肾移植患者术后早期肠内营养支持效果观察

目的：观察肾移植术后早期肠内营养支持的效果。方法：为4例肾移植患者提供早期肠内营养支持，观察术后血清白蛋白、血红蛋白、肾功能的变化情况。结果：术后第2周血清白蛋白、血红蛋白明显提高，肾功能明显改善。结论：肾移植术后早期肠内合理营养支持，可改善患者营养状况，促进肾功能恢复。     

肾移植患者术后早期肠内营养支持效果观察

目的观察肾移植术后早期肠内营养支持的效果.方法为4例肾移植患者提供早期肠内营养支持,观察术后血清白蛋白、血红蛋白、肾功能的变化情况.结果术后第2周血清白蛋白、血红蛋白明显提高,肾功能明显改善.结论肾移植术后早期肠内合理营养支持,可改善患者营养状况,促进肾功能恢复.     

肾移植患者术后早期肠内营养支持效果观察

目的:观察肾移植术后早期肠内营养支持的效果。方法:为4例肾移植患者提供早期肠内营养支持,观察术后血清白蛋白、血红蛋白、肾功能的变化情况。结果:术后第2周血清白蛋白、血红蛋白明显提高,肾功能明显改善。结论:肾移植术后早期肠内合理营养支持,可改善患者营养状况,促进肾功能恢复。     

肾移植术后患者的营养治疗

肾移植术后患合理的营养治疗是影响移植肾早期存活的重要因素。为了达到理想的治疗效果,促进临床营养治疗工作的发展．我们成立了专门小组．进行了有效的营养治疗．探索出一条肾移植术后营养治疗的新路子。     

高龄患者肾移植术后护理

我院自1978年开展。肾移植术以来，至今已累计进行肾移植3860余例次，是西南地区最大的器官移植中心，手术成功率达10％，5年以上存活率为92．5％。随着肾移植手术安全性的提高和手术期的管理进步，对年龄的限制逐渐减少，55岁以上者肾移植术的数量逐年上升，对术后并发症转归老年患者的术后护理及饮食因人而异，因病制宜。     

高龄患者肾移植术后护理

本文旨在研究根据高龄患者生理特点的特殊性，而提供的详尽的关于肾移植术后对于高龄患者的护理及健康宣教方面的问题，从而达到提高高龄患者术后生命质量的目的。在这里我们做了以下探讨。     

肾移植术后患者疼痛的护理研究

肾移植术后患者疼痛的护理研究５１０５１５第一军医大学南方医院叶桂荣，宣蓓众所周知，术后疼痛可引起身体活动减少而致静脉血栓、褥疮或各种功能的低下，同时，疼痛也可以反映病情，特别是夜间疼痛可引起睡眠障碍以及由此伴髓的生理、心理负担是护理上的重要问题。本研...     

高龄肾移植患者术后的观察护理

我院１９９０年１月至１９９５年９月期间，对５０风以上的高龄患者作肾移植１５例，术后各种并发症发生率为６０％，急性排斥反应发生率３３．３％。对急性排斥反应的患者，应注意大剂量激素冲击治疗诱发感染，消化道出血等并发症。术后护理对减少并发症和提高移植肾存活率具有重要意义。     

肾移植术后患者的营养状况评价

目的:调查肾移植术后患者的营养状况,探寻合理的临床营养治疗方案。方法:抽取2002-10/2006-09于江苏省中医院住院的肾移植术后1个月患者40例,患者均知情同意,配合各种测量、检查。调查内容:①膳食调查:采用饮食称重法。蛋白质应为总热量的30%～35%,碳水化合物应为50%～60%,脂肪应为10%～15%。②人体测量:包括身高、体质量、三头肌皮褶厚度、上臂围、上臂肌围。③生化实验室检查:包括血浆白蛋白、血胆固醇、血糖、血尿酸、血钾、血钠、总淋巴细胞计数。结果:40例患者全部进入结果分析,无脱落。①肾移植术后患者膳食结构不合理,其中脂肪(38%)和蛋白质(17%)摄入量超标,碳水化合物(45%)摄入不足。②40例患者中高血糖者9例(占22.5%),胆固醇、三酰甘油升高者28例(占70%),血尿酸升高者18例(占45%)。结论:通过营养评价可为改善肾移植术后患者营养状况提供依据,指导患者平衡膳食,维持理想的营养状况。     

Enteral nutrition support in acute pancreatitis

OBJECTIVE: To review the controversies surrounding the use of nutritional interventions, particularly enteral support, in patients with acute pancreatitis. DATA SOURCES: Articles were obtained through a MEDLINE search (1966-June 1999). Additionally, several textbooks containing information on the diagnosis and management of acute pancreatitis were reviewed. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELECTION: All original investigations in humans pertaining to the use of enteral nutritional support in acute pancreatitis were reviewed for inclusion. Studies that investigated parenteral nutrition in acute pancreatitis were also reviewed, with preference given to controlled comparisons with enteral regimens or no nutritional support. DATA EXTRACTION: The primary outcomes extracted from the literature were time to oral feeding tolerance, complications (e.g., infection) associated with nutritional support, and length of stay. DATA SYNTHESIS: The duration of pancreatitis and time to oral feedings is similar whether patients receive enteral (i.e., jejunal tube feedings) or parenteral nutrition. Additionally, complications, length of stay, and costs are either similar or decreased with enteral versus parenteral nutrition. CONCLUSIONS: Current evidence suggests that the enteral rather than parenteral route should be used to provide nutrition to patients with acute pancreatitis. Parenteral nutrition should be reserved for patients in whom nasojejunal feeding is not possible.     

Enteral nutrition and bone marrow transplantation.

This retrospective study evaluated the efficacy of enteral nutrition for pediatric patients undergoing the challenging treatment of allogeneic bone marrow transplantation. During the period from January 1999 to May 2000, 15 patients were transplant recipients. On admission to the hospital, 87% of patients were above the 50th percentile for weight for age. Nasogastric tubes were inserted while platelet counts remained greater than 50 x 10(9) mL/L. A specialized elemental formula for pediatric patients was commenced. These feeds were administered continuously and were titrated until caloric requirement or tolerance level had been achieved. During hospitalization for bone marrow transplantation, enteral nutrition was the major form of nutritional support for all patients. Enteral feeds continued even during maximal gut toxicity and were supported with antiemetics and analgesia. There were insignificant weight fluctuations during hospitalization, with 80% of children above the 50th percentile weight for age being discharged. Enteral nutrition via a nasogastric tube was effective in the provision of nutrition during bone marrow transplantation and continues to have an important role in this unit.     

Enteral nutrition in hypermetabolic surgical patients

Enteral nutrition is usually administered with premixed formulas and in a volume determined by the estimated total caloric need of the patient. The present study was undertaken to evaluate the nutritional outcome when isocaloric amounts of three commercial products were given as enteral nutrition in hypermetabolic surgical ICU patients. To qualify for the study, the patients had to be hypermetabolic and must have received and retained the volume of enteral formula estimated to meet energy and nutritional requirements for at least eight consecutive days. Caloric needs were defined as 30 to 35 total cal/kg.day. All data were prospectively collected; all patients had moderate to high-level metabolic stress after surgical intervention. Thirty-five patients participated in the study: 18 received a formula that was 23% amino acids, 20% fat, and had a nonprotein calorie/nitrogen (NPC/N) ratio of 97:1; ten patients received a formula with NPC/N 125:1 that was 17.5% protein and 35% fat; and seven patients received a formula with an NPC/N of 149:1 that was 15.3% amino acids and 2.5% fat. All formulas were given via nasoduodenal tube by continuous pump technique. Patients who received the low NPC/N had significantly greater N retention (p less than .05), increased plasma transferrin levels (p less than .05), and a lower RQ (p less than .05). There was a strong correlation between NPC/N and N retention and the increase in plasma transferrin levels. Thus, dosing enteral nutrition by total estimated caloric need does not presume optimal nutritional outcome. Formula composition is an important determinant of nutritional effect; formulas that have a lower NPC/N with more N and reduced calories as glucose demonstrate better nutritional results.     

重型颅脑创伤病人的胃肠营养支持

报道２０例重型颅脑创伤病人伤后早期开始使用改良要素膳的临床效果。２０例实验组病人采用以糊精为糖源的改良要素膳，２０例对照组病人按常规方法实施营养支持，研究发现：（１）实验组病人具备胃肠营养的条件，即开始时间平均为５．０±２．１天，对照组为９．１±４．６天（Ｐ＜０．０５）；（２）对照组病人血浆白蛋白在伤后４周内呈持续下降趋势（Ｐ＜０．０１），实验组于伤后第３周开始回升，伤后第４周略高于伤后第１周；（３）实验组病人伤后第５天血糖显著低于对照组（Ｐ＜０．０５）；（４）实验组病人腹泻发生率为４５％。研究认为改良要素膳的使用有助于胃肠营养支持的早期开展和改善颅脑创伤病人的营养状态。     

造血干细胞移植病人营养支持研究进展

造血干细胞移植（hematopoieticstemcelltransplantation,HSCT）是临床部分恶性血液病及实体瘤的有效治疗方法。移植期间大剂量的放化疗及并发症的发生等原因常常导致病人营养不良,而不良的营养状态会对病人的临床结局产生不利影响,如住院时间延长[1]、化疗耐受性降低以及生活质量下降等。法国癌症中心指出,营养不良是骨髓移植后死亡的独立危险因素。正确认识和实施营养支持治疗对造血干细胞移植病人具有重要意义。现就造血干细胞移植病人营养不良的原因、评估方法、支持方式及护理进行综述。