ENTERAL NUTRITION OF PATIENTS WITH MALIGNANT ESOPHAGEAL DISEASE

Probavni sustav se proteže od usta do anusa, a njegova uloga je primanje i razgradnja hrane, upijanje hranjivih tvari u krvotok te uklanjanje neprobavljivih dijelova hrane iz tijela. Probava započinje u ustima, no kada taj prirodni tijek ometa ili onemogućuje određena bolest i kada se oralni put hranjenja mora zaobići, postoje još dvije opcije kojima se može zadovoljiti čovjekova osnovna potreba za hranom. To su enteralna i parenteralna prehrana. Cilj ovog rada je prikazati mogućnosti enteralne prehrane bolesnika s malignom bolesti jednjaka, kao i aktivnosti koje medicinska sestra poduzima u hranjenju bolesnika i zdravstvenoj njezi stoma namijenjenih prehrani. Maligna bolesti jednjaka jedna je od najsmrtonosnijih malignih bolesti u svijetu i često se dijagnosticira tek u uznapredovalim stadijima zbog nedostatka ranih kliničkih simptoma. Prvo se javljaju smetnje pri gutanju krute, pa polukrute te konačno i tekuće hrane i same sline. Kada nije moguće hraniti bolesnika na usta, sljedeći korak je hranjenje enteralnom prehranom putem sonde, pa se bolesniku postavlja nazogastrična sonda kojom se hrana aplicira direktno u želudac. Naravno, to ne može biti trajno rješenje, a bolest najčešće progradira i zahtjeva postavljanje perkutane gastrostome ili jejunostome. Iako apetit može biti dobar, gubitak tjelesne težine gotovo je uvijek izražen, pa je ovim bolesnicima nutritivna potpora enteralnim i parenteralnim pripravcima od izuzetne važnosti. Ovisno o vrsti i lokaciji stome razlikuje se i sastav i vrsta enteralnih pripravaka koji će se detaljno razraditi u ovom radu.The digestive system extends from the mouth to the anus, and its role is to receive and break down food, absorb nutrients into the bloodstream, and remove indigestible parts of food from the body. Digestion begins in the mouth, but when this natural course is hindered or prevented by a certain disease and when the oral way of feeding has to be bypassed, there are two more options that can satisfy a person's basic need for food. These are enteral and parenteral nutrition The aim of this paper is to show the possibilities of enteral nutrition for patients with malignant esophageal disease,as well as the activities that nurses undertake in feeding patients and health care of stoma intended for nutrition. Malignant diseases of the esophagus is one of the deadliest malignant diseases in the world and is often diagnosed only in advanced stages due to the lack of early clinical symptoms. First, there are difficulties in swallowing solid, then semi-solid, and finally liquid food and saliva itself. When it is not possible to feed the patient by mouth, the next step is feeding with enteral nutrition through a tube, so the patient is placed with a nasogastric tube through which food is applied directly into the stomach. Of course, this cannot be a permanent solution, and the disease usually progresses and requires the placement of a percutaneous gastrostomy or jejunostomy. Although the appetite may be good, weight loss is almost always pronounced, so nutritional support with enteral and parenteral preparations is extremely important for these patients. Depending on the type and location of the stoma, the composition and type of enteral preparations differ, which will be elaborated in detail in this paper