营养支持治疗的并发症
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中国临床营养杂志000127Complications of nutritional support
Douglas W. Wilmore, MD.
The potential complications of nutritional support may be numerous, but can greatly be reduced to safe and acceptable levels with careful monitoring and administration guidelines.
The complications can be divided into three main categories: catheter related, metabolic and infectious. The catheter complications are related to central venous obstruction and thrombosis, air emboli, catheter occlusion and phlebitis. The metablolie complications are related to high or low levels of glucose, electrolytes, vitamins, trace minerals and hydrogen ions. Excess protein may cause hyperammonemia or an elevated BUN. Fluid overload, cholestasis and osmotic diuresis are further problems which may occur. Careful monitoring and following speeifie guidelines will minimize these problems.
TPN related infection is real, may be related to hyperglycemia and the presence of an indwelling catheter. Meticulous catheter care, single use of the TPN line and education of the nursing staff can reduce these complications. Early diagnosis and treatment of the infection is necessary for successful therapy. Removal of a central catheter may be required to elear some infections. Use of PICC lines may greatly reduee infection rates.
营养支持的潜在并发症可能有很多，但如果进行认真的监测和严格按照治疗原则给药，这些并发症可能避免或减少到可接受的程度。
并发症分为三类：导管相关并发症，代谢和感染并发症。导管相关并发症包括：中心静脉阻塞和血栓形成，空气栓塞，导管阻塞和静脉炎。代谢并发症包括：糖、电解质、维生素、微量元素和氢离子的水平过高或过低。过量的蛋白质供给可导致血氨过高或血尿素氮升高，进而可发生液体负荷过多，胆汁淤积和渗透性利尿。加强监测及按照特殊情况下的各种治疗原则给药，可以减少这类并发症。
肠外营养的感染并发症，可能与血糖升高和导管持续存在有关。通过严格的导管护理，输液管道一次性使用和对护士进行培训而减少感染并发症。感染并发症的早期诊断和治疗对治疗效果很重要。必要时可拔除中心静脉插管来减少感染的来源。应用经过周围静脉的中心静脉插管(PICC)，可大大减少感染并发症的发生率。, 百拇医药
单位：
关键词：
中国临床营养杂志000127Complications of nutritional support
Douglas W. Wilmore, MD.
The potential complications of nutritional support may be numerous, but can greatly be reduced to safe and acceptable levels with careful monitoring and administration guidelines.
The complications can be divided into three main categories: catheter related, metabolic and infectious. The catheter complications are related to central venous obstruction and thrombosis, air emboli, catheter occlusion and phlebitis. The metablolie complications are related to high or low levels of glucose, electrolytes, vitamins, trace minerals and hydrogen ions. Excess protein may cause hyperammonemia or an elevated BUN. Fluid overload, cholestasis and osmotic diuresis are further problems which may occur. Careful monitoring and following speeifie guidelines will minimize these problems.
TPN related infection is real, may be related to hyperglycemia and the presence of an indwelling catheter. Meticulous catheter care, single use of the TPN line and education of the nursing staff can reduce these complications. Early diagnosis and treatment of the infection is necessary for successful therapy. Removal of a central catheter may be required to elear some infections. Use of PICC lines may greatly reduee infection rates.
营养支持的潜在并发症可能有很多，但如果进行认真的监测和严格按照治疗原则给药，这些并发症可能避免或减少到可接受的程度。
并发症分为三类：导管相关并发症，代谢和感染并发症。导管相关并发症包括：中心静脉阻塞和血栓形成，空气栓塞，导管阻塞和静脉炎。代谢并发症包括：糖、电解质、维生素、微量元素和氢离子的水平过高或过低。过量的蛋白质供给可导致血氨过高或血尿素氮升高，进而可发生液体负荷过多，胆汁淤积和渗透性利尿。加强监测及按照特殊情况下的各种治疗原则给药，可以减少这类并发症。
肠外营养的感染并发症，可能与血糖升高和导管持续存在有关。通过严格的导管护理，输液管道一次性使用和对护士进行培训而减少感染并发症。感染并发症的早期诊断和治疗对治疗效果很重要。必要时可拔除中心静脉插管来减少感染的来源。应用经过周围静脉的中心静脉插管(PICC)，可大大减少感染并发症的发生率。, 百拇医药