【Tekang Pharmaceutical】How to scientifically supplement nutrition after surgery

Original: [Tekang Pharmaceutical] How to scientifically supplement nutrition after surgery

How can you supplement yourself with nutrition for patients who have undergone surgery and cannot take a natural diet? Today, on the basis of a new understanding of the intestine, the medical community proposes: "When intestinal function allows, enteral nutrition

So, what is enteral nutrition? How do patients undergo nutritional therapy after surgery?

1.

How much do you know about your gut? Maybe you just think of the intestine as a simple digestive and absorption organ, in fact, the intestine is also the largest immune organ in the human body, and it is a huge bacterial reservoir

If the mucosa of the small intestine of the human body is flattened, its area can reach about 10 square meters

Many studies have shown that a large proportion of intestinal mucosal damage stems from incorrect

2.

Enteral nutrition refers to the "extraction" of nutrients in the diet, according to the human body's nutritional needs standards, re-synthesis" of enteral nutrition preparations that are easy to be digested and absorbed by the gastrointestinal tract, and through oral or tube feeding, the enteral nutrient solution is absorbed into the human body

For patients whose gastrointestinal function is not allowed and have to use parenteral (intravenous) nutrition, attention should be paid to the appropriate administration of enteral nutrition solution after the gastrointestinal function improves, and strive for an early transition to complete gastrointestinal nutrition

How much nutrition is needed for patients after surgery? See information

Energy: The amount required is about 25 to 35 kcal/kg, and its role is to save protein and reduce tissue consumption;

Protein: The amount required is about 1.

Liquid volume: The amount of replenishment is determined by the amount lost

Minerals: The amount of supplementation is determined by the amount lost

Vitamins: vitamin C 100 ~ 300 mg, vitamin A, K and vitamin B family in an appropriate amount, vitamin C is involved in the formation of collagen and vascular endothelium, and is related to wound healing; B vitamins are cofactors of energy and protein metabolism; Vitamin A is a nutrient element of epithelial tissue; Vitamin K is involved in the formation

3.

Non-abdominal surgery has less effect on the digestive tract, and the factors that limit postoperative eating are mainly anesthesia

Abdominal surgery, especially gastrointestinal surgery, is generally fasted for 24 to 48 hours; On the 3rd to 4th day, after the intestinal function is restored, the anus begins to exhaust, and a small amount of liquid diet is started several times, gradually increasing to a full liquid diet; Semi-liquids begin on the 5th to 6th, and the normal diet

Regardless of the type of surgery the patient undergoes, the tissue breakdown phase
is required in the body after surgery.
Catabolism outweighs anabolism, and the energy source will be obtained
by depleting fat tissue and muscle.
After major surgery, especially those who are estimated to be unable to eat for a long time, it is necessary to provide nutrients through the parenteral route to supplement the consumption
of endogenous performance.

Surgical patients generally have difficulties in nutritional intake, which requires finding appropriate nutritional supply methods
.

The commonly used nutritional support methods are oral diet or nutrient solution, gastrointestinal tube feeding enteral nutrition and parenteral nutrition (also known as intraintestinal nutrition).

When making clinical choices, it should be noted that oral administration is the best, most natural, and most encouraging way
.

Even in the case of poor appetite and anorexia, bile salts, pancreatic enzymes, vitamins, and testosterone can be appropriately supplemented to promote the patient's eating
.
Of course, if the patient is in a coma, uncooperative or weak, and has a severe stomach failure, but the digestive function is still there, the nasal tube or even the gastrointestinal stoma intubation method can be used to provide nutrition
.

4.
How to eat after stomach and duodenal surgery?

Preoperative: Fluids are fed 2 days before surgery for intestinal preparation
.
Fast for 12 hours before surgery and water
for 4 hours.
If the patient is malnourished, parenteral nutritional support should be started before surgery, thereby providing sufficient energy and amino acids for postoperative recovery
.

The first stage after surgery: fasting is required
.
Patients with preoperative malnutrition or postoperative complications must be provided with a non-enteric approach to nutrition, which may be supportive with parenteral nutritional support
.
After gastric surgery, you cannot eat by mouth until gastrointestinal peristalsis is restored, and you can only resume eating after exhausting
and feeling hungry.

Postoperative stage 2: hydration, intestinal recovery
.
Patients should be asked to try ice or drink water at a temperature appropriate to make the patient feel comfortable
.
If vomiting is complicated, once vomiting stops, the lost water
should be replenished.

The third stage after surgery: liquid food
.
After the patient tolerates drinking water, a clear liquid diet
may be given.
After 24 to 48 hours, try to give a fully ground food with a texture close to a homogeneous paste that can pass through a straw
.
This condition should be maintained for 1 to 2 months
.

The fourth stage after surgery: low-sugar, low-fat soft food can be used
.

The fifth stage after surgery: after changing to solid food, the patient can first take the principle of a small number of meals, eat an average of 5 to 6 times a day, and it takes about half a year or so to recover before it can be changed to a regular diet
.
Postoperative patients should also pay attention to multivitamin supplementation, especially to give compound vitamin B, iron and other mineral supplements
.

5.
Tips

Intravenous fluids are often used in the acute phase of an acute illness or disease to replenish the body's need for water, sugar (energy), salt, electrolytes, or/and therapeutic drugs
.
It is undeniable that intravenous fluids have played, are and will continue to play their huge and unique role
as the most basic means of support and treatment.

However, intravenous fluids are not nutritional support, let alone a substitute for nutritional support
.
Intravenous infusion is composed of only sugar, salt, water and some electrolytes, and lacks protein, fat, vitamins, trace elements and dietary fiber, which are essential
for nutritional support.
For fasting patients, prolonged intravenous fluids without nutrient supplementation can lead to protein-caloric malnutrition
.

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