Ose, n\u00ebse kirurgu ka p\u00ebrvoj\u00eb, nj\u00eb hyrje dhe inflacion m\u00eb i sigurt abdominal arrihet duke par\u00eb shtresat nj\u00eb nga nj\u00eb me nj\u00eb trokar optik (trokar vizual). Prerja e par\u00eb; Ajo kryhet af\u00ebrsisht 6 gishta posht\u00eb dhe n\u00eb pjes\u00ebn e mesme t\u00eb kock\u00ebs s\u00eb gjoksit. Kjo prerje, p\u00ebrmes s\u00eb cil\u00ebs do t\u00eb hyj\u00eb kamera optike, \u00ebsht\u00eb af\u00ebrsisht 10 mm e gjat\u00eb. Ai \u00ebsht\u00eb i mbushur me gaz dioksid karboni n\u00eb m\u00ebnyr\u00eb q\u00eb presioni intra-abdominal t\u00eb jet\u00eb 15 mmHg. Q\u00ebllimi i k\u00ebsaj \u00ebsht\u00eb t\u00eb shtyj\u00eb zorr\u00ebt dhe organet e barkut prapa dhe t\u00eb mbroj\u00eb organet nga l\u00ebndimet.<\/p>\n\n\n\n
Futja e trokareve dhe instrumenteve t\u00eb dor\u00ebs: Gjithsej 5 trokare (kanula n\u00ebp\u00ebr t\u00eb cilat do t\u00eb kalojn\u00eb instrumentet) futen p\u00ebrmes prerjeve ekzistuese.<\/p>\n\n\n\n
Diseksioni: Anesteziologu fut n\u00eb stomak nj\u00eb tub nazogastrik me nj\u00eb tullumbace t\u00eb fryr\u00eb n\u00eb fund. Baloni intragastrik fryhet me 2.5 cc serum dhe t\u00ebrhiqet. N\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb, baloni ngjitet n\u00eb kryq\u00ebzimin gastroezofageal. Kjo fryrje n\u00eb stomak gjithashtu i lejon kirurgut t\u00eb vendos\u00eb se ku t\u00eb filloj\u00eb diseksionin.<\/p>\n\n\n\n
Diseksioni i lakimit t\u00eb vog\u00ebl: Ky diseksion duhet t\u00eb kryhet sa m\u00eb af\u00ebr murit t\u00eb stomakut, me p\u00ebrpjekje maksimale p\u00ebr t\u00eb mos e d\u00ebmtuar at\u00eb dhe nervi laterjet duhet t\u00eb mbrohet.<\/p>\n\n\n\n
Diseksioni i ligamentit frenogastrik: Fundusi gastrik, dometh\u00ebn\u00eb pjesa e sip\u00ebrme e stomakut, kapet me nj\u00eb kap\u00ebse duke hyr\u00eb p\u00ebrmes trokarit m\u00eb t\u00eb jasht\u00ebm dhe t\u00ebrhiqet posht\u00eb. K\u00ebshtu, lidhja midis stomakut dhe diafragm\u00ebs, e quajtur ligament frenogastrik, shtrihet.<\/p>\n\n\n\n
Tuneli retrogastrik: Rotikulatori Endograsp ose Disektori Artikulues futet p\u00ebrmes trokarit n\u00eb kuadrantin e sip\u00ebrm t\u00eb djatht\u00eb dhe avancohet p\u00ebrmes tunelit retrogastrik n\u00ebn vizionin e drejtp\u00ebrdrejt\u00eb. M\u00eb pas, instrumenti \u00ebsht\u00eb i k\u00ebnduar n\u00eb m\u00ebnyr\u00eb q\u00eb ligamenti frenogastrik t\u00eb jet\u00eb i duksh\u00ebm n\u00eb zon\u00ebn e diseksionit, dometh\u00ebn\u00eb n\u00eb an\u00ebn e kund\u00ebrt.<\/p>\n\n\n\n
Futja dhe vendosja e brezit: N\u00eb p\u00ebrgjith\u00ebsi, pjesa e tubit t\u00eb brezit vendoset n\u00eb bark p\u00ebrmes trokarit m\u00eb t\u00eb jasht\u00ebm 10 mm. Ky fund \u00ebsht\u00eb i lidhur me nj\u00eb rrotullues endograsp dhe kalohet pas stomakut n\u00eb nivelin e zon\u00ebs s\u00eb disektimit. Pasi tubi i shiritit kalohet p\u00ebrmes mekanizmit t\u00eb ky\u00e7jes, brezi i silikonit vendoset rreth stomakut dhe shtr\u00ebngohet.<\/p>\n\n\n\n
Pas operacionit me shirit gastrik, pacient\u00ebt duhet t\u00eb ken\u00eb kujdes q\u00eb t\u00eb konsumojn\u00eb sasi t\u00eb vogla t\u00eb ushqimeve t\u00eb sh\u00ebndetshme. K\u00ebto ushqime duhet t\u00eb jen\u00eb t\u00eb pasura me proteina dhe n\u00eb form\u00eb t\u00eb ngurt\u00eb. Kjo shum\u00eb \u00ebsht\u00eb af\u00ebrsisht nj\u00eb filxhan ndihm\u00ebs. Masa e gjysm\u00eb filxhanit \u00ebsht\u00eb m\u00eb tep\u00ebr nj\u00eb koncept sesa nj\u00eb matje aktuale.
Proteina \u00ebsht\u00eb makronutrienti m\u00eb i r\u00ebnd\u00ebsish\u00ebm p\u00ebr pacient\u00ebt me brez gastrik. P\u00ebr k\u00ebt\u00eb arsye duhet t\u00eb preferohen ushqimet e pasura me proteina dhe duhet t\u00eb konsumohen af\u00ebrsisht 50 g proteina n\u00eb dit\u00eb. Marrja ditore e proteinave t\u00eb pacient\u00ebve duhet t\u00eb monitorohet dhe nivelet e gjakut duhet t\u00eb maten rregullisht. Marrja mesatare e energjis\u00eb nuk duhet t\u00eb kaloj\u00eb 1500 kalori.<\/p>\n\n\n\n
Burimi m\u00eb i mir\u00eb i proteinave \u00ebsht\u00eb mishi. Megjithat\u00eb, mishi i kuq mund t\u00eb jet\u00eb i v\u00ebshtir\u00eb p\u00ebr t’u p\u00ebrtypur dhe p\u00ebr t’u shp\u00ebrb\u00ebr\u00eb. Prandaj, peshku \u00ebsht\u00eb m\u00eb i leht\u00eb p\u00ebr t’u p\u00ebrtypur dhe shum\u00eb lloje peshqish jan\u00eb shum\u00eb m\u00eb t\u00eb pasur me proteina. Mishi i bardh\u00eb \u00ebsht\u00eb nj\u00eb ushqim q\u00eb p\u00ebrtypet relativisht m\u00eb leht\u00eb. Vez\u00ebt, kosi dhe djathi jan\u00eb burime t\u00eb shk\u00eblqyera t\u00eb proteinave. P\u00ebrve\u00e7 burimeve shtazore, proteinat mund t\u00eb merren edhe nga bishtajoret. Gjysma e got\u00ebs duhet t’i kushtohet proteinave, dhe gjysma tjet\u00ebr duhet t\u00eb p\u00ebrb\u00ebhet nga fruta ose perime.<\/p>\n\n\n\n
Duhet t\u00eb konsumohen gjithmon\u00eb ushqime natyrale q\u00eb kan\u00eb p\u00ebsuar p\u00ebrpunim minimal. Nuk \u00ebsht\u00eb e d\u00ebmshme p\u00ebrdorimi i er\u00ebzave p\u00ebr t’i dh\u00ebn\u00eb shije ushqimeve.<\/p>\n\n\n\n
Kur t\u00eb hani?<\/p>\n\n\n\n
Pas operacionit n\u00eb stomak, pacienti duhet t\u00eb konsumoj\u00eb tre ose m\u00eb pak vakte n\u00eb dit\u00eb. N\u00ebse pacienti \u00ebsht\u00eb n\u00eb zon\u00ebn e gjelb\u00ebr – q\u00eb do t\u00eb thot\u00eb se shiriti i tij \u00ebsht\u00eb rregulluar sakt\u00eb – ai nuk do t\u00eb ndjej\u00eb nevoj\u00ebn p\u00ebr t\u00eb ngr\u00ebn\u00eb nd\u00ebrmjet vakteve. Prandaj, pacient\u00ebt duhet t\u00eb paralajm\u00ebrohen q\u00eb t\u00eb mos han\u00eb meze t\u00eb leht\u00eb midis vakteve. N\u00ebse uria ndihet pasdite, ata mund t\u00eb ken\u00eb sasi t\u00eb vogla ushqimi me cil\u00ebsi t\u00eb lart\u00eb. Kjo mund t\u00eb jet\u00eb nj\u00eb cop\u00eb perime ose fruta. N\u00ebse pacienti nuk \u00ebsht\u00eb n\u00eb zon\u00ebn e gjelb\u00ebr, ai duhet patjet\u00ebr t\u00eb vizitoj\u00eb mjekun e tij.<\/p>\n\n\n\n
Si t\u00eb hani?<\/p>\n\n\n\n
Ushqimi duhet t\u00eb hahet n\u00eb kafshata t\u00eb vogla dhe t\u00eb p\u00ebrtypet mir\u00eb. Gjysm\u00eb gote ushqimi duhet t\u00eb vendoset n\u00eb nj\u00eb pjat\u00eb t\u00eb vog\u00ebl. Duhet t\u00eb p\u00ebrdoren pirun\u00eb dhe lug\u00eb t\u00eb vegj\u00ebl. \u00c7do pickim duhet t\u00eb p\u00ebrtypet p\u00ebr t\u00eb pakt\u00ebn 20 sekonda. Kjo do t\u00eb siguroj\u00eb q\u00eb ushqimi t\u00eb shp\u00ebrb\u00ebhet n\u00eb m\u00ebnyr\u00eb adekuate. Pacient\u00ebt duhet t\u00eb motivohen p\u00ebr t\u00eb shijuar ushqimin. Ushqimet duhet t\u00eb g\u00eblltiten vet\u00ebm pasi jan\u00eb p\u00ebrtypur mjaftuesh\u00ebm.<\/p>\n\n\n\n
Pacient\u00ebt duhet t\u00eb presin derisa kafshimi i par\u00eb t\u00eb kaloj\u00eb plot\u00ebsisht p\u00ebrmes shiritit p\u00ebrpara se t\u00eb marrin nj\u00eb pickim tjet\u00ebr. Normalisht kjo k\u00ebrkon dy ose gjasht\u00eb kontraktime peristaltike. Kjo korrespondon me af\u00ebrsisht 1 minut\u00eb. Prandaj, pacienti duhet t\u00eb paralajm\u00ebrohet t\u00eb p\u00ebrtyp\u00eb mir\u00eb, t\u00eb g\u00eblltis\u00eb dhe t\u00eb pres\u00eb t\u00eb pakt\u00ebn 1 minut\u00eb.<\/p>\n\n\n\n
Nj\u00eb vakt nuk duhet t\u00eb zgjas\u00eb m\u00eb shum\u00eb se 20 minuta. Kjo do t\u00eb thot\u00eb 20 kafshime t\u00eb vogla, nj\u00eb minut\u00eb n\u00eb nj\u00eb koh\u00eb p\u00ebr \u00e7do pickim. Pacienti ndoshta nuk do t\u00eb jet\u00eb n\u00eb gjendje t\u00eb p\u00ebrfundoj\u00eb gjysm\u00eb gote ushqim gjat\u00eb k\u00ebsaj kohe. N\u00eb k\u00ebt\u00eb rast, ushqimi i mbetur n\u00eb pjat\u00eb duhet t\u00eb hidhet. \u00c7do pacient q\u00eb i n\u00ebnshtrohet shiritit gastrik, duhet t\u00eb dij\u00eb se mund ta hedhin ushqimin e mbetur n\u00eb pjat\u00ebn e tij.<\/p>\n\n\n\n
Me mbushjen optimale t\u00eb shiritit dhe zakonet e mira t\u00eb t\u00eb ngr\u00ebnit, pacient\u00ebt nuk ndihen t\u00eb uritur pas 20 ose m\u00eb pak kafshimesh. N\u00ebse nuk ndihet uria, ngr\u00ebnia duhet t\u00eb nd\u00ebrpritet patjet\u00ebr. Pas operacionit me shirit gastrik, pacient\u00ebt nuk duhet t\u00eb presin q\u00eb t\u00eb ndjehen t\u00eb fryr\u00eb pas ngr\u00ebnies. ndjenj\u00eb e fryr\u00eb; Do t\u00eb thot\u00eb q\u00eb ushqimi ndalon n\u00eb rrip dhe pjesa m\u00eb e r\u00ebnd\u00ebsishme e LECS \u00ebsht\u00eb shtrir\u00eb. N\u00ebse kjo gjendje b\u00ebhet kronike, ajo shkat\u00ebrron mekanizmin LECS.<\/p>\n\n\n\n
N\u00ebse pacienti ende ndihet i uritur pasi ka ngr\u00ebn\u00eb gjysm\u00eb gote, kjo ka shum\u00eb t\u00eb ngjar\u00eb t\u00eb thot\u00eb se ai nuk \u00ebsht\u00eb n\u00eb zon\u00ebn e gjelb\u00ebr dhe ka nevoj\u00eb p\u00ebr rimbushje.<\/p>\n","protected":false},"excerpt":{"rendered":"
Shiriti gastrik, i njohur gjer\u00ebsisht si shirit gastrik, \u00ebsht\u00eb nj\u00eb nga metodat kirurgjikale q\u00eb p\u00ebrdoret n\u00eb trajtimin e obezitetit morbid. Kjo metod\u00eb, e njohur edhe si banda gastrike; \u00cbsht\u00eb procesi i vendosjes s\u00eb nj\u00eb brezi rreth stomakut, af\u00ebrsisht 200 mm n\u00ebn kryq\u00ebzimin e ezofagut dhe stomakut. Shiriti i vendosur n\u00eb stomak fryhet hap pas hapi […]<\/p>\n","protected":false},"author":1,"featured_media":28140,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117],"tags":[],"class_list":["post-29153","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-sq"],"_links":{"self":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29153","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/comments?post=29153"}],"version-history":[{"count":0,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29153\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media\/28140"}],"wp:attachment":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media?parent=29153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/categories?post=29153"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/tags?post=29153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}