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重症胰腺炎病人肠外,肠内阶段性营养支持的合理性 总被引:9,自引:0,他引:9
目的:研究对重症胰腺炎病人进行PN、EN阶段性营养支持的合理性。 方法:根据日本厚生省(1987年)的诊断标准确诊的16例重症胰腺炎病人,在不同病理阶段、代谢特征及胃肠功能状态,依次进行阶段性的PN、EN,力图缩短TPN持续时间,适时而及早地过渡为EN(此指空肠喂养),避免长期TPN的不良影响。本组TPN持续时间4 ̄9天,平均7.8天;EN持续时间13 ̄33天,平均21.9天。 结果:本组7例并发 相似文献
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肠外瘘病人肠内营养支持临床应用研究 总被引:31,自引:5,他引:26
目的:观察肠内营养在肠外瘘病人应用的时机、条件、途径及肠内营养制品的选择,研究肠内营养在肠外瘘病人中的作用。方法:收集170例肠外瘘病人诊断、住院总天数及全肠外营养(TPN)、全肠内营养(TEN)、肠内+肠外营养(PN+EN)、经口饮食的天数,计算不同营养支持方法期间,非蛋白质热量、蛋白质的供给量和并发症的发生率。收集TPN、TEN支持前和支持后满15天病人的血清白蛋白浓度。另对40例肠外瘘病人进行为期15天的前瞻性观察,了解肠内营养对白蛋白、前白蛋白、转铁蛋白、纤维连结蛋白、总蛋白、球蛋白和肝酶谱的影响。结果:170例病人的总住院天数为13553天,其中164人曾使用TPN6040天(44.6%);129人使用TEN3676天(27.1%);83人使用肠内+肠外营养489天(3.6%);128人经口饮食233 相似文献
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手术后短期胃肠内、外营养支持效果比较 总被引:7,自引:0,他引:7
为比较手术后短期胃肠内、外营养支持的效果,探讨不同途径营养支持的优缺点。将手术后病人20例随机分为EN和PN两组(各10例)。术后1d起两组分别接受等热量营养支持10d,EN组和PN组非蛋白质热量∶氮分别为128∶1和131∶1。营养支持前后分别测体重;营养支持期间每日计算氮平衡;术前及营养支持3、7、10d后分别测血清GPT、直间接胆红素、AKP、白蛋白水平;支持5、10d后分别测定血清总铁结合力(TIBC)水平。结果表明:PN组营养支持5d达到正氮平衡,EN组6d达到正氮平衡,但两组间累积氮平衡无统计学差异;营养支持10d后PN组TIBC水平显著高于EN组(P<0.01);两组间其它指标无显著差异。结论:两种营养方式对手术后短期营养支持的效果均较满意,以胃肠外营养支持更好;术后早期开始胃肠内营养可促进病人胃肠功能的恢复。 相似文献
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探讨危重、应激病人合理的营养支持模式。对 2 5例普外科危重、大手术后病人进行全肠外 (TPN) -部分肠外 (PN)、部分肠内 (EN) -全肠内 (TEN)序贯营养支持 ,观察营养支持的效果和并发症。结果 :治疗前后营养状态有明显改善 ,营养支持平均时间 16 .3天 ,其中 TPN7.2天 ;PN、EN4.6天 ;TEN4.5天。并发症 :导管并发症 1例 ;代谢并发症 2例 ;严重腹泻 1例。结论 :TPN- EN、PN- TEN序贯营养支持模式是危重病人较合理的实用模式。肠外、肠内序贯营养支持在普外科大手术后危重病人的应用@姜海平$暨南大学医学院附属第一医院普外科
@… 相似文献
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我科采用经鼻插入导管进行小肠减压治疗粘连性肠梗阻48例,发现本组病人均有营养不良。从1992年起,在治疗原发病中对其中28例实行个体化营养支持方案:病程2周以上者行TPN;肠减压后转为不完全性肠梗阻者,TPN数天后改为经导管EN;置管于肠内作肠排列者... 相似文献
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自1994年以来,对17例外科危重病人经周围静脉进行了全胃肠外营养。营养支持时间为4~40d,其中14d以上的7例病人进行了氮平衡监测,均获得了正氮平衡,有2例术后严重并发症病人经TPN支持1个月以上,均顺利康复。临床观察表明:①只要应用得当,在基层... 相似文献
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Michael Nelson† Gillian F. Hague† Cyrus Cooper‡ Valda W. Bunker§ 《Journal of human nutrition and dietetics》1988,1(2):115-127
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly. 相似文献
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Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.443.59), back pain (RR=1.84;Cl=1.2372.75), vasospastic disease of the fingers (RR=2.05;Cl=1.183.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.16711.6). 相似文献
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Context
Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.Methods
Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.Results
In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.Conclusion
An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases. 相似文献14.
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Occupational health hazards in mining: an overview 总被引:1,自引:0,他引:1
Donoghue AM 《Occupational medicine (Oxford, England)》2004,54(5):283-289
This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled. 相似文献
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This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers. 相似文献
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江捍平 《中华医院管理杂志》2012,28(10):743-746
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测. 相似文献
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Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2. 相似文献
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Brown AM 《Occupational medicine (Oxford, England)》1999,49(7):443-447
Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested. 相似文献