两种膳食对重症患者肠内营养的疗效分析

目的 探讨重症患者应用要素膳和匀浆膳两种不同肠内营养的疗效.方法 在我院收治的重症昏 迷患者中,随机收集应用要素膳的患者17例为要素膳组,应用匀浆膳的患者17例为匀浆膳组.评价两组患者用膳7d与28 d后 上臂围、上臂肌围、三头肌皮褶厚度及血清清蛋白、总蛋白、淋巴细胞指标.结果 两组患者营养评价指标及生化指标 比较的差...     

自制非要素膳早期肠内营养在食管癌手术中的临床应用

目的探讨食管癌术后早期应用自制非要素膳进行肠内营养的临床应用价值。方法选择120例食管癌手术病人随机分为自制非要素膳组和商品化组各60例,同时随机抽取以前的38例肠外营养组,分析比较三组术后的营养指标及住院费用,进行统计学处理,了解其效果。结果肠内营养组在术后氮平衡恢复、肌酐身高指数、淋巴细胞记数、血清白蛋白等营养指标及肠道功能恢复较肠外营养组好,自制非要素膳组和商品化组术后营养指标恢复程度相当,但费用明显降低。结论自制非要素膳行早期肠内营养在食管癌手术中的应用是安全可行的,能够明显改善机体的营养状态,且价格低廉,有很高的临床应用价值。     

匀浆膳与要素膳用于昏迷患者营养支持效果的对比

目的 :探讨匀浆膳与要素膳对神经外科术后昏迷患者营养状况的影响。方法 :将2001年1月～2001年12月住在本院神经外科86例术后昏迷患者随机分成两组 ,第一组管饲匀浆膳 (44例 )、第二组管饲要素膳 (42例 )。于术后24小时开始胃肠外营养(TPN)治疗 ,两组患者在获得能量与氮量方面差异无显著性。术前及术后10天、20天测定血前白蛋白 (PA)、白蛋白(ALB)、血红蛋白(Hb)、氮平衡 (NB),比较两组上述指标在术后的差异。结果 :两组间术前、术后10天、20天测定的血PA、ALB、Hb、NB比较 ,差异无显著性。结论 :管饲匀浆膳完全可替代管饲要素膳用于昏迷患者的营养支持。     

自制非要素膳早期肠内营养在食管癌手术中的应用护理

目的 探讨食管癌术后早期应用自制非要素膳进行肠内营养的护理.方法 对70例食管癌手术患者进行自制非要素膳营养.结果 肠内营养组在术后氮平衡恢复、肠功能恢复较肠外营养组好.结论 应用非要素膳肠内营养通过合理配制、鼻肠管及各种引流管的护理、严密观察病情、口腔护理、并发症的观察与护理等,患者营养状况得到明显改善,减少了并发症发生,显著提高了生存质量.     

复方要素膳的临床应用(附10例报告)

<正> 复方要素膳是根据人体所需全部营养素,按一定比例配制而成的粉剂药物,又称化学配制膳或元素膳,它含有人体所需要的必需氨基酸、脂肪酸、单糖、多种微生素、无机盐和微量元素。无渣,到胃后,不需消化或很少消化,被机体迅速、充分地吸收,因而,在不进食的情况下,少量要素膳即可代替正常饮食,对消化道瘘、烧伤、各种原因引起的低蛋白血症、严重消耗性疾病、消     

要素膳治疗18例危重病人疗效观察

<正> 要素膳又名元素膳,是一种有效的肠道高营养疗法。近年来经临床大量应用,已取得良好疗效。我院用要素膳配合临床治疗危重病人18例,总有效率达83.2％,结合文献分析报告如下。 临床资料和方法 1 一般资料: 本组18例中,男11例,女7例,年龄20～82岁,平均44.3岁。其中小肠膀胱瘘1例,食道气管瘘1例,食道灼伤胃造瘘术4     

要素膳的临床应用

要素膳又名要素药,是近年来临床营养治疗中的重大进展。要素膳不但营养成份齐全,而且可经口服,胃内滴注,空肠造瘘管滴注等多途径供给,操作简单,并发症少,是治疗各种营养不良患者及抢救危重病人必不可少的有效措施。要素膳的组成要素膳的基本组成成份是:蛋白质(以2/3氨基酸,1/3短肽形式存在);脂肪(基本为脂肪酸);碳水化合物(以单糖或双糖形式存在);各种必需的无机盐,微量元素,维生素等。虽然各家要素膳营养成份的来源不同;但营养成份的含量基本接近人体生理需要。我国目前已有不少药厂生产多种定型的要素膳供临床应用。要素膳的特性要素膳有以下特牲:1.溶解于水,呈酸性。2.无粗蛋白,无致敏作用。3.含膳食纤维极少,据报道,5—6天方排便一次。     

严重脑损伤后早期肠内营养支持的合理应用

目的探讨严重脑损伤后早期肠内营养支持的合理应用。方法选择本院收治的重症颅脑损伤患者00N，随机分为实验组和对照组，实验组（50例）采用了早期鼻饲要素膳，对照组（50例）按常规方法实施鼻饲营养支持；实验组开始时间为伤后48h，对照组为伤后6～8d。结果患者对早期通过胃管滴注胃肠营养液有较好的耐受性，喂养计划切实可行。与对照组相比，实验组获得较优的氮平衡，血清白蛋白、肌酐身高指数、体重等营养指标均明显改善（P〈0．05）。结论早期鼻饲要素膳对改善颅脑损伤患者营养状况有重要的临床意义。     

自制非要素膳在食管、贲门癌术后早期肠内营养中的运用

目的 探讨食管、贲门癌术后早期应用自制非要素膳进行肠内营养的安全性、可行性和临床效果.方法 99例行食管、贲门癌根治术的患者随机分为自制非要素膳肠内营养(enteral nutrition,EN)组和肠外营养(parenteral nutrition,PN)组,两组均于术后第1天开始给予营养支持或静脉营养,分别于术后第1天、第8天测定营养相关指标并进行比较,对术后并发症发生率、营养支持费用、肠道功能恢复时间以及平均住院天数等临床相关指标进行分析.结果 术后第8天两组患者的血清总蛋白、白蛋白、前白蛋白和淋巴细胞计数在营养支持后均升高,EN组升高较PN组更为显著 (P<0.05);肠外营养组并发症发生率也高于肠内营养组(P<0.05).营养支持费用、肠道功能恢复时间以及平均住院天数等比较,肠内营养组均优于静脉营养组(P<0.05).结论 食管、贲门癌术后自制非要素膳行早期肠内营养支持是安全可行、有效、经济的,较PN更具优势.     

经肠营养用几种膳食的研制

<正> 临床上很多病人处于蛋白质——热量营养不良的状态而使治疗与康复感到困难。虽然肠外营养可作为营养支持的手段,但其并发症多,操作要求高与费用较大而不能普遍应用。如胃肠道功能良好或部分完整,可分别采用非要素膳(NED)或要素膳(ED),在需要增加某种(些)营养素时,可采用组件膳(MD)进行经肠(口服或管饲)营养以满足代谢需要。经肠营养膳为化学成份明确与营养素齐全     

Blood alcohol level and caloric intake in the gravid rat as a function of diurnal period, trimester, and vehicle

Blood ethanol levels, caloric intake and weight gain were monitored over the 21-day gestational period in the gravid Sprague-Dawley rat as a function of the administration of ethanol in either a liquid diet (Ensure) or an aqueous saccharin solution. The mean daily percentage of ethanol consumed (38% vs 31%), and g/Kg of ethanol consumed (11.9 vs 9.7 g/Kg) were higher for the liquid diet group than the aqueous solution group. Ethanol consumption varied by the trimester in the Ensure but not in the saccharin solution rats. Proportional maternal weight gain, live litter size, and live litter weight did not vary as a function of the method of ethanol administration. Both groups exhibited significant diurnal periodicity in ethanol consumption, and the greatest caloric intake during the second trimester. The implications of these results for ethanol administration in gravid rats is discussed.     

Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial

BACKGROUND: Although thiopurines have a proven role in maintenance therapy for Crohn's disease, an alternative therapy is needed for patients intolerant or resistant to thiopurines. AIM: To evaluate the effectiveness of home enteral nutrition as a maintenance therapy regimen in which half of the daily calorie requirement is provided by an elemental diet and the remaining half by a free diet. We refer to this home enteral nutrition therapy as 'half elemental diet'. METHODS: Between 2002 and 2005, 51 patients in remission from two hospitals were randomly assigned to a half elemental diet group (n = 26) or a free diet group (n = 25). The primary outcome measure of this study was the occurrence of relapse over the 2-year period. RESULTS: The relapse rate in the half elemental diet group was significantly lower [34.6% vs. 64.0%; multivariate hazard ratio 0.40 (95% CI: 0.16-0.98)] than that in the free diet group after a mean follow-up of 11.9 months. Compliance was similar in the two groups. No adverse event occurred in any of the patients throughout the study. CONCLUSION: This randomized-controlled trial shows the effectiveness of an half elemental diet, which is a promising maintenance therapy for Crohn's disease patients.     

Clinical trial: normal diet vs. partial replacement with oral E028 formula for the prevention of gastrointestinal toxicity in cancer patients undergoing pelvic radiotherapy

Background  Acute gastrointestinal symptoms affect 90% of patients during pelvic radiotherapy. Elemental diet is protective in animal models. A nonrandomized study suggested benefit from a partial elemental diet. A pilot study suggested that radiotherapy patients only tolerate oral elemental diet comprising one-third of total calories for 3 weeks.
Aim  To assess the feasibility and efficacy of replacing one-third of normal diet with elemental diet during the first 3 weeks of pelvic radiotherapy in reducing acute gastrointestinal toxicity.
Methods  Patients were randomized to elemental diet or no intervention. Toxicity was assessed using the Inflammatory Bowel Disease Questionnaire, Vaizey Incontinence scale and Radiation Therapy Oncology Group tool. Faecal calprotectin measured intestinal mucosal inflammation.
Results  Twenty-nine women and 21 men, median age 61.5 years were randomized. Patients taking elemental diet did not have lower gastrointestinal toxicity ratings or inflammatory markers ( P  > 0.2). The mean dose taken was 21% (2–36%) of total caloric requirements.
Conclusions  Patients cannot tolerate large volumes of oral elemental diet. The quantities consumed in this study produced no therapeutic benefit. Future studies should aim to replace a higher proportion of nutritional intake for a longer duration of radiotherapy treatment.     

Early postoperative feeding with elemental diet.

The value of early postoperative feeding with an elemental diet was assessed in 30 patients after major gastrointestinal operations. The patients were allocated at random to conventional treatment (control group) or feeding with the elemental diet (ED group). The clinical and metabolic course of the 15 patients in the ED group was significantly better than that of the controls. Patients in the ED group lost less weight and had a shorter stay in hospital. Negative nitrogen balance was more pronounced in the control group throughout the seven postoperative days. Energy intake was higher in the ED group. Provided elemental feeding is used with caution, it may be given from the first postoperative day. Patients do better metabolically and require shorter stays in hospital.     

Polyunsaturated fatty acids in treatment of acute remitting multiple sclerosis.

One hundred and sixteen patients with acute remitting multiple sclerosis (MS) took part in a double-blind controlled trial of treatment with polyunsaturated fatty acids and were randomly allocated to one of four groups. Two groups received linoleic acid, one alone as a spread and one with gamma-linolenic acid in capsules (Naudicelle); and two control groups received oleic acid, one as a spread and one in capsules. Rates of clinical deterioration and frequencies of attacks were not significantly different between treated and control groups. Exacerbations were shorter and less severe in patients receiving a high dose of linoleic acid than in controls, but those receiving a lower dose--that is, Naudicelle--showed no such difference. Thus supplementing the diet with 20 g linoleic acid marginally affected the duration and severity of relapses of MS but had no effect on overall disability. The dose of Naudicelle used provided insufficient supplementation.     

A randomized controlled study comparing elemental diet and steroid treatment in Crohn's disease

Background : Elemental diet is considered an effective primary treatment for active Crohn's disease, but it is usually given by a feeding tube.
Methods : Twenty-two patients (12 males, median age 30 years, range 18–60) with moderately active Crohn's disease were enrolled in a randomized study in which the efficacy of an elemental diet administered orally was compared to high-dose corticosteroids in achieving clinical and laboratory remission. Ten patients were treated by oral elemental diet (Peptamen, Clintec, USA) and 10 received corticosteroids. Both treatment regimens lasted 2 weeks. The two groups did not differ with respect to age, sex, body weight, location of disease, treatment or disease activity prior to the study. In all patients studied, simple Crohn's disease activity index, nutritional status (expressed as body mass index), percentage of ideal body weight, fat mass, fat free mass, erythrocyte sedimentation rate, interleukin-6, intestinal permeability (expressed as permeability index), prealbumin, retinol binding protein and multiskin test were evaluated before and after treatment.
Results : After 2 weeks of treatment, there were significant improvements in simple Crohn's disease activity index, erythrocyte sedimentation rate, permeability index, body mass index, prealbumin, retinol binding protein and multiskin test in the elemental diet group. There were significant improvements in simple Crohn's disease activity index and fat free mass in the corticosteroid group.
Conclusions : These data suggest that, in the short term, an oral elemental diet is at least as effective as steroids in inducing remission of mild-moderately active Crohn's disease, but it may be more effective in improving the nutritional status of these patients, probably through a more rapid restoration of normal intestinal permeability.     

Media to simulate the postprandial stomach I. Matching the physicochemical characteristics of standard breakfasts

To better predict food effects on the bioavailability/bioequivalence of drugs and drug products from in-vitro data, a dissolution medium that simulates the initial composition of the postprandial stomach was developed. First, the physical parameters of two homogenized standard breakfasts often administered to assess food effects in pharmacokinetic studies were measured. These included pH, buffer capacity, osmolality, surface tension and viscosity. Subsequently, the match of the physical parameters of several commercially available liquid meals, including long-life milk, Ensure and Ensure Plus to those of the breakfasts was evaluated. Of the three liquid meals studied, Ensure Plus had the closest physicochemical behaviour to that of homogenized standard breakfasts. By increasing the viscosity of Ensure Plus with 0.45% pectin, it was possible to obtain a medium that closely resembles the FDA standard breakfast.     

Hypolipemic and potential antiatherosclerotic properties of diprophyllinyl-4-benzyloxybenzoate

To assess the hypolipemic and antiatherosclerotic activity of diprophyllinyl-4-benzyloxybenzoate guinea-pigs were kept on a high-lipid diet alone or with the tested compound for 21 days, and rabbits--for 3 months. It was found that diprophyllinyl-4-benzyloxybenzoate displays a distinct hypolipemic activity, particularly with respect to cholesterol, both in guinea-pigs and rabbits. It also depresses the cholesterol and the trigliceride content in liver homogenates and shows a tendency to normalize the low-density-lipoprotein fraction in guinea-pigs, as well as cholesterol of the high-density lipoprotein fraction, and malon dialdehyde in rabbits. The area of intima covered with atheromatous plaques was smaller in rabbits receiving the high-lipid diet with diprophyllinyl-4-benzyloxybenzoate than in those receiving that diet alone.     

糖尿病饮食治疗的临床效果观察

目的观察饮食干预对糖尿病患者的影响。方法对糖尿病患者280例干预前给予常规饮食指导,干预时根据患者自身情况制订饮食治疗方案。观察并记录饮食治疗干预前后患者体质量及血糖水平变化情况。结果干预后患者空腹血糖及餐后2h血糖水平均低于干预前,血糖达标率及体质量下降值均高于干预前,差异均有统计学意义(P<0.05)。结论对糖尿病患者采取饮食治疗,可改善患者血糖水平,控制患者体质量,对提高糖尿病治疗效果及改善预后均有一定的促进作用。     

Sorafenib: in advanced renal cancer

black triangle Sorafenib is an oral multikinase inhibitor that targets the mitogen-activated protein kinase signalling pathway and receptor tyrosine kinases involved in tumour proliferation and angiogenesis.black triangle In the large, phase III, randomised, double-blind, multicentre Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGET) of patients with advanced clear-cell renal cell cancer in whom previous systemic therapy had failed, median progression-free survival was doubled in patients receiving sorafenib compared with those receiving placebo (5.9 vs 2.8mo).black triangle Significantly more patients receiving sorafenib than those receiving placebo in the phase III trial experienced complete or partial responses or stable disease.black triangle Age, risk-assessment score, prior treatment, metastasis in lung or liver, or time from diagnosis did not affect the improved progression-free survival in sorafenib recipients.black triangle In a randomised, phase II discontinuation trial of patients with advanced renal cancer, in which only those showing stable disease with sorafenib were randomised to further sorafenib or placebo, more patients receiving sorafenib were free of progressive disease 12 weeks after randomisation than were those receiving placebo, and median progression-free survival was longer in sorafenib recipients.black triangle In clinical trials, most drug-related adverse events were mild to moderate in severity. Grade 3/4 hand-foot skin reaction and hypertension occurred more often with sorafenib than with placebo.