POSTOPERATIVE NURSING OF ACUTE HEMORRHAGIC NECROTIC PANCREATITIS OF
CHILDREN
REN ZM
Children’s Hospital, Chongqing University of Medical Sciences,
Chongqing, China
Objective: To explore the mainpoint of postoperative nursing of
acute hemorrhagic necrotic pancreatitis of children, and reduce the
postoperative complications.
Methods: 11 patients with acute hemorrhagic necrotic
pancreatitis had been treated from 1993 to 2000. Exploratory laparotomy,
decompressingof the case and draining of abdominal cavity were performed in
all the patients and all were proved to be acute hemorrhagic necrotic
pancreatitis by pathologic examination. After operations, bleeding in
abdominal cavity, DIC, Draining tube unobstruction and proper nutritional
therapy should be paid much attention to. The nutritional therapy plans
were has three stages. The first stage was total parenteral nutrition (TPN)
during 2 to 7 days after operation including intralipid sod, paediatric
amino acid, and soluvit with electrolyte, carbohydrate, microelement,
glucose. Heat energy supply should be up to 292.880kj/(kg.d), and protein
supply should be up to 2g/(kg.d). When the patient has a normal body
temperature, better spirit, soft abdomen after pulling draining tube out
and patient felt hungry, the second stage could begin. In-vein nutrition
and EN (enteral nutrition) were both practised. EN was performed by nasal
feeding with essential food (80mg Elental mingled with 300ml warm water was
dropped in gastric tube at the speed of 30gtt/min once a day, 5 days a
course). When the patient has no vomitting, diarrhea stomachache and normal
defecation was appeared. Patients could do out-of-bed activity, the third
stage could begin. In this stage, patients got total enteral nutritions.
Meanwhile, the basic care and the post-hospital rehabilitation instructions
should be emphasized.
Results: The postoperative complications did not happen in all
patients. The draining passage in abdominal cavity was pulled out after 7
days of postoperation. The average weight was reduced 1~1.5kg and the serum
amylase was reduced to 84~130U/dl. The average duration of hospitalization
was 18 days.
Conclusion: The careful postoperative care and the proper
nutritional therapy are vital for saving lives and improving the cure rate.