FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to endocrinology, surgery, resuscitation and gastroenterology, and can be used for diabetes mellitus therapy in patients after total duodenopancreatectomy (TDPE). Glycemia is continuously monitored in the intraoperative and early postoperative periods. In the early postoperative period, a continuous intravenous infusion of insulin is initiated to achieve the target values of 8–11 mmol/l according to the specified protocol. From the first postoperative day, enteral nutrition is administered in dose of 300 ml 3 times a day for up to 7 days. In the surgical department, the basic-bolus insulin therapy is carried out: a starting dose of basal insulin 0.1 units/kg, prandial insulin 0.5 units per 1 bread unit of food. Therapy is carried out under glycemic control 9 times a day by glucometer before each main meal, two hours after the main meals, at 10 p.m., 3 a.m., 6 a.m., 40,000 units of pancreatin in minimicrospheres is taken for each meal.
EFFECT: method provides achieving compensation of diabetes mellitus in outcome of TDPE, and also provides a low risk of developing intra- and postoperative complications, zero mortality and increased duration and quality of life for the given cohort of patients due to the combination of techniques of the claimed invention.
4 cl, 8 dwg, 4 ex
