外科液体治疗及营养支持（Surgical fluid therapy and nutrition support）.docVIP

外科液体治疗及营养支持（Surgical fluid therapy and nutrition support） Surgical fluid therapy and nutrition support Chapter I surgical fluid therapy Liquid treatment is a skill that must be mastered in clinical practice. Any deterioration of water, electrolyte and acid-base imbalance can lead to death. From the perspective of surgery, the relative steady-state of the patients environment is the basic guarantee of successful operation. The fundamental problem of surgical fluid therapy is the treatment of primary pathogenesis, water electrolyte and acid-base imbalance. The total amount of the replenishment includes three aspects: the cumulative loss, the continued loss and the quantity of physiological demand. 1. Physical and chemical properties of bodily fluids Body fluids are 60 percent of adult males and 55 percent of women. The main components are water and electrolyte, which are divided into intracellular fluid and extracellular fluid. Intracellular fluid is about 40 percent of the weight of men and about 35 percent of women. The extracellular fluid accounts for about 20% of body weight and is divided into plasma and interstitial fluid. Plasma is about 5% of body weight and about 15% of tissue fluid. The interstitial fluid is divided into functional extracellular fluid and non-functional extracellular fluid, which accounts for about 10 per cent of intertissue fluid, or 1 to 2 per cent of body weight. Normal adults are about 7-8% of their weight, made up of plasma and blood cells. Plasma contains water (90-91%), protein (6.5 to 8.5%) and electrolytes and small organic compounds (about 2%) 2. Quantity and quantity of body fluid balance The daily water intake and discharge of normal human body remain relatively stable, and we are divided into physiological needs, dominant and non-dominant water loss according to physiological needs. Daily water discharge and intake of adults (ml) Discharge (ml) Non-dominant water loss: 300ml skin evaporation 500ml of skin exhalation Dominant los