B ai 5
MOT SO CHE DO AN BENH LY
MUC Tieu
1. Trinh bdy diidc nguyen tac xay ditng khau phan an cho ngiidi benh.
2. Neu diidc khai niem, muc dich, chi dinh cua mqt so che do an benh ly.
1. NGUYEN TAC XAY DUNG KHAu PHAn An CHO NGUOl BENH
• •
- Dam bao chat ltfdng va ty le can doi giiia protid, lipid, glucid, vitamin va
muoi khoang.
- Dam bao du nang ltfdng.
- Dam bao yeu cau ve protid (trong do protid dong vat chiem toi thieu 30 -
50%, nhieu nhat la 65%).
- Khau phan an trong ngay can chia ra lam nhieu bQa, khau phan &n
khong nen dung lau, tra lai che do &n sinh ly cang sdm cang tot.
- Phai dong vien ngtfdi benh an uong, khong nen ep ngtfdi benh mot cach
qua mtic.
- Dam bao che do an hdp ve sinh, kich thich vi giac cua ngtfdi benh.
2. MOT SO CHE DO AN BENH LY
• • •
2.1. Che do an han che sOi va xO
• • •
• Thiic an co chat sdi va xd:
- Sdi co trong thtic &n dong vat nhtf to chtic lien ket, gan, cd, sun.
- Xd co trong rau cu, vo ngoai cua te bao thtfc vat.
• Tac dung:
- Tac dung kich thich co b6p cua ong tieu hoa nhat la doi vdi nhu dong ruot.
- Vdi nhting ngtfdi ton thtfdng ong tieu hoa tac dung kich thich tren tin c6 hai.
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• Tranh chon thiic pham sdi, xd:
- Dau do, san khoai, rau difa, cai, mang...
- Hoa qua co nhieu ba: dtfa, le, tao...
• Nen chon thiic pham khong co sdi, xd:
- Suta, trtfng bd.
- Khoai nghien, rau non.
- Niidc ep hoa qua (chanh, cam, chuoi).
• Che bien:
- Rau qua nghien nho, nau nhtf.
- Thit ca ham nhii de cac sdi bien thanh keo long.
- Gao da loai cam.
- Khong nen ran, khong an song.
• Ap dung:
- Ngildi benh loet da day, ta trang.
- Viem ruot, cac ton thtfdng khac d ruot.
• Che do an han che xd diidc chia lam 3 loai:
- Han che chat che: chi an suta, chao, bot.
- Han che vtfa phai: an suta, chao, bot them trufng khoai nghien.
- Han che it: Sn them thit dong vat, chon nac, bo bi, gan, phai n&u nhtf.
2.2. Che do an han che chat beo
• Dac diem che do an cd nhieu chat beo:
- Cung cap nhieu nang ltfdng.
- Che bien kheo se thdm ngdn nhung chong chan.
- Lau tieu.
- Kich thich tiet dich mat.
• Ap dung che do an han che chat beo:
- Ngufdi benh co benh gan mat (suy gan, viem gan, tui mat...).
- Beo phi.
- Benh tim mach.
• Tranh cac loai thiic an:
- Thit nhieu m3, md dong vat, thutc &n ran.
- Socola.
- Trutng, gia vi.
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• Nen dung:
- Bot gao, thit nac, ca luoc.
- Dung dau thtfc vat: dau oliu, dau vtfng, dau lac.
- Hoa qua tUdi.
2.3. Che d o an han ch e p ro tid
• Muc dich:
Lam giam san pham chuyen hoa cua protein la NH3 de tranh hien ttfdng
tang ure huyet.
• Ap dung:
- Benh viem cau than cap, suy than cap, viem than man.
- Cac hoi chtfng dan den ure huyet cao: tan huyet, chan thildng, phlu thuat.
• Khong dp dung:
- Ngildi benh co hoi chtfng than hil.
- Xd gan (khong chong chi dinh tuyet doi).
• Chu y:
- Tranh dung cac loai thtfc pham co nhieu protid: thit, ca, trtfng, stfa, ca
cao, cac thiic an ho dau.
- Nen dung thiic an co nhieu glucid (l)anh mi, khoai, ntfdc qua, bd...).
- Tuy thuoc mtfc do ure huyet cao ma co che do an han che cho thich hdp.
- Neu ngildi benh tang ure huyet cap tinh phai giam protid xuong 20g -
lOg/ngay hoac bo han.
- Neu ure mau cao man tinh phai kiem tra ltfdng ure thai ra hang ngay
trdng ntfdc tieu, co the han che vtfa phai bang cach cho an ttf 40g den 30g
protid/ngay.
2.4. Che do an tang protid
• Muc dich:
- Dam bao cung cap protid cho cd the bu vao ltfdng protid da huy dong khi
bi benh.
*
• Ap dung:
- Hoi chting than htf.
- Ngtfdi benh bi cac benh man tinh gay suy mon Gao, nhiem khu£n man).
- Cac benh thieu mau, viem gan thdi ky hoi phuc.
- Cac benh ngoai khoa: gay xtfdng, sau mo...
• Khdng dp dung:
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- Ngiidi benh suy than kem ure huyet tang.
- Hon me gan, suy gan nang.
• Nen an thiic an: thit ,ca, tom, cua...
2.5. Che do an han che muoi
Muc dich che do an han che muoi: lam giam ltfdng Na dtfa vao cd the
trong luc cd the co hien ttfdng tf dong Na.
- Han che muoi tuyet doi:
+ Thtfc Sn nau khong co muoi.
+ Tranh cac loai thtfc pham thien nhien co sin muoi (ca bien, siia, trtfng...).
+ Nen an chao dtfdng, stfa dau nanh, ntfdc hoa qua.
• Che do an han che muoi tuyet doi dp dung cho:
- Ngtfdi benh viem cau than cap, viem cau than man.
- Suy tim nang.
- Phu cap tinh do cac nguyen nhan khac nhau.
• Han che muoi ttfcfng doi:
- La loai thtfc an khong co muoi khi nau.
- Dtfdc dung cac loai thtfc pham thien nhien co s in muoi (tom, cua, ca bien,
rau muong, stfa, trtfng).
• Che do an han che muoi ttf Ong doi dp dung cho:
- Ngtfdi benh co phu keo dai (suy tim nhe, than nhiem md con phu nhe).
- Ngtfdi benh dieu tri bang corticoid keo dai.
2.6. Che do an cho ngtfdi benh tieu dtfdng
2.6.1. Dac diem ve chuyen hod trong benh tieu diidng
Benh tieu dtfdng co nhieu nguyen nhan, nguyen nhan pho bien la do
thieu nang tuyen tuy, noi tiet gay nen roi loan chuyen hoa dtfdng trong cd the.
Ngtfdi benh co bieu hien cua tang dUdng mau, ntfdc tieu co dtfdng, dong thdi
lam tang thoai bien protid, lipid nen ngtfdi benh gay nhanh, suy kiet. Do
khong chuyen hoa dtfdc dtfdng nen trong che do an phai than trong khi sti
dung thtic an co glucid.
2.6.2. Nguyen tac xay dung khau phan an
- Dam bao vtfa du so nang ltfdng can thiet khong nen qua 30 calo/kg/24 gi<i
- Han che glucid, moi ngay chi cho ngtfdi benh fin khoang 100 gam gao.
- Tang mtic an protid nhtfng khong qua nhieu chi ftn ttf 1 - l,5g/kg.
- Lipid: han che md dong vat
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Dam bao tieu chuan calo: protid cung cap 15 - 20% nhu cau nang ltfdng,
lipid 40 - 45%, glucid 40%.
- Nen phan bo' 1/5 khau phan an vao buoi sang, 2/5 vao buoi trtfa. 2/5 vao
buoi toi.
• Cac thtfc an stf dung:
- Thtfc an khong co glucid: thit, ca, trtfng, dau phu.
- Thtfc an co it glucid (3%) nhtf rau ttfdi, cai bap, sup Id, dtfa chuot, bau, bi,
gia do...
• Cac th iic an han che:
Ngu coc: gao, mi, khoai, san, cac loai dtfdng, cac loai hoa qua ngot deu
phai kiem soat.
• Chu y:
- Han che glucid nhtfng phai dam bao ngtfdi benh an du, co the an nhieu
rau, tang thit
- Tuyet doi khong de ngtfdi benh ttf y an them dtfdng, bot ngoai thtfc pham
quy dinh.
2.7. Che do an cua ngtfdi benh mo
• Anh htfdng cua viec mo doi vdi ca the:
- Mo gay mat mau, roi loan dien giai.
- Lam cd the tieu hao nang ltfdng.
•>
- Anh htfdng den hoat dong cua bo may tieu hoa (an kem, chan an).
• Che do an trtfdc mo:
- Khi con xa ngay mo can cho an che do boi dtfdng co nhieu protid, glucid,
ntfdc va calo.
- Vai ngay trtfdc mo: che do an khong co ba, giam calo xuong 1/3.
- Ngay mo: ngtfdi benh nhin Sn, uong it ntfdc.
• Che do an sau khi mo:
- Giai doan chtfa thoat hdi (chtfa co trung tien).
+ Truyen cac loai dung dich muoi, dtfdng, huyet ttfdng.
+ Neu mo ngoai bo may tieu hoa cho uong ntfdc chao, ntfdc ep hoa qua.
+ Neu mo bo may tieu hoa chi cho nhap it ntfdc khoi kho mieng.
- Giai doan da trung tien: che do &n long, it n&ng ltfdng, it protid, glucid,
nhieu vitamin va ting din so' ltfdng.
- Giai doan hoi phuc: che do &n boi dtfdng tang dan ning ltfdng tii 1.600 -
2.000 - 3.000 calo. protid tir 1 - l,5g/kg/24h.
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