第二十二章 营养与儿科疾病.ppt

1、第二十二章 营养与儿科疾病Chapter22 Nutrition and pediatric diseases,唐玉涵 刘菊英,主页目录-Home,第一节 蛋白质-热能营养不良,Section 1 Protein-energy malnutrition PEM,一、PEM与营养的关系The relationship between PEM and nutrition,蛋白质和热能摄入不足 Inadequate intake of protein and energy 蛋白质和热量消耗增加或机体需要突增 Consumption of protein and calories or the nee

2、ds increasing suddenly 营养代谢变化 Changes in nutrient metabolism,二、营养预防 Nutritional Prevention,提倡母乳喂养 Advocate breastfeeding 及时治疗相关疾病 Treatment of associated diseases timely 早发现、早冶疗 Early detection and early treatment,三、营养治疗 Nutrition Therapy,营养治疗原则 Principles of nutrition therapy 蛋白质和能量 Protein and ene

3、rgy 维生素和矿物质 Vitamins and minerals 水电解质平衡 Water and electrolyte balance 流质、半流质 Liquid, or semi-liquid diet,三、营养治疗 Nutrition Therapy,食物和营养素的选择 choice of food and nutrients 能量和蛋白质 Energy and protein 食物和营养素 food and nutrients 婴儿饮食 Baby food recipes 儿童饮食 Childrens diet,第二节 肥胖症,Section 2 Obesity,定义 defini

4、tion,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。 Obesity is an excess of body fat that frequently results in a significant impairment of health. Obesity results when the size or number of fat cells in a persons body increases. Obesity is associated with an increased risk of illness, disability, and death.,一、本病

5、与营养的关系 Relationship between obesity and nutrition,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 Blood Glucose,二、营养预防 Nutritional prevention,三、营养治疗 Nutrition therapy 原则 Principles 能量负平衡、促进脂肪分解根本原则 Negative energy balance and promoting the lipolysis are fundamental principles.,食物

6、及营养素选择 The choice of food and nutrients 蛋白质、脂肪、糖类 Protein、fats、carbohydrate 能量供给 energy supply 低脂、高蛋白、高维生素、高膳食纤维 Low-fat, high-protein, high-vitamin and high-fiber 满足食欲和避免饥饿感 Satisfying the appetite and avoiding hunger,一、本病与营养的关系 Relationship between Infant diarrhea and nutrition 急性腹泻 Acute Diarrhea

7、 病程不超过14天 clinical course less than 14 days 慢性腹泻 Chronic Diarrhea 病程超过两个月 clinical course more than 2 months 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Changes in metabolism and nutrition prevention 三、营养治疗 nutrition treatment 治疗原则 Treatment principles 急性腹泻:减轻肠道负担 Acute diarrhea: reducing the burden of intestinal

8、慢性腹泻:对症和对因治疗，勿滥用抗生素。 Chronic diarrhea :symptomatic treatment and due to treatment, not to use antibiotics indiscriminately.,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 Choice of food and nutrients: fastin the initial； Limit fat、 mono- or di-saccharides，moderate protein and large dose of w

9、ater-soluble vitamins； Dietary modification； Supply nutrient after fasting , maintain water and electrolyte balance.,第四节 小儿糖尿病 Section 4 Pediatric Diabetes,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。 diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia

10、 with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. 本病在小儿有两个发病高峰年龄组：56岁和1113岁。 The incidence is high when children are 5 6 years old or 11 13 years old.,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

11、均阳性 代谢性酸中毒 微量元素和维生素改变 Changes in metabolism Hyperglycemia Dislipidemia glycosuria , ketonuria Metabolic acidosis presenting Trace elements and vitamins changing.,二、营养治疗 nutrition treatment 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3

12、0%。 Treatment principles: diet management Calorie needs = 1000+ages(70100) 3 ys: 100kcal/age，10 ys: 7080kcal/age Caloric distribution: carbohydrate 45% 60%, protein 10% 20%, fat 30%.,餐次分配 Distribution of meals 低血糖 Hypoglycemia,第五节 苯丙酮尿症 Section 5 Phenylketonuria,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

13、产物而得名。 Phenylketonuria (PKU) is autosomal recessive disorder of metabolism in which phenylalanine cannot be converted to tyrosine. Blood phenylalanine levels are elevated and phenylpyruvic acid is excreted in the urine.,一、本病与营养的关系 Relationship between Phenylketonuria and nutrition 二、营养治疗 Nutrition treatment 饮食治疗 diet therapy 食物选择 food choices,Questions What are the nutrition prevention and nutrition treatment of children with PEM? How to choose healthy foods for obesity children? Outline the nutrition therapy of acute diarrh