个性化膳食指导和营养干预对妊娠结局及新生儿影响的研究

目的探讨个性化膳食指导和营养管理对妊娠结局及新生儿的影响。方法选取福建省妇幼保健院行产前检查的201例孕妇,随机分为干预组(104人)和对照组(97人)。对照组给予常规健康教育及产前检查;干预组在此基础上给予个性化膳食指导和营养管理。比较两组孕中、晚期能量及营养素摄入量,孕期增重、新生儿出生体重、分娩方式和孕期并发症。结果干预组孕妇孕中、晚期能量、蛋白质和脂肪摄入量低于对照组,钙的摄入量高于对照组;孕期增重(13.0±2.1)kg低于对照组的(19.1±3.5)kg;新生儿体重为3.0~3.5kg的占比(70.2%)高于对照组(45.4%);干预组贫血和巨大儿发生率(9.6%和1.9%)低于对照组(24.7%和13.4%),自然分娩率(76.0%)高于对照组(42.3%)。结论个性化膳食指导和营养管理能促使孕妇孕期膳食摄入接近合理,孕期增重较适宜,减少了巨大儿发生率,有利于孕妇以及新生儿健康。     

分析孕期营养指导对改善孕妇孕期营养与妊娠结局的影响

目的:分析孕期营养指导对改善孕妇孕期营养与妊娠结局的影响.方法:选取我院2015年2月至2016年2月在我院进行孕期保健的200例孕妇作为研究对象,采用随机分配的方式分为观察组与对照组各100例.对照组孕妇进行常规健康指导,观察组孕妇在此基础上给予营养指导,对比两组孕妇的孕期影响及妊娠结局.结果:观察组孕妇在蛋白质、叶酸、铁、钙、维生素等营养物质的日均摄入量普遍高于对照组(P<0.05),具备统计学意义;纳、脂肪等摄入量明显低于对照组(P<0.05),具备统计学意义;观察组出现宫内窘迫、胎儿生长受限、巨大儿、低体重儿、早产发生率均低于对照组,差异明显(P<0.05),具备统计学意义.结论:孕期营养指导能有效孕妇的营养摄入,减少新生儿并发症发生率,保证新生儿的健康成长,值得在临床推广应用.     

营养健康教育联合针对性营养指导对孕妇营养状况和母婴结局的影响

目的探讨营养健康教育联合针对性营养指导对孕妇营养状况和母婴结局的影响。方法选取2015年1月-2016年1月行孕期保健的80例孕妇为研究对象,将孕妇随机分为营养组和常规组,每组各40例。营养组孕妇在常规保健基础上实施营养健康教育联合针对性营养指导,常规组孕妇给予常规孕期保健。比较两组孕妇的营养状况及母婴结局。结果营养组孕妇孕期增重不适发生率为15.00%,与常规组孕妇(37.50%)相比明显降低,差异具有统计学意义(χ~2=5.230,P0.05)。营养组孕妇妊娠期糖尿病、妊娠期高血压疾病、巨大儿、胎儿窘迫发生率与常规组相比明显降低,差异均具有统计学意义(均P0.05)。结论营养健康教育联合针对性营养指导能改善孕妇的营养状况,减少妊娠期及新生儿并发症,改善母婴结局,可在孕妇中应用。     

孕期个体化膳食营养指导对孕产妇体质量增长及新生儿状况的影响

目的探讨孕期个体化膳食营养指导对孕产妇体质量增长及新生儿状况的影响。方法选取2015年8月-2016年8月在该院建立孕产妇保健手册的326例孕妇为研究对象。根据孕妇意愿,将176例选择接受个体化营养膳食指导的孕妇作为观察组,剩余150例孕妇作为对照组(仅接受孕期知识宣教以及产科门诊常规孕期检查)。观察并评价两组孕妇体质量增长情况,比较两组孕妇妊娠期并发症的发生情况。记录两组孕妇的分娩方式(阴道分娩、剖宫产),比较两组孕妇妊娠结局和新生儿情况。结果观察组孕妇体质量增长(13.45±1.69)kg,明显低于对照组孕妇的(15.26±1.76)kg(P0.05)。观察组增重正常的孕妇比例明显高于对照组,而增重过少和过多的孕妇比例分别低于对照组(P0.05)。观察组孕妇妊娠期糖尿病和贫血发生率明显低于对照组孕妇(P0.05)。观察组孕妇阴道分娩率为69.32%,明显高于对照组的48.67%(P0.05)。观察组新生儿体质量为(3.28±0.66)kg,明显低于对照组的(3.69±0.73)kg(P0.05),同时低出生体质量儿和巨大儿发生率明显低于对照组(P0.05)。结论孕期个体化膳食营养指导对确保孕产妇体质量合理增长、降低妊娠期糖尿病和贫血的发生率、提高阴道分娩率有明显的效果,同时对保证新生儿适宜的出生体质量,降低低出生体质量儿和巨大儿发生率有重要意义。     

营养指导对妊娠期营养和妊娠结局的影响

目的评价妊娠期营养指导效果,探讨妊娠期营养对妊娠结局的影响。方法对73例经过营养门诊定期营养指导的孕妇和48例同期未经过营养指导的孕妇妊娠晚期膳食营养状况、外周血微量元素水平、妊娠结局进行比较。结果观察组孕妇膳食营养比较均衡,血液钙、镁、铜、铁水平高于对照组,新生儿平均出生体重高于对照组,胎膜早破、妊娠期高血压疾病、贫血的发生率低于对照组。结论妊娠期营养指导可以改善孕妇营养状况,促进胎儿生长发育,减少围生期并发症。     

营养教育和个体化营养指导对孕妇营养状况的影响

目的探讨孕期营养教育和个体化营养指导对孕妇膳食结构和营养状况的影响。方法 2012年8月-2013年8月在产科定期孕检的单胎初产孕妇150例,分为干预组和对照组。对干预组孕妇进行营养教育和个体化营养指导至分娩。结果干预组中谷类、蔬菜、水果、蛋类、奶类及豆类的摄入量符合推荐量的人数明显高于对照组(P0.05);干预组粗粮、鱼虾及其他海产品、动物肝脏和豆类的摄入频率较对照组合理(P0.05);干预组能量、蛋白质、维生素A、维生素B1、维生素B2、钙、铁和膳食纤维的实际摄入量与推荐量的差值较对照组小(P0.05);干预组孕妇孕晚期的血红蛋白高于对照组,贫血患病率低于对照组(P0.05)。结论营养教育和个体化的营养指导可以有效的改善孕期妇女的营养状况。     

孕期营养指导在围产期孕妇保健工作中的应用探讨

目的:分析孕期营养指导应用于围产期孕妇保健工作的临床效果。方法:收集近期该院产科门诊建册和产科病房住院的224例孕产妇临床资料作为观察组,对照组只行常规健康教育,对围产期的母婴健康状况进行分析比较。结果:定期营养指导观察组孕产妇的蛋白质、钙、铁、钾、硒及维生素A均高于对照组,而脂肪、钠的摄入量显著低于对照组;而观察组胎儿生长受限、妊娠糖尿病、妊娠期高血压疾病、妊娠期贫血、胎儿窘迫、新生儿窒息、巨大胎儿、低体重儿、早产、流产及产后出血发生率也显著低于对照组(P<0.05)。结论:通过孕期营养指导,将营养干预纳入围产期保健工作能够改善妊娠结局,增强母婴安全。     

体质指数指导的营养干预对妊娠结局的影响

目的:探讨体质指数指导下孕期营养干预对妊娠结局的影响。方法:选择280例在响水县妇幼保健所围保门诊孕期体检的正常单胎初产孕妇,随机分成观察组和对照组,每组140例,两组均给予定期孕期检查直至分娩,观察组在此基础上以体质指数为指导进行营养干预。比较两组妊娠结局。结果:观察组GDM、HDCP、胎膜早破、贫血发生率均低于对照组(P<0.05,P<0.01),观察组阴道分娩率明显高于对照组(P<0.05),低体重儿、巨大儿、高胆红素血症新生儿发病率均显著低于对照组(P<0.05)。结论:体质指数指导下进行营养干预能有效降低妊娠期及分娩期合并症,提高阴道分娩率,降低新生儿并发症的发生。     

孕期个性化膳食营养指导对母婴健康和妊娠结局的影响

目的 探讨孕期个性化膳食营养指导对母婴健康和妊娠结局的影响。方法 选取2016年6月至2019年6月在武汉市某妇幼保健院产科门诊建立孕产妇保健手册的492名孕妇。按照随机化的方法，把研究对象分对照组和干预组，每组246人。对照组仅给予常规孕期健康知识宣教、健康检查和膳食调查；干预组在对照组的基础上，根据孕妇营养健康状况，给予全面专业的膳食营养宣教和个性化膳食营养指导。干预周期为自怀孕建档起持续到分娩。在孕中期和孕晚期对两组孕妇各开展一次膳食评估。采用t检验和卡方检验探究孕中、晚期两组之间营养素摄入及妊娠结局有无差异，评价个性化膳食营养干预的效果。结果 孕中期干预组孕妇能量、蛋白质、钙、铁、维生素A摄入量明显高于对照组（P<0.05）；孕晚期干预组孕妇能量、蛋白质、钙、铁、维生素A、维生素B2摄入量显著高于对照组（P<0.05），孕中晚期脂肪供能比均显著低于对照组(P<0.05)，低出生体重儿、巨大儿、剖宫产、妊娠期糖尿病发生率均明显低于对照组，其差异具有统计学意义（P<0.05)。结论 孕期科学合理的个性化膳食营养指导，在保证孕期均衡营养的同时，可降低巨大儿、剖...     

孕期营养指导对孕产妇分娩方式及妊娠结局的影响

目的探讨孕期营养指导对孕产妇分娩方式及妊娠结局的影响。方法选取2016年1-10月在该院进行围生期保健的孕产妇300例,随机分为观察组与对照组各150例。对照组采用常规围生期保健,观察组在常规围生期保健基础上给予孕期营养指导。比较两组分娩方式,分娩前孕妇健康素养评价合格率,孕末期体质量增加,新生儿出生体质量,胎儿宫内窘迫、新生儿窒息发生率,妊娠期糖尿病、妊娠合并贫血、羊水过少发生率以及产后出血率。结果观察组分娩前的孕妇健康素养评价合格率显著高于对照组(P0. 05);观察组自然分娩率显著高于对照组(P0. 05);观察组孕末期体质量增加12. 5 kg的比例显著高于对照组,20 kg的比例显著低于对照组(P0. 05)。观察组新生儿4 000 g的比例显著低于对照组(P0. 05)。观察组首次母乳喂养成功时间30 min、30 min～1 h的比例均显著高于对照组(均P0. 05)。观察组胎儿宫内窘迫发生率显著低于对照组(P0. 05)。观察组产后出血、贫血、羊水过少、妊娠期糖尿病发生率显著均低于对照组(均P0. 05)。结论孕期营养指导能够显著提高自然分娩率,减少巨大儿的发生,进而减少相关并发症的发生率。     

Impact of nutrition behaviour research on nutrition programmes and nutrition policy

Development of a society is interrelated with research. Innovation in food and nutritional sciences enable citizens to live in conditions of food security. Current dietary goals can be reached by understanding the biopsychosocial background of human nutrition behaviour. Examples of diffusion of such findings into practice are presented with emphasis on Germany and the activities of AGEV (the Working Association of Nutritional Behaviour), which was founded 25 years ago. Nutrition behaviour research should strengthen the focus on practical applications of its findings, since the prevalence of nutrition-related problems, like obesity in children and the estrangement on food and nutrition, is increasing.     

Total parenteral nutrition and enteral nutrition in diabetes

A quarter or more of critically ill patients are likely to have carbohydrate intolerance or frank diabetes, either pre-existing or secondary to the stress of illness. Those patients who require parenteral nutrition should be treated using regimens similar to those used in nondiabetic patients, along with sufficient insulin (given by separate infusion) to maintain near-normal glycaemia. The role of novel substrates in diabetes remains to be established. In patients who require enteral nutrition, there is accumulating evidence that high-fat (as monounsaturated fatty acid) formulations achieve better overall metabolic control than conventional high-carbohydrate preparations. In view of the fact that macrovascular disease is the major cause of morbidity and mortality in type 2 diabetes in particular, and the fact that the risk of macrovascular complications is relatively unaffected by glycaemic control, the improved lipid and haemostatic profile achieved with preparations that are high in monounsaturated fatty acids is of particular importance in patients on long-term nutritional support.     

Neonatal nutrition: a focus on parenteral nutrition and early enteral nutrition.

No population has benefited more from the development and advancement of specialized nutrition support than pediatric patients. Today, neonates comprise the largest group of pediatric patients receiving parenteral nutrition (PN). Nutrient needs of neonates differ substantially from other populations, presenting unique challenges in optimizing nutrition care. Neonates are highly susceptible to catabolic stress because of reduced energy stores and markedly increased energy needs. Immature organ systems and metabolic pathways further complicate the delivery of adequate nutrition in the preterm neonate. Early nutrition support is essential to improve survival, reduce catabolism, promote growth, and limit developmental complications. This article discusses feeding strategies for PN and early enteral nutrition in neonates, particularly the preterm neonate.     

胃癌术后肠内营养与肠外营养的护理分析

目的：探讨胃癌术后肠内营养与肠外营养的护理。方法：研究我院2014年3月至2015年12月期间随机抽取的胃癌术后患者80例,分为对照组与观察组各40例,其中对照组运用肠外营养支持护理,观察组运用肠内营养支持护理,分析两组患者营养支持护理效果差异。结果：在护理前后各蛋白指数上,观察组改善幅度高于对照组,p<0.05;在术后感染率显著并发症发生率上,观察组低于对照组,p<0.05;在肛门排气与住院时长上,观察组短于对照组,p<0.05。结论：胃癌术后通过肠内营养支持护理可以有效的提升患者恢复效果,加快术后恢复,减少术后并发症。     

Towards implementation of optimum nutrition and better clinical nutrition support

Clinical Nutrition Support--defined as nutrition for hospitalized patients suffering from metabolic stress--plays a limited role in the therapeutic routine of the physician. This is not surprising as most research in the field of clinical nutrition is disappointing with regard to the objective outcomes: morbidity and mortality. These reflections advocate a more 'pharmaceutical approach' to nutrition in order to perform more proper studies on the potential effectiveness of this treatment modality. To provide all patients in the Academic Medical Centre (AMC) in Amsterdam, The Netherlands, with optimum clinical nutrition support, a Nutrition Support Team (NST) was established in 1996. This NST is coaching the dieticians and physicians in the AMC regarding clinical nutrition support. In practice this coaching consists of providing clear guidelines on what is supposed to be optimum nutrition, a basic course in parenteral nutrition and further continuous education. The concept of optimum nutrition is spread by the NST through various ways of education, both nationally and internationally. For adults, optimum nutrition is defined as the amount of protein, that stimulates whole body protein synthesis maximally (1.7 g/kg actual body weight) and covers anabolic energy need (35 kcal/kg actual body weight). The dietician is considered to be the expert in the field of optimum nutrition by oral, enteral or parenteral route. The Dietetic Department has increased its influence in the care of the patient by placing nutritional status and care on the chart of the patient's treatment. To provide optimal Nutrition Support for children and severe ill patients (Intensive care department) specialized teams were started which were co-ordinated by the central NST. The central NST has a co-ordinating and educating role, while the Specialized Nutrition Support Teams (Specialized NST) construct guidelines, undertake research and provide continuous optimum nutrition care.