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   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 look of surprise flashed in her eyes, not because she was a female doctor, but because she was really young. There are many excellent female doctors in internal medicine. There is something like their Xuanwu.

   "Didn't I tell you? They are interns who haven't graduated yet." Wei Guoyuan raised his eyebrows at him, "And they are 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 should be students of surgeons, saying that they have unique skills in endoscopic techniques in gastroenterology.

   It could only be that he was so anxious that he was cramming his feet. Wei Guoyuan didn’t listen to everything he said. He just thought it would be good to ask anyone to help solve the problem. Even a medical student came to join in.

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

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

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

On the way   , Shao Jialiang introduced his patient to a colleague: "malnutrition, wound healing is much slower than normal people, and now he is strengthening nutritional injections."

   "Intravenous nutrition? Don't you plan to do jejunostomy?" As a physician, Yu Xuexian is also familiar with all the surgical methods of gastroenterology. Because even if it is a patient in his internal medicine department, in such a situation, it is necessary to consider asking for surgical assistance for ostomy.

  jejunostomy is to insert a tube into the patient's jejunum, so that the nutrient solution dripped from outside the body can directly enter the patient's intestine. Generally as a temporary measure, it must be unplugged after the patient resumes normal gastrointestinal feeding.

   Yu Xuexian said this, which clarified the basic principles of clinical treatment of patients who cannot eat normally through the digestive system. Even if the doctor wants to make a hole in the patient's body, he must fill the patient's intestine with nutrient solution, and avoid intravenous nutrition, that is, total parenteral nutrition as much as possible. The reason is very simple. Too high risk of total parenteral nutrition can lead to many complications. Hyperglycemia, cholecystitis, blood clots, bacterial infections, etc. can be fatal.

  Only in the last resort of patients who are unable to enteral nutrition, doctors will consider long-term intravenous nutrition. For example, Chen Chengran, a patient with Crohn's disease just received today, can't eat at all, because his intestines are inflamed, and he can't do enteral nutrition.

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

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

   (end of this chapter)