全消化道外营养在小儿外科应用的初步体会

Tentative Experience about Total Poreutenal Nutrition in Surgical Department of Pediatrics

本文报道用全消化道外营养在小儿外科治疗刀口裂开,高位肠瘘、先天性腹裂、重症感染等19例危重病儿。根据不同年龄组病儿的生理病理特点,配制不同的营养液,获得了正氮平衡。实行全消化道外营养治疗中首先应考虑患儿的体液平衡,其次考虑热量和氮量。对维生素和微量元素的需要亦不可忽视。本组死亡1例,出现低血钾、低血镁各1例、高渗性利尿2例。作者认为①在应激状态下,全消化道外营养虽不能使其负氮平衡得以逆转,但给予适量的营养液对达到预期治疗效果是有益的。原则是从最小剂量开始,以维持体重减少,体蛋白丢失为适。②赞同年龄越小,高分解越严重,其用氮量、热量也应越大,其比值也应越高的观点。

Total poreutenal nutrition is used for treatment of split of skin-cut , high-position intestines fistula, conger ital abdominal split and serious infection etc. in surgical department of pediatrics. According to physio-logial and pathological characteristics of different age groups of children, different nutritious Liquids are made and positive balance of nitrogen is gained. The need of vitamins and trace elements should not be neglected. The principle is to start from the minimal dose to maintain dropping of body weight until the vanishing of body protein. The younger the sick child is, the more serious the-decomposition is,and the more nitrogen and heat it will need, and the higher specific value will be.