摘要
目的总结29年来应用静脉营养于围手术期和术后严重并发症的经验。方法①水解蛋白和高渗葡萄糖溶液治疗术后多数性肠瘘;②单能源静脉营养治疗腹膜后型急性坏死性胰腺炎;③全价静脉营养治疗肠瘘、胆瘘、胰瘘,吻合口瘘、吻合梗阻,术后坏死性胰腺炎,术后甲状腺危象伴肝细胞坏死,不全性粘连性肠梗阻伴胆道逆行感染,术后肝衰、心衰、肺衰等46例严重术后并发症和用于切除肝癌、胰腺癌、胆囊癌、肝门胆管癌、食管癌、贲门癌、胃癌、结肠癌、直肠癌等439例大手术的围手术期。经中心静脉插管注输167例、周围静脉318例。结果严重术后并发症46例的救治成功率为80.4%,围手术期治疗的死亡率为0.23%。静脉营养期中,中心静脉营养发热7例,周围静脉2例,血液及导管尖端细菌培养皆阴性。周围静脉血栓性静脉炎34例。低血钾性室上性心动过速,肝细胞重度脂肪沉积各1例。结论静脉营养有助提高术后严重合并症的抢救成功,减少污染切口的感染和切口裂开的发生,并使伴发的水、电解质失衡的纠正变得容易。
Objective Application of parenteral nutrition (PN)in postoperative patients with major complica-tions and in Perioperative patients during the passed29years.Methods (1)Protein hydrolysate and hypertonic glucose solution containing PN for the treatment of multiple postoperative intestinal fislulas.(2)Aminoacid and hypertonic glucose containing solution as PN for the retroperitoneal type acute necrotic pancreatitis.(3)TPN for46postoperative patients suffering from enteric,biliary,pancreatic and anastomotic leakages,obstruction of anastomotic stroma ,necrotic pancreatitis,thyroid crisis with focal hepatocelluar necrosis,retrograde cholangitis from imcomplete adhesive intestinal obstruction,heart,liver?pulmonary failures etc and439perioperative patients undergone resection of cancer of liver,pancreas,gallbladder,hilar bileduct,oesophagus,cardia,stomach,colon and rectum,etc.Central venous PN in167cases and peripheral in318cases.Result(1)The salvage rate of major postoperative complication (MPC)was80.4%.(2)The postoperative mortality of perioperative PN patients was0.23%.Fever was observed in7cases by central PN and2by peripheral with negative blood bacteria culture.Thirty four patients complicated with peripheral thrombophlebitis,one with hypokalemic supraventricular tachvcardia and one with heavy fat deposition in hepatocytes were observed.Conclusions PN was contributory to increased rate of salvage for patients suffering from MPC,reduced rate of wound infection in contaminated operations and rupture of closed wound and facilitating the correction of water and electrolytes imbalance in dehydration patients.
出处
《中国临床营养杂志》
CAS
2002年第2期112-115,共4页
Chinese Journal of Clinical Nutrition
关键词
静脉营养
围手术期
术后并发症
临床研究
parenteral nutrition
perioperation
postoperative complication
