营养与儿科疾病.ppt

营养与儿科疾病Chapter22Nutritionandpediatricdiseases,主页目录-Home,.,第一节蛋白质-热能营养不良,Section1Protein-energymalnutritionPEM,一、PEM与营养的关系TherelationshipbetweenPEMandnutrition,蛋白质和热能摄入不足Inadequateintakeofproteinandenergy蛋白质和热量消耗增加或机体需要突增Consumptionofproteinandcaloriesortheneedsincreasingsuddenly营养代谢变化Changesinnutrientmetabolism,二、营养预防NutritionalPrevention,提倡母乳喂养Advocatebreastfeeding及时治疗相关疾病Treatmentofassociateddiseasestimely早发现、早冶疗Earlydetectionandearlytreatment,三、营养治疗NutritionTherapy,营养治疗原则Principlesofnutritiontherapy蛋白质和能量Proteinandenergy维生素和矿物质Vitaminsandminerals水电解质平衡Waterandelectrolytebalance流质、半流质Liquid,orsemi-liquiddiet,三、营养治疗NutritionTherapy,食物和营养素的选择choiceoffoodandnutrients能量和蛋白质Energyandprotein食物和营养素foodandnutrients婴儿饮食Babyfoodrecipes儿童饮食Childrensdiet,第二节肥胖症,Section2Obesity,定义definition,肥胖症：机体脂肪过度积聚和脂肪组织过量扩增的一种营养障碍性疾病。Obesityisanexcessofbodyfatthatfrequentlyresultsinasignificantimpairmentofhealth.Obesityresultswhenthesizeornumberoffatcellsinapersonsbodyincreases.Obesityisassociatedwithanincreasedriskofillness,disability,anddeath.,一、本病与营养的关系Relationshipbetweenobesityandnutrition,血脂lipid三酰甘油triglyceride、胆固醇cholesterol、低密度脂蛋白LDL，高密度脂蛋白HDL血糖BloodGlucose,二、营养预防Nutritionalprevention,三、营养治疗Nutritiontherapy原则Principles能量负平衡、促进脂肪分解根本原则Negativeenergybalanceandpromotingthelipolysisarefundamentalprinciples.,食物及营养素选择Thechoiceoffoodandnutrients蛋白质、脂肪、糖类Protein、fats、carbohydrate能量供给energysupply低脂、高蛋白、高维生素、高膳食纤维Low-fat,high-protein,high-vitaminandhigh-fiber满足食欲和避免饥饿感Satisfyingtheappetiteandavoidinghunger,一、本病与营养的关系RelationshipbetweenInfantdiarrheaandnutrition急性腹泻AcuteDiarrhea病程不超过14天clinicalcourselessthan14days慢性腹泻ChronicDiarrhea病程超过两个月clinicalcoursemorethan2months吸收不良以及免疫性、过敏性腹泻,二、营养代谢变化及营养预防Changesinmetabolismandnutritionprevention三、营养治疗nutritiontreatment治疗原则Treatmentprinciples急性腹泻:减轻肠道负担Acutediarrhea:reducingtheburdenofintestinal慢性腹泻:对症和对因治疗，勿滥用抗生素。Chronicdiarrhea:symptomatictreatmentandduetotreatment,nottouseantibioticsindiscriminately.,食物和营养素选择初期禁食限制脂肪、单双糖，适量蛋白质，大量水溶性维生素饮食调整禁食后的营养供给补水Choiceoffoodandnutrients:fastintheinitial；Limitfat、mono-ordi-saccharides，moderateproteinandlargedoseofwater-solublevitamins；Dietarymodification；Supplynutrientafterfasting,maintainwaterandelectrolytebalance.,第四节小儿糖尿病Section4PediatricDiabetes,糖尿病是由于胰岛素缺乏或其他原因造成糖、脂肪、蛋白质的代谢紊乱症。diabetesmellitusdescribesametabolicdisorderofmultipleaetiologycharacterizedbychronichyperglycaemiawithdisturbancesofcarbohydrate,fatandproteinmetabolismresultingfromdefectsininsulinsecretion,insulinaction,orboth.本病在小儿有两个发病高峰年龄组：56岁和1113岁。Theincidenceishighwhenchildrenare56yearsoldor1113yearsold.,一、本病与营养的关系营养代谢变化血糖空腹血糖或血浆浓度增加血脂血清胆固醇、三酰甘油和游离脂肪酸明显增加尿检尿糖、尿酮体均阳性代谢性酸中毒微量元素和维生素改变ChangesinmetabolismHyperglycemiaDislipidemiaglycosuria,ketonuriaMetabolicacidosispresentingTraceelementsandvitaminschanging.,二、营养治疗nutritiontreatment治疗原则适当饮食控制食物选择热量需要总热量（kcal）=1000+年龄（70100）（3岁内每岁增100kcal，10岁以上每岁增7080kcal）。热卡分配：糖类占45%60%，蛋白质占10%20%，脂肪占30%。Treatmentprinciples:dietmanagementCalorieneeds=1000+ages(70100)3ys:100kcal/age，10ys:7080kcal/ageCaloricdistribution:carbohydrate45%60%,protein10%20%,fat30%.,餐次分配Distributionofmeals低血糖Hypoglycemia,第五节苯丙酮尿症Section5Phenylketonuria,苯丙酮尿症是一种常见的氨基酸代谢缺陷病，因患儿尿液中排出大量苯丙酮酸等代谢产物而得名。Phenylketonuria(PKU)isautosomalrecessivedisorderofmetabolisminwhichphenylalaninecannotbeconvertedtotyrosine.Bloodphenylalaninelevelsareelevatedandphenylpyruvicacidisexcretedintheurine.,一、本病与营养的关系RelationshipbetweenPhenylketonuriaandnutrition二、营养治疗Nutritiontreatment饮食治疗diettherapy食物选择foodchoices,QuestionsWhatarethenutritionpreventionandnutritiontreatmentofchildrenwithPEM?Howtochoosehealthyfoodsforobesitychildren?Outlinethenutritiontherapyofacuted