1342 Arriving for Consultation

Wei Guoyuan put his mouth next to his ear and said, "It's a female doctor."

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

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

This girl wants to be a surgeon? Shao Jialiang was confused. It's not that girls can't be surgeons, but why they want to be surgeon students, saying that they have unique skills in endoscopic techniques in gastroenterology.

It can only be that he himself was in a hurry to cram his feet. He didn't hear everything Wei Guoyuan said, and he just thought it would be good to invite anyone to help solve the problem. Even a medical student came to join in the scene.

"Thank you for coming to help." Shao Jialiang sincerely expressed his gratitude to several doctors of the National Association of China.

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

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

On the way, Shao Jialiang introduced his patient to his colleagues: "Malnutrition, the wound healing is much slower than normal people, and now we are strengthening nutrition injections."

"Intravenous nutrition? Are you planning to do jejunostomy if you can't get enteral nutrition?" As a physician, Yu Xuexian is also familiar with all surgical methods in the gastroenterology department. Because even if it is a patient of his internal medicine department, in such a situation, it is still necessary to consider asking the surgeon to assist in the fistula.

Jejunostomy is to insert a tube into the patient's jejunum so that the nutrient solution dripped from the outside of the body can directly enter the patient's intestinal tract. Generally as a temporary measure, it must be unplugged after the patient returns to normal gastrointestinal eating.

Yu Xuexian said this, clarifying 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 on the patient, he must pour nutrient solution into the patient's intestinal tract, and try to avoid intravenous nutrition, that is, total parenteral nutrition. The reason is simple. The risk of total parenteral nutrition is too high to cause many complications, such as hyperglycemia, cholecystitis, blood clots, bacterial infections, etc. can be fatal.

Only as a last resort for patients who cannot enter enteral nutrition, doctors will consider long-term parenteral nutrition. For example, Chen Chengran, a patient with Crohn's disease who was just admitted today, can't eat at all. His intestines are inflamed and he can't do enteral nutrition. He can only rely on total parenteral nutrition to give nutrient solution through veins.

Received a question from the consulting doctor, Shao Jialiang explained: "This patient is like this. He was diagnosed with adenocarcinoma of the lower esophagus, cardia and fundus of the stomach four months ago. The tumor volume is relatively large, and he underwent total gastrectomy with esophagojejunostomy. The digestive tract was reconstructed and the surrounding lymph nodes were removed. During the operation, an enteral nutrition tube must be reserved for him, so that the nutrient solution can be fed directly to his jejunum for enteral nutrition through nasal feeding. Enteral nutrition was given to him during the period when he could not eat in the early postoperative period support."

Speaking of enteral nutrition again, enteral nutrition is divided into oral and transcatheter according to the feeding route. Orally, that is, the patient can supplement the nutrient solution by mouth. Transcatheter, most commonly a nasogastric tube, the tube that goes from the nose to the stomach.