Munguva pfupi yapfuura pakanga paine mushumo wekuti kambani yeAmerica Gl Dynamics yakagadzira nzira nyowani yekurapa kufutisa, inogona kuve yakachipa uye yakachengeteka imwe nzira kune iripo yekuvhiya nzira dzekurasikirwa uremu. Yakagadzirwa neGl Dynamics, iyo EndoBarrier mudziyo ichubhu isina mhango yakagadzirwa ne elastic polymer, inosungirirwa kune base yakagadzirwa nitinol (alloy yetitanium uye nickel). Nheyo yeEndoBarrier inogadziriswa mudumbu, uye "sleeve" yayo yepolymer inenge 60 centimita yakareba inoputika mumatumbo maduku, kudzivirira kunwa kwezvokudya. Kuedza kune vanopfuura zana nemakumi mashanu vanozvipira kwakaratidza kuti iyo EndoBarrier yekumisikidza haina kushomeka pane kuvhiya kuderedzwa kwevhoriyamu yemudumbu nebhandi. Panguva imwecheteyo, chigadzirwa chacho chinoiswa uye chinobviswa kuburikidza nemuromo, uchishandisa endoscopic nzira iri nyore uye yakachengeteka kumurwere, kana zvichidiwa, inobviswa, uye mari yaro yakaderera zvikuru kupfuura yekurapa kwekuvhiya. Obesity imamiriro ekuti kuwanda kweadipose tishu mumuviri kunotyisidzira hutano hwevanhu. Body mass index (BMI) inoshandiswa seyero yechinangwa chekuve wakafuta kana kuderera. Inoverengerwa nekukamura huremu hwemuviri mumakirogiramu neskweya yehurefu mumamita; semuenzaniso, munhu anorema makirogiramu makumi manomwe uye kureba kwemamita 70 ane BMI ye1,75/70 = 1,752 kg/m22,86. A BMI ye18,5 kusvika 25 kg/m2 inoonekwa seyakajairika. Indekisi iri pasi pe18,5 inoratidza kushaikwa kwehuwandu, 25-30 inoratidza kuwanda kwayo, uye pamusoro pe30 inoratidza kufutisa. Parizvino, kudya uye kurovedza muviri kunonyanya kushandiswa kurapa kufutisa. Chete kana dzikasashanda, shandisa zvinodhaka kana kuvhiya kurapwa. Zvokudya zvekuderedza uremu zvinowira muzvikamu zvina: pasi-mafuta, pasi-carb, yakaderera-calori, uye-yakaderera-calori. Zvokudya zvakaderera-mafuta zvinogona kuderedza uremu neanenge makirogiramu matatu mukati memwedzi 2-12. Yakaderera-carb, sezvakaratidzwa neongororo, inoshanda chete kana iyo calorie yemukati yechikafu yakaderedzwa, ndiko kuti, haitungamiri pakurasikirwa nekurema ivo pachavo. Zvokudya zvakaderera-calori zvinoreva kuderera kwesimba rekukosha kwechikafu chinopedzwa ne500-1000 kilocalories pazuva, izvo zvinoita kuti zvibvire kurasikirwa kusvika 0,5 kilogiramu yehuremu pasvondo uye kuwana avhareji yekurasikirwa kwemasere muzana mukati me3- 12 mwedzi. Zvikafu zvakaderera-calori zvine chete 200 kusvika 800 kilocalories pazuva (pamwero we2-2,5 zviuru), ndiko kuti, ivo vanofa nenzara muviri. Nerubatsiro rwavo, unogona kurasikirwa kubva pa1,5 kusvika ku2,5 kilogiramu pavhiki, asi ivo havana kushivirirwa zvakanaka uye vazere nematambudziko akasiyana-siyana, akadai sekurasikirwa kwemasuru, gout kana kusaenzana kwe electrolyte. Zvokudya zvinokubvumira kukurumidza kuderedza uremu, asi kuchengeta kwavo uye kunotevera kuchengetedza kwehuwandu hunowanikwa kunoda kuedza kwekuti havasi vose vanorasikirwa nehuremu vanogona - kazhinji, tiri kutaura nezvekuchinja kwehupenyu. Kazhinji, makumi maviri kubva muzana chete evanhu vanogona kubudirira kurasikirwa nekuchengetedza uremu nerubatsiro rwavo. Kubudirira kwekudya kunowedzera kana kwakabatanidzwa nekurovedza muviri. Kuwedzera huwandu hweadipose tishu kunowedzera njodzi yekuva nezvirwere zvakawanda: mhando 2 chirwere cheshuga mellitus, hosha dzemoyo, obstructive sleep apnea (kunetsekana kwekufema panguva yekurara), deforming osteoarthritis, mamwe marudzi egomarara uye mamwe. Naizvozvo, kufutisa kunoderedza zvakanyanya tarisiro yehupenyu hwevanhu uye ndechimwe chezvikonzero zvinodzivirirwa zverufu uye imwe yematambudziko akakomba ehutano hweveruzhinji. Nayo pachayo, kurovedza muviri, kunowanikwa kune vanhu vazhinji, kunotungamirira kune kuderera kuduku, asi kana kusanganiswa ne-low-calorie diet, migumisiro inowedzera zvakanyanya. Mukuwedzera, basa remuviri rinodiwa kuchengetedza uremu hwemazuva ose. Iyo yakakwira nhanho yekudzidziswa mitoro inovimbisa kukosha kwakakosha uremu kunyangwe pasina calorie kurambidzwa. Imwe ongororo yakaitwa muSingapore yakaratidza kuti kwemavhiki makumi maviri ekudzidziswa kwechiuto, vakafutisa vakarasikirwa neavhareji ye20 kilogiramu yehuremu hwemuviri, ivo vachidya chikafu cheukoshi hwesimba. Kudya uye maekisesaizi, kunyangwe ari iwo makuru uye ekutanga ekurapa kufutisa, anogona kusabatsira varwere vese.
Mushonga wemazuva ano wepamutemo une mishonga mikuru mitatu yekuderedza uremu ine nzira dzakasiyana dzekuita. Aya ndiwo sibutramine, orlistat uye rimonabant. Sibutramine ("Meridia") inoshanda panzvimbo yenzara uye kuguta senge amphetamines, asi panguva imwechete haina chirevo chakadaro che psychostimulating uye hachikonzereri kuvimba nezvinodhaka. Migumisiro nekushandiswa kwayo inogona kusanganisira muromo wakaoma, kushaya hope uye kuvimbiswa, uye inopesana nevanhu vane zvirwere zvakakomba zvemwoyo. Orlistat ("Xenical") inokanganisa kugaya uye, semugumisiro, kutorwa kwemafuta mumatumbo. Kubviswa kwekudya kwemafuta, muviri unotanga kushandisa matura ayo, izvo zvinotungamirira mukurasikirwa. Zvisinei, mafuta asingagadziki anogona kukonzera flatulence, manyoka uye kusagadzikana kwechigaro, izvo muzviitiko zvakawanda zvinoda kurega kurapwa. Rimonabant (Acomplia, parizvino yakabvumidzwa muEU) ndiyo nyowani yekurasikirwa uremu mushonga. Iyo inogadzirisa kudya nekuvharira cannabinoid receptors muuropi, izvo zvinopesana neiyo inoshanda musanganiswa mu cannabis. Uye kana kushandiswa kwembanje kunowedzera chido, ipapo rimonabant, pane zvinopesana, inoderedza. Kunyangwe pakaiswa mushonga pamusika, zvakaonekwa kuti unoderedzawo havi yefodya kune vanoputa. Kuipa kwerimonabant, sezvinoratidzwa nezvidzidzo zvemashure-yekutengesa, ndeyokuti kushandiswa kwayo kunowedzera mukana wekuora mwoyo, uye mune vamwe varwere zvinogona kumutsa pfungwa dzekuzviuraya. Kubudirira kwemishonga iyi kwakanyanyisa: chiyero chekurasikirwa nehuremu nehurefu hwenguva yekutonga ye olistat ndeye 2,9, sibutramine - 4,2, uye rimonabant - 4,7 kilograms. Parizvino, makambani mazhinji emishonga ari kugadzira mishonga mitsva yekurapa kufutisa, mamwe ayo anoita zvakafanana kune aripo, uye mamwe ane maitiro akasiyana ekuita. Semuenzaniso, zvinoita sekuvimbisa kugadzira mushonga unoshanda pane zvinogamuchira leptin, hormone inodzora metabolism uye simba. Nzira dzinonyanya kushanda uye dzakasimba dzekurapa kufutisa ndeyekuvhiya. Mazhinji maoparesheni akagadzirwa, asi ese akakamurwa kuita mapoka maviri akasiyana zvichienderana nemafambiro avo: kubviswa kweadipose tissue pachayo uye kuchinjwa kwegastrointestinal turakiti kuitira kuderedza kudyiwa kana kunwa kwezvokudya. Boka rekutanga rinosanganisira liposuction uye abdominoplasty. Liposuction ndiko kubviswa ("kusveta") kwemafuta akawandisa kuburikidza nedikidiki paganda uchishandisa vacuum pombi. Hapana anodarika makirogiramu mashanu emafuta anobviswa panguva, sezvo kuoma kwematambudziko zvakananga zvichienderana nehuwandu hwenyama yakabviswa. Liposuction isina kubudirira izere nedeformation yechikamu chinoenderana chemuviri uye zvimwe zvisingadiwe mhedzisiro. Abdominoplasty ndiko kubviswa (kubvisa) kweganda rakawandisa uye mafuta emadziro emukati medumbu kuitira kuti asimbise. Kuvhiya uku kunogona kubatsira chete vanhu vane dumbu rakawandisa. Iinewo nguva yakareba yekudzorera - kubva pamwedzi mitatu kusvika kumitanhatu. Kuvhiyiwa kwekugadzirisa gastrointestinal tract kungave kwakanangana nekudzikisa huwandu hwedumbu kuti utange kuguta. Iyi nzira inogona kusanganiswa nekuderedzwa kwekudya kunovaka muviri. Pane nzira dzakawanda dzokuderedza kuwanda kwedumbu. Mune vertical Mason gastroplasty, chikamu chedumbu chinoparadzaniswa kubva kune chikuru vhoriyamu ine masipi ekuvhiya, ichigadzira bhegi diki rinopinda chikafu. Zvinosuruvarisa, iyi "mini-mudumbu" inokurumidza kutambanudza, uye kupindira pachayo kunobatanidza nehuwandu hwematambudziko. Nzira itsva - gastric banding - inosanganisira kuderedza inzwi rayo nerubatsiro rwebhandi rinofambisa rinopoteredza dumbu. Iyo hollow bhandeji yakabatanidzwa kune reservoir yakagadziriswa pasi peganda re anterior abdominal wall, izvo zvinoita kuti zvikwanise kudzora dhigirii regastric constriction nekuzadza uye kubvisa dura ne physiological sodium chloride solution uchishandisa yakajairwa hypodermic tsono. Zvinotendwa kuti bhandeji rinokurudzirwa kushandisa chete kana murwere achikurudzirwa zvakanyanya kuderedza uremu. Mukuwedzera, zvinokwanisika kuderedza huwandu hwemudumbu nekuvhiya kubviswa kwehuwandu hwayo (kazhinji inenge 85 muzana). Kuvhiya uku kunonzi sleeve gastrectomy. Inogona kuomeswa nekutambanudza kwedumbu rasara, depressurization ye seams, nezvimwe. Dzimwe nzira mbiri dzinosanganisa gastric vhoriyamu kudzikisira nekudzvanywa kwekudya kunovaka muviri. Paunenge uchiisa gastric bypass anastomosis, bhegi rinogadzirwa mudumbu, sezvakaita vertical gastroplasty. Jejunamu inosonerwa mubhegi iri, munopinda chikafu. Iyo duodenum, yakaparadzaniswa nejejunamu, inosungirirwa mukati yakaonda "yakadzika". Saka, mazhinji emudumbu uye duodenum anodzimwa kubva pakugaya. Mugastroplasty ine duodenal kubviswa, kusvika ku85 muzana yemudumbu inobviswa. Iyo yakasara inobatanidza zvakananga kune chikamu chepasi chemukati mudiki mamita akawanda kureba, iyo inova iyo inonzi. digestive loop. Chikamu chikuru chedumbu diki, kusanganisira duodenum, yakadzimwa kubva pakugayiwa, yakashongedzwa nemapofu kubva kumusoro, uye chikamu chezasi chinosonerwa muchiuno ichi chinhambwe chingangoita mita isati yayerera ichipinda muura hombe. Maitiro ekugaya uye kunyura mushure meizvozvo achaitika kunyanya muchikamu chemita iyi, sezvo ma enzymes ekugaya achipinda mu lumen ye gastrointestinal turakiti kubva pancreas kuburikidza ne duodenum. Kuchinja kwakadaro kwakaoma uye kusingagadziriswi kwegadziriro yezvokudya zvinowanzokonzera kukanganisa kwakanyanya mubasa rayo, uye, naizvozvo, mune yose metabolism. Nekudaro, maoparesheni aya anoshanda zvisingaenzaniswi kupfuura dzimwe nzira dziripo, uye anobatsira vanhu vane madhigirii akanyanya ekufutisa. Yakagadzirwa muU.SA, EndoBarrier, sezvinotevera kubva kuongororo yekutanga, inoshanda sekurapa kwekuvhiya, uye panguva imwechete haidi kuvhiyiwa pamaturakiti emimba uye inogona kubviswa chero nguva.
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