Recently, the Department of Oncology and Gastroenterology of Luzhou Branch hospital performed gastroscopic nutrition tube insertion for two elderly patients to solve the problem of eating, protect the intestinal mucosal barrier and improve the nutritional status of patients, and placed an exclusive "nutrition express line" for gastric cancer patients.
It is understood that a patient is an 81-year-old elderly man, who has stopped eating for more than a month before the operation of stomach cancer one year after the operation, and is accompanied by nausea, vomiting and other symptoms. The patient is tormented by illness, physically and mentally exhausted, physically weak, and severely emaciated.
After careful examination of the patients, Zhao Jun, director of the Department of Oncology of the General Hospital, and Maning, deputy chief physician of the Department of Oncology of the Branch Hospital, found that the patient's tolerance to gastroscopy was poor, the gastrointestinal mucosa was edematous, and the mucous membrane was easy to bleed when touched. In order for patients to solve the problem of feeding, the two directors carefully considered proposing a treatment plan for placing nutritional tubes.
Gastroscopy-assisted imaging to confirm that the catheter is correct
Postoperative patients have stable vital signs and begin enteral nutrition therapy
Before the operation, after careful evaluation and research of the patient's situation, under the guidance of Li Jing, deputy chief physician of the Department of Gastroenterology of the General Hospital, zhang Lijuan, chief nurse of the Department of Oncology, Hu Yanling, attending physician of the gastroscopy room, and wang Xiaoshuang, the chief nurse, cooperated with each other, rigorous and realistic, steady and steady, and successfully delivered the nutrition tube to the duodenal descending department. After imaging, the position of the nutritional tube is again made to ensure that the nutritional tube is correct. Postoperative patients have stable vital signs and begin enteral nutrition therapy.
Another 75-year-old postoperative patient with esophageal cancer was unable to eat due to a recurrence of the tumor. After seeing the smooth placement of clinical patients, the elderly and their families put forward the idea of also wanting to be catheterized. Director Zhao Jun carefully analyzed the patient's condition during the rounds, assessed the patient's benefits, and agreed to catheterize. However, during the operation, the gastroscopy found that the patient's anastomotic stenosis was obvious, and the gastroscope could not pass, and the team quickly made a decision to perform esophageal dilation for the patient, and successfully sent the nutritional tube through the esophageal stenosis under the gastroscope direct view and into the stomach.
Successful catheterization after esophageal dilation
Gastroscopic guided gastroscopic nutrition tube insertion requires the surgeon to master gastroscopy and operation techniques, and the patient has anastomotic obstruction and postoperative gastrointestinal reconstruction, which increases the difficulty of surgery. After imaging imaging, the tip of the catheter was unobstructed, the catheter was successful, and the patient's physical symptoms improved under the professional care of the nursing team.
Previously, parenteral nutrition was used for patients who could not eat or had difficulty eating, but long-term fasting caused intestinal mucosal atrophy, intestinal barrier function was impaired, and bacterial ectopic infection of the digestive tract increased infection, while enteral nutrition can both support systemic nutrition and protect the mucosal barrier, promoting the recovery of intestinal function. Therefore, gastroscopy-guided nasolabial nutrition tube insertion satisfies the patient's enteral nutrition needs, and the nutritional status gradually improves, especially for patients with advanced cancer in the next step of systemic and local chemotherapy and radiotherapy, and the survival period is improved. It is reported that the Department of Oncology of the Branch Hospital has completed nasolabio-jejunal catheterization for 15 patients, which reduces the economic burden of patients while improving the quality of life of patients.
Specialized diagnosis and treatment techniques for oncology and gastroenterology of the branch hospital extend the medical service capacity of the main hospital and benefit more patients.
The Department of Gastroenterology of Luzhou Branch specializes in the diagnosis and treatment of common diseases of the digestive tract such as peptic ulcer, cirrhosis, ulcerative colitis, and gastrointestinal bleeding. The department has an Olympus 290 endoscopic host, three gastrointestinal endoscopes, can carry out gastrointestinal stenosis treatment, esophageal stenosis dilation treatment, endoscopic nutritional tube insertion, foreign body removal and other treatments; endoscopic gastrointestinal polyp treatment, endoscopic mucosal dissection, endomorrhoid sclerotherapy and other surgeries will also be carried out.
The Department of Oncology of Luzhou Branch (Department of Oncology of Changzhi People's Hospital) relies on the medical team of the Department of Oncology of Changzhi People's Hospital, and currently has 46 beds. The Department of Oncology of Changzhi People's Hospital is the first specialized department of oncology in southeastErn Jindong, which is a comprehensive department integrating medical treatment, teaching, scientific research and prevention of malignant tumors, such as chemical drug therapy, endocrine therapy, immunotherapy, standardized treatment of cancer pain, minimally invasive interventional therapy, molecular targeted therapy, etc., and is the teaching clinical base of the Affiliated Hospital of Shanxi Medical University. The Department of Oncology of Changzhi People's Hospital and the Department of Oncology of Luzhou Branch adopt the unified management mode of "department director + attending physician"; the department director regularly teaches and rounds every Thursday, and the attending physician teaches and checks twice a week. Truly achieve the whole process of management of tumor patients. Let patients truly enjoy the "secondary hospital fees, tertiary hospital services".
Source: Changzhi People's Hospital