| 摘要 |
FIELD: medicine.SUBSTANCE: enteric therapy is started intraoperatively with introducing a glucose-electrolyte mixture 100 ml by means of a silicone probe inserted behind a gastroentero- or duodenoenteroanastomosis. On the first postoperative day, the amount of the fractionally introduced GEM is increased to 300.0 ml at 60 ml/hour, which is followed by enabling a passive outflow of the intestinal content. If the intestinal peristalsis tends to recover from the second postoperative day, a nutritional probe therapy is added with Nutrison Advanced Diason isocaloric formula 498 ml that is 10.0 kcal/kg at 60 ml/hour, which is followed by enabling the passive outflow of the intestinal content. If the probe spillage makes more than 50% of the amount of the nutritional formula administered for 1 hour, the previous rate of the washout intestinal infusion is maintained. If the nutritional formula is digested, the amount of Nutrison Advanced Diason isocaloric formula is increased to 700-800 ml/day. If the patient has a compensated glucose profile on the 4postoperative day, the amount of the tube feeding is increased to 1398 ml of Nutrison Standard that is 15.0 kcal/kg with the infusion rate to be increased to 90 ml/hour. On the fifth postoperative day, the patients having a good tube feeding tolerance are given with Nutrison Energy hypercaloric hypernitrogenous polymer nutritional formula with dietary fibres in an amount of 1000.0 ml that is 20.0 kcal/kg with keeping the infusion rate the same. On the sixth day, the patient starts unassisted enteric nutrition and is nutritionally supported with Nutridrink hypercaloric nutritional formula in an amount of 200.0 ml 2 or 3 times a day by sipping.EFFECT: improving the trophological values that causes reducing the number of postoperative complications, mortality and length of staying in hospital by the optimum regimen of treatment.6 tbl |
