In exceptional circumstances, the use of peripheral intravenous injection can not reach a large number of additional protein and calories, the use of intravenous hyperalimentation therapy to receive good results, generally supplemented by the superior vena cava approach. Thick vena cava, the blood flow speed, so it can be a lot of hydrolyzed protein infusion (or amino acids, hypertonic glucose), to achieve high nutritional purposes.
Cancer patients after a large vein of high nutritional Method 1. Indications
(1) due to tumor made thin, long-term treatment of chronic obstruction or gastrointestinal tract after thin;
(2) severe malnutrition who can not be corrected by oral administration to achieve;
(3) complex surgical trauma or severely infected patients, increased nutrient loss, and consumption, supplemented by oral or intravenous generally have difficulty;
(4), surgery, trauma patients with severe complications such as acute renal failure, hypertension after the small veins of hepatic encephalopathy, coma, cranial trauma or surgery, a serious obstruction of gastric resection, extensive resection of small intestine to form short bowel syndrome;
(5) after tumor response to radiotherapy or chemotherapy heavier;
(6) certain gastrointestinal diseases, such as Crohn's, disease, stains War colitis, bowel management, rooms go far in the long term can not eat, etc. before and after surgery.
Cancer patients after a large vein of high nutritional Method 2. Means
Generally use the superior vena cava cannula, because the inferior vena cava superior vena cava blood flow than slow and prone to contamination, embolism and infection, it is generally not used.
Exingzhongliu large veins of patients after high nutritional method 3. Nutrient solution preparation principles General shall, in accordance heat, moisture, protein, electrolytes, trace elements and vitamins with the five aspects to the specific carefully prepared, according to the specific circumstances of each patient to determine the amount.
Questions about the vitamin supplement: adult daily multivitamins should be given regular intravenous solution 10ml. Which contains vitamin K :14 – 8mg, vitamin Bl250 tons, folic acid 0.5 – 1.5mg. Anemia by adding iron per day 2 – 3mg.
Hydrolyzed protein solution containing trace elements, if necessary, blood transfusions or plasma per week 1 – 2 times, in addition to hydrolyzed protein can still be used outside of amino acids, primarily essential amino acids. Essential amino acids in the metabolic process and the hydrolyzed protein is different from not produce ammonia, and non-protein nitrogen increased very little. Therefore, for liver and renal dysfunction patients.
Cancer patients after high-nutrient approach a large vein 4. Nutrient solution and precautions to use
(1) The solution must be configured under strict sterile conditions, if the configuration can not immediately input should be refrigerated, but not more than 12 hours.
(2) a daily supplement of the nutrient solution should be evenly divided within 24 hours of infusion, to achieve maximum utilization.
(3) Note that water and electrolyte balance in patients with cardiopulmonary conditions, and detailed record of intake and output, body weight measurement. Blood, urine, sodium, bait, carbon dioxide combining power, non-protein nitrogen, urea nitrogen and other tests. Important early after the operation, a daily check 1, check 1 week later.
(4) Section 6 hours 1 urine test, urine maintained at 0 – 4, between this value should be high if the blood glucose control, and adjust the infusion rate and the amount of insulin or join gland. With diabetes, with particular attention, but not a contraindication for intravenous hyperalimentation. Measured at each urea nitrogen, calcium, phosphorus, globulin, serum mirror, anti-blood glucose tolerance. Usually 1 every 3 days for blood culture tube at the entrance, if necessary, change the number in order to accurately understand the situation and in a timely manner for proper treatment to ensure patient safety.
- large veins in cancer patients