营养不良病ppt课件

1、protein-energy malnutrition( pem )李圭华第五章第六节（1）武汉科技大学儿科学教研室 to master the clinical manifestation of pem. to master the ways of prevention and treatment of pem. to master the complications of pem . to be familiar with the etiology and pathophysiology of pem. 能量和能量和/ /或蛋白质缺乏或蛋白质缺乏( (energy and energy a

2、nd protein deficiency)protein deficiency)所致的一种营养缺所致的一种营养缺乏症。乏症。多见于多见于3 3岁以下的婴幼儿岁以下的婴幼儿, ,体重减轻体重减轻( (loss of body weight)loss of body weight), ,皮下脂肪减少皮下脂肪减少( (decrease of subcutaneous fat)decrease of subcutaneous fat), ,水肿水肿( (edema)edema), ,器官功能紊乱器官功能紊乱( (disturbance of disturbance of the function o

3、f visceral organs and the function of visceral organs and tissues)tissues) 。 definitionv祖国医学：疳积 长期摄入不足长期摄入不足 (insufficient intake of protein and energy in long periods) 消化吸收障碍消化吸收障碍 (the disturbance of digestion and absorption) 需要量增多需要量增多 (requirements increasing) 消耗量过大消耗量过大 (consumption enlarging)

4、etiologyetiologyreasonable feeding, to advocate breast feeding reasonable regime prevent and treat diseases, correct deformity monitor the growth and development preventioprevention n 新陈代谢异常新陈代谢异常蛋白质：低蛋白血症蛋白质：低蛋白血症 水肿水肿（edema)脂肪：消瘦脂肪：消瘦( (emaciation)，肝脏脂肪浸润及变性肝脏脂肪浸润及变性( (fatty infiltration and degen

5、eration)碳水化合物：糖原不足碳水化合物：糖原不足 低血糖低血糖（hypoglycemia)水、盐代谢：脱水、低血钾、低血钙等水、盐代谢：脱水、低血钾、低血钙等体温调节体温调节 病理生理 各系统功能低下各系统功能低下消化系统 食欲不振(anorexia), 腹泻(diarrhea) 循环系统 血压下降、脉搏细弱、肢凉 泌尿系统 多尿、低比重尿 神经系统 表情淡漠、智力低下、学习困难 免疫功能 易感染 病理生理 marasmus: total calorie deficiency edema: protein deficiency marasmus edemaclinical typesc

6、linical types marasmusedema 体重不增为体重不增为最早最早症状症状 体重减轻体重减轻 (initiated with failure to gain weight, followed by loss of weight) 皮下脂肪减少、消失顺序：皮下脂肪减少、消失顺序： abdomen truck buttock limbs face 器官功能紊乱器官功能紊乱(disorders of multiple organs and tissues)临床分度临床分度(消瘦型）消瘦型）3岁以下儿童营养不良特点岁以下儿童营养不良特点 体重低于正常体重低于正常 15-25% 25-

7、40% 40%腹壁皮褶厚度腹壁皮褶厚度 0.8-0.4cm 30% nutritional microcytic anemia all kinds of vitamins deficiency infections spontaneous hypoglycemia complications 体重低下（体重低下（underweight） 生长迟缓（生长迟缓（stunting） 消瘦（消瘦（wasting）diagnosis ages：it usually affects the infant under three years old of age history : feeding hist

8、ory and a history of infection and systemic disease clinical manifestations : loss of weight, decrease and disappearance of subcutaneous fat assistant examination：igf-1，prealbumindiagnosis excluding causes adjusting diets calories由低正常超正常正常60卡110卡150卡110卡/kgmild：6080kcal/kg.d mid-severe：4055kcal/kg.dprotein 1.52.0g/kg.dmultiple vitamins and minerals supplyingtreatmentfacilitating digestion the therapy of complications intensive care 中医疗法 中药参苓白术散 针灸、割脂疗法、捏脊疗法、推拿按摩treatment各系统功能低下免疫功能消化系统泌尿系统循环系统神经系统各种感染食欲不振、腹泻多尿、低比重尿血压下降、脉弱、肢凉表情淡漠、学习困难、智力低下饮食不当疾病因素营养不良营养不良低蛋白