1314例育龄妇女缺铁性贫血发病现状调查

目的 :研究育龄妇女缺铁性贫血 (IDA)的发病现状及营养状况与IDA的关系。方法 :检测青岛市城市及农村 1314例妊娠期和非妊娠期育龄妇女的外周血红蛋白浓度 (Hb)、平均红细胞体积 (MCV)、平均红细胞血红蛋白量 (MCH)、血清铁蛋白 (SF) ,并进行个人问卷调查 ,应用营养计算软件评价膳食营养。结果 :1314例育龄妇女IDA发病率为 2 0 .4 0 % ,其中非孕妇的发病率高于孕妇。农村育龄妇女的发病率明显高于城市。孕妇中孕≥ 2 8周组发病率最高 (4 0 % ) ,与其他孕周组相比差异有高度显著性 (P <0 .0 1)。营养评价结果显示非孕妇组热量、维生素A、E、B1、B2 、PP、C的缺乏率高于孕妇组(P <0 .0 0 1)。结论 :农村育龄妇女及孕 2 8周以上的孕妇为IDA高发人群。应加强对农村育龄妇女的膳食营养宣教及指导 ,对孕晚期的孕妇及时采取有针对性的干预措施。     

Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures

Background: Many reconstruction procedures have been developed in efforts to resolve patients' complaints after total gastrectomy. However, there have been few reports of longterm comparisons between reconstruction procedures, especially with regard to the prevention of duodenal food passage. This study was undertaken to compare the longterm subjective and functional results among Roux-en-Y esophagojejunostomy (R-Y), R-Y with pouch (P-Y), and jejunal interposition with pouch (P-I) after total gastrectomy. Methods: Consecutive patients requiring curative total gastrectomy were enrolled in this prospective study by the envelope method. Results: Hospital stay was longer following a P-I than an R-Y or a P-Y. Over 50% of R-Y patients complained of heartburn, and 20% of R-Y patients showed dumping syndrome throughout the postoperative period, with this rate being significantly different from rates in the other two groups. P-Y patients complained of early satiety in the late postoperative period, while P-I patients complained of early satiety in the early postoperative period. The nutritional index in P-I patients was higher than those in patients with the other two procedures. Gastrointestinal and hepatobiliary dual scintigraphy (GHDS) showed that the rate of bile reflux with an R-Y was relatively high after surgery. Food reflux with a P-Y was increased (9.4% to 11.1%), but with a P-I food reflux was decreased at 3 years after surgery (13.3% to 9.9%). Patients with a P-Y had a faster recovery of body, weight in the early postoperative period; however, at 5 years after operation, body weight recovery with a P-I was greatest. Conclusion: Reconstruction should be performed with pouch formation after total gastrectomy with curative intent. Received: March 7, 2002 / Accepted: September 26, 2002 Acknowledgments This study was partly supported by the University of Tsukuba Research Project. Offprint requests to: S. Adachi     

重症监护病房急性危重病患者的临床营养支持

目的 探讨综合性重症监护病房（ICU）急性危重病患者临床营养支持的时机与模式、营养液输注途径与方法以及营养支持并发症的防治等问题.方法 回顾性分析1 141例原发病因混杂、伴单一或多器官功能障碍的急性危重病患者在综合性ICU内积极治疗原发病的同时接受肠外营养（PN）与肠内营养（EN）支持临床资料.结果 1 141例患者接受PN 3～45 d（平均4.9 d）,其中687例患者在PN过程中联合EN 3～32 d（平均5.1 d）,营养支持效果满意.结论 急性危重病患者完整的治疗方案中必须包括合理的临床营养支持;合理的营养支持就是要模式合理、营养物质供给比例和量合理,同时还要提供辅助疗法.     

某艺术中专学生营养知识、态度、行为调查分析

目的 了解艺术中专学生的营养知识、态度、行为状况，为进行学生营养教育提供参考。方法 采用KAP问卷对衡阳艺术学校一、二、三年级408名学生进行营养知识、态度及饮食行为等三方面的调查。结果 艺术中专学生具有一定的营养知识。营养知识测试中三年级成绩好于一、二年级。营养知识主要来源于家长和广播电视。大部分学生有端正的营养态度及良好的饮食习惯，但也存在不定时定量进食、常吃零食及油炸食品等不良饮食行为。结论 艺术中专学校要加强对学生营养知识教育，采用多种形式不断宣传营养知识，使学生养成良好饮食行为。     

营养教育对幼儿家长营养知识·态度·行为的影响

目的了解营养教育对合肥市幼儿家长营养知识、态度与行为的影响,以便为制定幼儿营养干预措施的制定提供科学依据.方法采取随机、分层、整群抽样的方法在合肥市选取8所幼儿园,随机分为干预组和对照组.在干预组幼儿园定期举办家长营养知识培训班,并将编写的幼儿营养知识手册分发给家长学习.采用自拟调查问卷对干预前、干预中期和终期幼儿家长营养知识、态度与行为进行调查.结果组间比较显示,干预组家长的营养知识水平明显提高,每周吃1～2次及以上水果、牛奶、鱼类的人数增加.自身对照研究显示,通过营养教育,干预组家长每周吃1～2次及以上杂粮、牛奶、水产品、海带和紫菜的人数增加,而吃畜肉、街头小吃、西餐的人数减少.无论是干预组还是对照组,家长对接受营养知识均持积极的态度.结论营养教育对家长的营养知识、态度和行为有积极的影响,可通过书籍、报刊、杂志、电视节目、专家义务讲座等途径进行.     

营养教育对学龄前儿童营养状况的影响

目的了解营养教育对合肥市学龄前儿童营养状况的影响,以便为学龄前儿童的营养干预研究提供依据.方法采取随机、分层、整群抽样的方法在合肥市选取8所幼儿园,随机分为干预组和对照组.在干预组幼儿园,悬挂营养挂图,按照编写的教材和教案,开展营养教学活动(持续1学年);定期举办家长营养知识培训班,将编写的幼儿营养知识手册分发给家长.收集干预前期、中期和终期幼儿人体测量指标、功能性指标、营养性疾病的症状和体征资料,并进行比较.结果组间比较发现,干预组男童和女童的体重、坐高、胸围和上臂围及男童的ZHA、ZWA和ZWH高于对照组,干预组患唇苍白、龋齿的比例低于对照组.自身对照显示,干预组女童的体重,男童和女童的身高、坐高、头围、胸围、上臂围、肺活量、握力均增加,女童的ZWA、ZWH和BMI降低,干预组患面色苍白、唇干裂、唇炎的比例减少.结论应加强早期营养教育,使儿童获得良好的营养,促进其形态和功能的发育,改善其健康状况.     

青春期学生膳食营养状况对骨量的影响

目的研究学生青春期膳食营养状况对骨量的影响,以增加骨峰值,预防骨质疏松的发生.方法抽取贵阳某高等院校239名青春期学生进行一般情况和食物摄入情况调查,再从摄入豆类、奶类和同时摄入豆类、奶类的学生中抽取60人分为3组,用双能X线骨密度仪测定前臂1/3处骨密度(BMD)及骨矿化物含量(BMC).结果 60例学生的热能及多种营养素的摄入水平很低,尤其是钙摄入量仅占现行供给标准的39%;结果还显示BMD降低率高达58.3%.3组学生的BMD、BMC差异无显著性.BMC、BMD与身高、体重及食物中蛋白质、能量、钙、磷等摄入量呈正相关.结论骨量较低与其膳食营养素摄入低有关.应加强营养宣教,提高膳食营养状况以增加骨量.     

Morphologie et alimentation de l’enfant : Évolution au cours des dernières décennies

Growth is a favourable period to study the association between environmental factors and body composition, as many body parameters can be investigated. The analysis of secular trends in nutrition and growth could suggest hypotheses about the factors responsible for the body parameter changes over time.We have conducted several studies at different periods to assess secular trends. We also have developed growth indicators such as the BMI growth curves, the adiposity rebound and the arm muscle and arm fat areas.Since many years, increased stature has been recorded in various countries. The same trend was recorded in our studies. Mean stature in 2000 was 1.31m and 1.30m in 8-year-old boys and girls respectively. In 1960, in the French reference study, these figures were 1.27 and 1.26m, corresponding to a 4cm increase over the last 40 years. A comparison between two longitudinal studies conducted 30 years apart, indicates that the higher stature recorded at adult age in the more recent study, mainly results from an increase stature in early life. This increase mainly results from increased leg length. Birth weight recorded in studies conducted at different periods did not reveal any changes. By contrast, in school children, an increase in weight has been recorded in the last decades. Studies conducted in 10-year-old children at different time periods revealed that the prevalence of overweight defined by the 97^th centile of the French reference values was about 3% in 1965, 6% in 1980, 12% in 1995 and 16% in 2000. The age at adiposity rebound was 6.2 years in children born in 1965 and 5.6 in those born 30 years later. The earlier rebound recorded in the more recent study reflects an acceleration of growth.While children are taller, fatter, and grow faster, mean energy intake decreases over time, particularly due to a decrease in fat intake. The infant diet in many countries (by the age of 6-12 months) is characterised by high levels of proteins and low levels of fat. The high protein diet in infancy could explain the rapid growth process observed nowadays. Various studies have suggested that an accelerated growth in early life is associated with risk factors. Like in adults, obesity in children, is associated with metabolic diseases.In conclusion, growth is the period when environmental factors can have long lasting influence on body composition. The secular trends reported in many countries, such as increased stature, accelerated growth or the increasing prevalence of obesity, could result from influences taking place early in life. It is then important to develop research focussing on the identification of the early environmental factors which influence adult health.     

北京市小学生与肥胖相关知识、态度、行为的现况调查

目的　了解北京市小学生的营养状况及其膳食与运动相关知识、态度、行为的现状。方法　采用整群抽样法抽取北京市 4所小学三、四年级全体学生 ,进行问卷调查。结果　北京市小学生瘦长型营养不良率1 3 0 3 % ,肥胖型营养不良率 3 2 0 4%。膳食与运动相关知识掌握较好的学生占 0 73 % ,正确态度持有率 5 6 75 % ,良好行为形成率 1 1 2 7%。知信行均为女生好于男生。知信行间存在一定的关联。结论　健康教育可传授正确的膳食与运动知识给学生 ,转变他们的错误态度 ,从而改变他们的不良行为习惯 ,以促进学生营养状况的改善。     

老年人胃癌术后早期肠内营养支持的临床研究

目的:研究老年人胃癌术后早期肠内营养支持的安全性和合理性.方法:选择年龄60岁以上胃癌手术的26例病人,随机分为肠内营养(EN)组和肠外营养(PN)组,每组13例.检测手术前后人体测量学指标及血红蛋白(Hb)、血浆清蛋白(ALB)、转铁蛋白(TFN)和纤维连接蛋白(Fn),同时观察胃肠功能恢复情况.两组营养支持均为等热量.结果:术后两组病人的人体测量学指标和Hb、ALB差异均无显著性意义(P＞0.05);术后第8 d病人均由负氮平衡转为正氮平衡;术后第4、8 d时,两组的Fn比术前明显升高(P＜0.05、P＜0.01),而且术后第8d时EN组的上升比PN组更明显(P＜0.05);肛门排气时间EN组比PN组早(P＜0.05).结论:老年人胃癌术后给予早期肠内营养支持,可促进病人胃肠功能的恢复和改善营养代谢.