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Chapter 3410 【3410】Speak or not

Wei Guoyuan put his mouth next to his ear and spoke: "She is a female doctor."

There was only one female doctor at the scene, which was very conspicuous. It was not difficult for Shao Jialiang to recognize Xie Wanying, and a flash of surprise flashed in his eyes. It was not that she was a female doctor, but that she was really young. There are many excellent female doctors in internal medicine.

.There are many like them Xuanwu.

"Didn't I tell you? I am an intern and have not graduated." Wei Guoyuan raised his eyebrows at him, "And I am studying surgery."

This girl wants to be a surgeon? Shao Jialiang is confused. It's not that girls can't be surgeons, but why she wants to be a student of a surgeon. She says she has unique skills in endoscopic techniques in gastroenterology.

It can only be that he was too anxious to do anything at the last minute. He didn't listen to everything Wei Guoyuan said, and he just thought that anyone could be invited to help solve the problem. Even a medical student was invited to join in the trouble.

"Thank you for coming over and helping us." Shao Jialiang sincerely expressed his gratitude to several doctors from the National Association of China.

"You're welcome." Yu Xuexian replied, looking at Wei Guoyuan, he only knew that this man was much more shameless than Shao Jialiang.

Wei Guoyuan didn't seem to catch his gaze, smiled, and said to the group of people: "The patient is in the digestive endoscopy room."

On the way, Shao Jialiang introduced his patient to his colleagues: "He is malnourished and his wounds heal much slower than normal people. Now he is receiving more nutritional injections."

"Intravenous nutrition? If enteral nutrition is not enough, are you not planning to do jejunostomy?" As a physician, Yu Xuexian is equally familiar with all surgical methods of gastroenterology. Because even his internal medicine patients, such

In the same situation, you should consider asking a surgeon to assist in creating a fistula.

Jejunostomy is a tube inserted into the patient's jejunum to facilitate the direct entry of nutrient solution dripped from the outside into the patient's intestines. It is generally used as a temporary measure and must be removed after the patient returns to normal gastrointestinal feeding.

What Yu Xuexian said clarified the basic principles of clinical treatment of patients who cannot eat normally through the digestive system. Even if the doctor wants to make an incision in the patient, he must pour nutrient solution into the patient's intestines and avoid intravenous nutrition as much as possible.

External nutrition. The reason is very simple. The risk of total intravenous nutrition is too high and can cause many complications, including hyperglycemia, cholecystitis, blood clots, bacterial infections, etc., which can be fatal.

Only under unavoidable circumstances will doctors consider giving long-term intravenous nutrition to patients who are really unable to enter. For example, Chen Chengran, a patient with Crohn's disease who was admitted today, is completely unable to eat. His intestines are inflamed and enteral nutrition is not possible.

Total parenteral nutrition can only be relied on intravenous nutrient solution.

After receiving questions from the consulting doctor, Shao Jialiang explained: "This patient is like this. Four months ago, he was diagnosed with adenocarcinoma of the lower esophageal cardia and stomach bottom. The tumor was relatively large and he underwent total gastrectomy with esophagojejunostomy.

The digestive tract was reconstructed and surrounding lymph nodes were cleared. During the operation, a nutritional tube in the intestine must be reserved for him, so that the nutritional solution can directly reach his jejunum through nasogastric feeding for enteral nutrition. He was given enteral nutrition during the early period after the operation when he was unable to eat.

support."

Let’s talk about enteral nutrition again. Enteral nutrition is divided into two types according to the feeding route: oral and transcatheter. Transoral, that is, the patient can use the mouth to supplement the nutritional solution. Transcatheter, the most common one is the nasogastric tube, the tube is inserted into the nasal cavity.

to the stomach.

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