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yxfbbiedtj · Wysłany: Sob 4:25, 05 Mar 2011

TPN, TEN in the treatment of pancreatic fistula

Total parenteral nutrition) and TEN (enteral nutrition) in the treatment of 9 cases of pancreatic fistula patients, results were satisfactory. First, the brain-bed data 1. General information: Bong of male spider 7, 2 patients aged 27-66 years old professionals. One pancreatic fistula after pancreatoduodenectomy in 5 cases, acute hemorrhagic pancreatic pancreatic fistula embedded, total gastrectomy and combined spleen and pancreas tail resection pancreatic fistula, pancreatic pancreatic fistula after traumatic clear plane, portal hypertension spleen and pancreatic fistula after cutting the l gland spider. 6 were transferred to other hospital. Volume of pancreatic fistula Et5O a per 700ml, pancreatic fistula duration of 7-26 days. 2. Nutritional support. Line 7 patients TPN,[link widoczny dla zalogowanych], TEN treatment in 5 cases (including TPN + TEN treatment for 3 down). TPN support time is 6-24 days} TEN support time J2 ~ 28 days. TPN7 case, the superior vena cava central venous catheter line parenteral nutrition (CV-TPN) 5 cases of peripheral venipuncture or catheter nutritional support (PV-TPN) 2 cases; by amino acids of a fat emulsion of a dual-glucose energy supply, heat than the side by the supply of nitrogen, was added by electrolysis, a living Hao, trace elements (such as the Schedule), intermittent loss and fresh eggs from the plasma, whole blood. TEN5 case entombment enterostomy in 2 cases,[link widoczny dla zalogowanych], nasal gastric feeding tube anastomosis in gastrointestinal surgery at the place by word of enteral (nasal jejunal feeding tubes) 3 sides' use of compound nutrients or ENSURE, hand prepared by a nutritionist, 241J ~ even when the trickle-down. Application of TPN, TEN monitoring the course of treatment wells kitchen police TPN solution t atlas stomach side project the amount of calories per day 126 ~ 210kJ/kg N 0.2 ~ 0.4 ~ plus feet Ⅲ oI/LP60 ~ 120m Ⅲ 01 / L insulin iU: S ~ 12g sugar trace Addmel (trace system Li) a living tangled Soluvit (the case of water-soluble vitamin preparation) a Vitalipid (dark soluble vitamin Pina agent) a patient blood glucose, the ball of sugar, blood biochemistry, liver and kidney function and nitrogen balance. 3. Treatment outcomes. Fistula healing 6 patients, 3 patients on the basis of nutritional support to withstand the surgery and cured again, no significant complications, 9 patients met the guillotine positive nitrogen balance. =, Discussion 1. Pancreatic fistula patients pancreatic juice of pancreatic amylase, lipase, protease activated can produce their own digestion,[link widoczny dla zalogowanych], resulting in tissue necrosis, hemorrhage, abscess and sepsis, in the course of treatment clamor to strictly limit the oral intake of food to suppress pancreatic exocrine, Therefore, only the line nutritional support. TEN of pancreatic secretory function of people have different views, we apply the 5 patients are enteral nutrition and found no increase in pancreatic secretion. 7TN, TEN can correct the patient's negative nitrogen balance, maintenance of water and electrolyte balance, reduce the secretion of pancreatic juice well to promote the healing of pancreatic fistula in the treatment of patients with pancreatic fistula has very important significance. 2. Pancreatic bury the treatment of patients as early as possible with TPN, TPN with double the energy supply. Patient education as the history of pancreatic resection wood, inadequate secretion of insulin orderly, normal application of glucose with insulin use should pay attention. In a high catabolism of pancreatic fistula patients, even if the application of glucose, amino acid supply is also difficult to meet the energy demand; fat emulsion to provide a high caloric, and add essential fatty acids to meet human needs. As stress increases blood glucose,[link widoczny dla zalogowanych], Insulin resistance of glycogen can not benefit rejection, leaving muscle protein breakdown surge in consumption, promote the concentration of branched-chain amino acids decreased, so the application of hydrogen amino acids rich in branched-chain amino acids should be given to the products to help maintain improve the negative nitrogen balance; other patients of pancreatic fistula associated with liver damage and more, also need to provide high branched chain amino acids can increase the protein synthesis, and improve liver function. TEN application must be controlled abdominal inflammation,[link widoczny dla zalogowanych], gastrointestinal function was improved before implementation, and should Luggage Enteral Nutrition, TEN method is simple, to provide complete nutrition, fewer complications, so we stood under the conditions allow, or should be applied TEN transition to the TEN as soon as possible by the TPN treatment. , 2l ·