Описание актуально на 24.04.2018
- Эффективность: лечебный эффект через 21 день
- Сроки: до 2 месяцев
- Стоимость продуктов: 1600-1700 руб. в неделю
Общие правила
Удаление матки (гистерэктомия) или матки с придатками (гистеросальпингоовариэктомия) — самые распространенные операции в гинекологии. К ним не обязательно прибегают при наличии злокачественных образований. Показаниями могут быть травмы и обильные маточные кровотечения, эндометриоз, множественные или крупных размеров лейомиомы, кисты яичников и прочее.
В любом случае наркоз и хирургическое вмешательство — это стресс для организма, который вызывает местную и общую реакцию и его нужно преодолеть. После полостного вмешательства послеоперационный период делят на ранний и поздний. Ранний длится первые три-четыре дня, второй — до 12-20 дней.
В первые сутки всем пациенткам рекомендуется полный голод, а потери жидкости восполняются внутривенным введением растворов. При отсутствии рвоты, которая связана с раздражением слизистой ЖКТ наркотическим веществом, не ранее чем через 3-4 часа после операции можно пить крепкий чай с лимоном. А при появлении аппетита (через 12-24 часов в зависимости от состояния) женщина может переходить на прием легкой пищи: кефир, йогурт, бульон.
Разумеется, что необходима щадящая диета, исключающая агрессивные, трудноусвояемые или раздражающие слизистую ЖКТ продукты. Это объясняется тем, что при полостной операции обнажаются, охлаждаются и травмируются брюшина и петли кишечника, как бы осторожно с ними не обращались. Отрицательное действие оказывает и общий наркоз. Именно поэтому возникает метеоризм, боли и колики в животе, которые к третьим суткам чаще всего проходят.
Правильное питание, которое постепенно расширяется, помогает восстановить функцию желудочно-кишечного тракта. На второй день добавляют жидкие каши (овсяную, манную, гречневую), овощное пюре, сухарики, легкие супы крупяные и овощные, омлет, яйца всмятку. То есть, рекомендуется питание в пределах Стола №1Б.
Обязательным является введение в рацион продуктов, усиливающих перистальтику кишечника: размоченный чернослив, тертая свекла с растительным маслом или любые привычные для женщины продукты, которые у нее стимулируют дефекацию. После первого естественного опорожнения кишечника питание может расширяться, и рекомендуются мясо, рыба, рассыпчатые каши. Разрешается пить настой плодов шиповника и облепихи, компот из сухофруктов, кисели ограничиваются при склонности к запорам.
В целом питание после полостной гинекологической операции строится на принципах:
- Дробность — принимать пишу до 7 раз за день не очень большими порциями.
- Включение продуктов для восстановления естественной функции кишечника, поскольку после полосной операции у многих возникает его парез. Упор делается на продукты, содержащие пищевые волокна (овощи, чернослив, фрукты), однако они должны быть в вареном или тушеном виде, так как сырые вызывают вздутие.
- Исключение продуктов, вызывающих вздутие. Нельзя употреблять хлеб, капусту, газированную воду, бобовые, дрожжевую выпечку, квас, сырые овощи и фрукты, цельное молоко.
- Исключение закрепляющих продуктов: крепкий чай и кофе, шоколад, рис, яйца вкрутую.
- Постепенное введение мясных и рыбных блюд, особенно при склонности к запорам, поскольку белковая пища провоцирует их.
- Приготовление блюд на пару или отвариванием.
- Выполнение питьевого режима — 1,5 л в сутки и более (по рекомендации врача).
- Из рациона исключаются: жирные и жареные блюда, кондитерские изделия, крепкий чай, кофе, острые блюда, специи, шоколад.
После выписки из стационара относительно щадящей диеты следует придерживаться до одного месяца. У некоторых женщин этот период сокращается до двух недель. Обязательно нужно следить за ежедневной дефекацией, не допуская возникновения запоров. После операции не разрешается тужиться — это представляет угрозу для швов. В связи с этим изначально исключаются продукты, оказывающие закрепляющее действие и замедляющие перистальтику. К ним относятся супы-пюре, разваренные слизистые каши, кисели, рис и протертая пища, шоколад, творог в большом количестве, обилие мясных изделий и вообще белковой пищи, крепкие чай, какао, изделия из теста, гранаты, айва, черника, мучные изделия в большом количестве.
Так же нельзя допускать вздутия, поэтому следует исключить бобовые, квас, черный хлеб, виноград, изюм, пряности и специи. На этом этапе важно сбалансированное питание, поскольку активируются процессы: усиливается синтез белка, необходимый для роста и развития. Восстанавливаются функции желудочно-кишечного тракта и сердечно-сосудистой системы.
Питание обязательно должно включать белки, жиры, витамины и углеводы. В среднем калорийность питания должна составлять 2800-2900 ккал, белка до 95 г, столько же или чуть больше жиров и 400 г сложных углеводов. В восстановительный период важно устранить дефицит белков и витаминов, который возникает при кровопотерях, лихорадке и распаде тканевых белков.
В рацион вводится достаточное количество белка (мясо, творог, молочная продукция, яйца, рыба) и полезные жиры, источниками которых являются орехи, жирные сорта рыбы, растительные масла (особенно оливковое, кунжутное и льняное). Ограничения касаются только простых углеводов (сладости, сахар, мучные изделия). Сложные углеводы (крупы, злаковый хлеб, овощи) — это основной источник энергии, поэтому обязательно должны включаться в рацион.
Разрешенные продукты
Диета после полостной гинекологической операции включает:
- Блюда из нежирной говядины, курицы, телятины, кролика, приготовленные на пару или отвариванием. По предпочтениям можно мясо готовить в виде рубленых изделий (котлеты, тефтели и прочее) или куском.
- Супы на овощных или слабых мясных бульонах. В них добавляют крупы, вермишель и овощи.
- Хлеб пшеничный подсушенный — первое время ограничивают. Вводят сухое печенье.
- Нежирная рыба в первое время, а в период реабилитации рацион расширяют введением жирных видов рыбы 1-2 раза в неделю. Способ приготовления — на пару, отваривание или запекание.
- Яйца всмятку или омлет.
- Нежирное молоко первое время ограничивается или исключается в виду возможного вздутия кишечника после его употребления. Затем оно вводится в составе блюд (молочные каши, молочные супы). Сметана в виде приправ к блюдам. Любые кисломолочные напитки, которые хорошо переносятся. Полужирный творог ограничивают только при склонности к запорам.
- Крупы в виде каш и запеканок. Стоит учитывать, что кукурузная, перловая, пшенная и ячневая относятся к трудноперевариваемым, поэтому на две недели после операции исключаются, а затем осторожно вводятся.
- Овощи в первое время употребляются в отварном, запеченном или тушеном виде, исключая грубые (редис, редька, грибы). Из них делают пюре, икру, рагу. В последующем овощи вводятся в свежем виде — салаты с растительным маслом.
- Фрукты и ягоды сначала употребляются в термически обработанном виде — компоты, как добавка при варке каш, кисели (при отсутствии запоров).
- Напитки: овощные и фруктовые соки, настой плодов шиповника, вода без газа, некрепкий чай (можно с молоком), полезен отвар овса.
Операция по удалению матки считается одной из самых сложных. Но очень часто такое хирургическое вмешательство спасает пациентке жизнь, поэтому оно необходимо.
В послеоперационном периоде очень важно обеспечить правильный уход, подобрать эффективные методы лечения и восстановления. Но не менее важно позаботиться о правильном питании, которое поможет восполнить дефицит полезных веществ после операции и восстановить силы.
В этой статье мы поговорим о том, каким должно быть питание после удаления матки, что можно кушать в раннем и позднем послеоперационном периоде, каким должен быть рацион питания, чтобы организм быстро восстановился после операции.
Удаление матки: питание после операции
В раннем послеоперационном периоде пациентке необходимо избежать обезвоживания, поэтому очень важен питьевой режим. Нужно выпивать не менее 1,5 литра чистой воды. Что касается продуктов питания, то тут необходимо следовать принципу постепенного расширения рациона, сначала вводя в меню жидкие и полужидкие блюда, затем переходить к более твердым продуктам питания.
В раннем послеоперационном периоде питание после удаления матки должно быть несоленым (чтобы исключить задержку жидкости и появление отеков), нежирным и неострым, но при этом в организм должно поступать достаточное количество витаминов и микроэлементов.
Приемы пищи должны быть дробными, принимать еду нужно до 6-7 раз в день небольшими порциями. Питание после удаления матки должно быть направлено на восстановление функции кишечника.
Так как после хирургического вмешательства на органах малого таза существует риск расхождения послеоперационных швов, нельзя употреблять в пищу продукты, которые могут привести к запорам и метеоризму (белый хлеб, выпечка, шоколад, крепкий чай, кофе).
Калорийность пищи увеличивают постепенно, чтобы желудочно-кишечный тракт успел адаптироваться после операции и начал нормально функционировать. Питание после удаления матки должно включать в себя рассыпчатые каши, свежие овощи и фрукты, растительные масла, нежирное мясо, кисломолочные продукты.
После оперативного вмешательства по поводу удаления матки у пациентки часто наблюдается снижение гемоглобина. Употребление в пищу кураги, гранатового сока, гречки, нежирного мяса (телятина) поможет избежать анемии.
Рекомендации по питанию после удаления матки нужно соблюдать на протяжении 2-4 месяцев, после чего можно перейти к обычному рациону.
Питание после удаления матки в раннем послеоперационном периоде
В первые дни (1-3 день) после гинекологических операций врачи рекомендуют придерживаться диеты №1А или 1Б.
Основные продукты, которые можно употреблять: протертые слизистые супы (крупяные, молочные), жидкие каши на воде или молоке, яйца всмятку или паровой омлет, молоко (если нет проявлений метеоризма), растительное масло, фруктовые или ягодные кисели, соки, чай некрепкий с молоком, отвар шиповника.
На второй-третий день после операции можно кушать мясные или рыбные блюда, протертые и приготовленные на пару, протертые паровые овощи.
Соль и сахар ограничить, дополнительно необходимо принимать витаминные комплексы. Принимать пищу нужно каждые два-три часа, еда должна быть теплой.
Питание после удаления матки в позднем послеоперационном периоде
На 5-6 день после оперативного вмешательства можно переходить к столу № 15. Это полноценное питание с достаточной калорийностью и необходимым набором питательных веществ и витаминов с исключением жирных, острых, трудноперевариваемых продуктов.
Следует помнить, что расширять рацион необходимо постепенно, следя за реакцией организма и своими ощущениями. В среднем для восстановления сил после операции необходим сбалансированный рацион с калорийностью в 2800-2900 ккал, при этом белка должно быть 90-95 грамм, жира – 100-105 грамм, углеводов – 400 грамм.
В меню должны присутствовать мясные и рыбные блюда, сезонные овощи и фрукты, крупяные блюда, молочные и кисломолочные продукты. Следует избегать продуктов с искусственными добавками (красителями, ароматизаторами), тугоплавких животных жиров, острых приправ и специй, сладостей в больших количествах.
Не стоит забывать о достаточном потреблении жидкости: отдать предпочтение стоит фруктовым сокам, отварам трав, некрепкому чаю, минеральной воде без газа.
Постепенно расширяя рацион, можно переходить к общему столу. В любом случае операция – это дополнительная нагрузка на организм, поэтому не стоит забывать о правильном питании с набором необходимых питательных веществ.
Существует ошибочное мнение, что диета помогает только при заболеваниях желудочно-кишечного тракта. На самом деле строгое ограничение и смещение баланса рациона в пользу определенного вида продуктов назначается врачами при многих патологиях.
Многие люди, желающие сбросить избыточный вес, стараются сделать это за максимально короткий срок. Конечно, хочется привести свое тело в порядок за несколько дней, но такой подход к решению проблемы нередко приводит к обратным результатам — потерянные килограммы возвращаются с запасом.
Правильное питание при диагностировании онкологических заболеваний не является отдельным методом лечения, но диетотерапия способствует активизации защитных сил организма.
Диета назначается и при раке матки. Предпочтение отдается продуктам, содержащим антиоксиданты, щелочи, натуральные кислоты. Но этого недостаточно. Чтобы диетотерапия дала результаты, важно соблюдать правила питания при прохождении курса химиотерапии, перед гистерэктомией, во время лучевого лечения.
Питание при раке матки
Питание при диагностированной онкологии матки следует максимально изменить. Режим потребления пищи тоже требует внесения корректив.
Разрешенные продукты
Первое требование к питанию при лечении рака тела матки заключается в том, чтобы употреблять только натуральные, витаминизированные продукты. Важно, чтобы они укрепили иммунитет, помогая организму бороться с опасной болезнью.
Пациентке с этой болезнью важно предпочесть:
- Фрукты – яблоки, груши, апельсины, лимоны. Подвергать термической обработке не рекомендуется.
- Овощи – тыкву, цветную капусту, шпинат, зелень, салат.
- Ягоды – сливу, черную смородину, шиповник. Содержат противоопухолевые вещества, помогают выведению из организма канцерогенов, свободных радикалов.
- Зерновые культуры – овес, льняные семена, чечевицу.
- Обезжиренное мясо и рыбу – курятину, говядину или телятину, лосось.
- Некоторые виды пряностей – кориандр, красный перец.
- Пользу при раке матки также принесут мед, корень женьшеня, куркума.
Запрещенные продукты
Женщине с онкологическим поражением детородного органа запрещается употреблять:
- любые виды колбасных изделий;
- полуфабрикаты;
- выпечку;
- сладости, десерты;
- пакетированные соки;
- спиртное;
- газированные напитки;
- фастфуды;
- какао;
- шоколад;
- кофеинсодержащие напитки.
Отказ от соленого, копченого, жареного обязателен. Под табу попадают консервы – овощные, мясные или рыбные.
Режим питания
Питаться дробно, маленькими порциями. Интервал между едой – 4-5 часов. Вес одной порции – не больше 300 г.
Несмотря на описанные запреты в еде, у женщины остается большой выбор продуктов для составления полезного и вкусного меню на неделю. Приводим пример рациона.
- Завтрак: стакан свежевыжатого одно- или многокомпонентного сока.
- Второй завтрак – 1 яблоко, чашка отвара шиповника (шалфея ромашки, валерианы), обезжиренный творог.
- Обед – овощной суп, маленький кусок отварного мяса, каша из любого вида круп, чашка зеленого чая.
- Полдник – 1 фрукт или овощ, стакан сока.
- Ужин – маленькая порция салата с куском запеченной рыбы, чашка чая. Перед отходом ко сну разрешается употребить стакан кефира или свежевыжатого сока.
Если ежедневно чередовать продукты, то меню на неделю получится комплексным, разнообразным.
Супы, каши важно включать в меню каждый день, так же как соки, сырые фрукты или овощи. Мясо и рыбу разрешено есть с интервалом в 1-2 дня.
Особенности питания перед операцией
Подготовка к гистерэктомии при раке матки требует обязательного соблюдения диеты. За сутки до оперативного вмешательства пациентке рекомендуется:
- исключить трудноперевариваемые, раздражающие слизистую оболочку кишечника продукты;
- отказаться от еды, вызывающей повышенное газообразование (фасоль, горох, бобы, капуста).
Еда должна легко усваиваться, содержать витамины. Перед операцией рекомендуется питаться овощами, фруктами, съедать небольшую порцию злаковых каш. Исключить кисломолочную и молочную продукцию.
Диета после гистерэктомии
Питание после операции по удалению матки должно быть щадящим. Организму необходимо восстановиться после стресса, которым для него стало хирургическое вмешательство.
Нельзя резко возвращаться к привычным объемам порций. После отхождения от наркоза пациентке разрешается пить исключительно чистую воду без газа. Только через несколько часов, а иногда через сутки, разрешается первое употребление пищи.
Запрещено в послеоперационный период
Во время реабилитационного периода исключают из меню продукты, раздражающие слизистую оболочку кишечника. До полного восстановления организма после гистерэктомии отказаться от:
Полезные продукты
На протяжении реабилитационного периода рекомендуется употреблять:
- крупяные каши;
- кисломолочную продукцию;
- нежирные мясные бульоны;
- орехи.
Фрукты с овощами – обязательный элемент ежедневного рациона (помогают избежать запора).
Нельзя забывать о питьевом режиме. 1,5 литра жидкости, включая соки и чистую негазированную воду, будет достаточно для скорейшего восстановления организма после операции.
Примерный рацион
Приблизительное меню в послеоперационный период выглядит так:
- Завтрак: мультивитаминный фреш – овощной или фруктовый.
- Второй завтрак – яблоко или другой фрукт, горсть орехов.
- Обед – нежирный бульон из курицы или телятины с маленьким ломтиком хлеба, либо злаковая каша.
- Полдник – фрукт или овощ, стакан фреша.
- Ужин – обезжиренный творог.
- Перед сном разрешается употребить стакан нежирной простокваши или ряженки.
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Лучевая терапия тоже требует пересмотра женщиной рациона. Рационально разработанное меню поможет снизить интенсивность проявлений побочных эффектов лечения – тошноты, рвоты, общего недомогания. Внимание должно быть обращено на пищу с высоким содержанием калорий. Употреблять ее нужно понемногу, дробно. Еда с большим содержанием калорий придаст организму сил для борьбы с опасной болезнью.
После сеансов лучевой терапии прием пищи иногда сопровождается ощущением жжения или першения в горле. В этом случае рекомендуется перед употреблением перетирать продукты питания через сито, либо разминать ложкой.
Полезным при прохождении курса лучевой терапии будет употребление:
- кефира;
- творога;
- ряженки;
- бифилюкса;
- домашних йогуртов;
- цельнозернового хлеба;
- каш из чечевицы, ячменя, овса, гречки;
- супов и бульонов с нежирным мясом;
- жирных сортов рыбы (обогащают организм кислотами Омега-3).
Употреблять как можно больше свежевыжатых соков. Готовить их нужно из фруктов, ягод, зелени и овощей. Список фрешей, полезных для организма женщины, которая проходит курс лучевого лечения:
- яблочный,
- грушевый,
- вишневый,
- апельсиновый,
- лимонный,
- картофельный,
- сельдерейный,
- огуречный и другие.
Пациентке, которая лечит рак матки лучевой терапией, рекомендовано отказаться от употребления:
- кофе и других напитков, содержащих кофеин (в том числе, черного чая, какао);
- жареного, острого, копченого, соленого;
- консервации;
- маринадов;
- кислой продукции;
- молочных продуктов.
Несмотря на пользу бобовых плодов, капусты и грибов, при раке их тоже придется убрать из меню. Эти продукты питания вызывают повышенное газообразование, что усугубляет состояние женщины, усиливает проявление неприятной симптоматики.
Полезно периодически употреблять кисели, зеленый и белый чай, травяные отвары. Следить за тем, чтобы напиток не был слишком сладким, так как это способно вызвать приступ тошноты.
Наряду с изменением меню, важно скорректировать образ жизни. Отказ от курения, алкоголя, употребления токсических веществ – условия, которые должны быть соблюдены обязательно. Благодаря этому удастся устранить недомогания, вызванные облучением, ускорить процесс выздоровления.
Диетотерапия при онкологических процессах в тканях матки — вспомогательный метод лечения опасного заболевания. Принципы питания и меню на каждый день схожи между собой, но разные виды лечения требуют различных подходов к рациону.
Следовать изложенным правилам рационального питания при лечении рака детородного органа должна каждая пациентка. Такой подход поможет улучшить самочувствие, придаст силы организму для борьбы с болезнью, будет способствовать снижению веса. Это тоже важно для успешной борьбы с онкологией, ведь у многих женщин она развивается и стремительно прогрессирует на фоне избыточной массы тела.
Если самостоятельно разработать меню на каждый день не удается, справиться с задачей поможет врач-онколог и диетолог.
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