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Surgical Nutrition

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Surgical Nutrition 20 5 Transplantation Medical Imagination TPN ICU Key-hole surgery ... – PowerPoint PPT presentation

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Title: Surgical Nutrition


1
????
  • Surgical Nutrition

2
20??????????5????
  • Transplantation
  • Medical Imagination
  • TPN
  • ICU
  • Key-hole surgery

3
???????????
  • 1?1716?william harvey????
  • 2?1887?handerer???????(?????)
  • 3?1911?kansch???????(????)
  • 4?1940s ???????????????
  • 5?1950s ???????
  • 6?1959?Francis Moore??????

4
???????????(?)
  • 7?1961??????????
  • 8?1968?Stanley Dudrick?????TPN
  • 9?1969?Henry Randall???????

5
?????????
6
??????????
  • ?????????
  • ???????,????????
  • ??????????
  • ?????????????????
  • ?????????????????
  • ??????????????
  • ????????????????,?????(BCAA)????????????

7
(No Transcript)
8
(No Transcript)
9
?????????
  • ?????(essential amino acids,EAA)???????(nonessenti
    al amino acids,NEAA)
  • ?????????????????????????????
  • ?????(BCAA)????

10
???????
11
  • ??????(basal energy expenditure,BEE)?????????????
    ??,???????????????????????????????????????(BMR)???
    Harris Benedict?????BEE?

12
  • ??????(Resting Energy Expenditure,REE)???????????
    ,???????,???????30???????????????

13
  • ?????????18002000kcal??25kcal/kg/d?
  • ????????15?????,85????????????????,????????????
    ??,????????(kcal)???(g)???100 1501?

14
?????????
  • ???????????,????(????)
  • ?????????
  • ???
  • ?????

15
???????????
  • ????????
  • ??????????????????????,?????????
  • ???????????
  • 100ml??3g?19g???
  • ????????

16
???????????
  • 1???????,??????,??,??,??
  • 2?????
  • 1)??????
  • 2)????????
  • 3)???????
  • 4)???????????????????????????????????????

17
???????????(?)
  • 3??????
  • 1)24?????????????-????
  • 2)????????????????????

18
????????????
  • ???????
  • ????????,??????
  • ??????
  • ??????,?????
  • ??????
  • ???????
  • ????? ????? ????? ????? ??

19
??/??????????
  • 1???????
  • 2????????
  • 3??????
  • 4?????

20
(No Transcript)
21
???????????
  • ????(metabolic support)??????????????,???????????
    ?????,???????30-35kcal/kg/d???40?????????????,???
    ?????????????????????????0.3-0.35g/kg/d,????????10
    01?
  • ??????(bacterial translocation)TPN?????????????,?
    ?????,???????????,????????????
  • ????(metabolic intervention)??????????,??????,???
    ???,??????,??????????????????????????

22
?????????????
  • TEN and TPN

23
????
  • Enteral nutrition,EN

24
??????
  • ?????????
  • ????????????

25
?????????
  • 1?????
  • ????????????????????????????????????????????
  • 2?????
  • ???????????????,????????????????????

26
????(element diet)
  • 1????????????????????????????????????
  • 2????????????
  • (1)????????????????(2)?????????????(3)??
  • 3?????????????????????????????????
  • 4?????
  • 5????

27
(No Transcript)
28
TPN
  • ???????,???????????????,???????????????

29
TPN???
  • ???????
  • 1)GI????-GI??,?,?????
  • 2)??????-????,????,??(??)??,Anorexia,Cachexia
  • 3)??????-?? ???(????)
  • ??????
  • 1)??????????-??(??)????1940s
  • 2)???????-1950s

30
?????????
  • ???
  • ????LCT?MCT?
  • ???????????????
  • ???
  • ???
  • ????
  • ????

31
TPN????
  • 1???????????,???????????????????????
  • 2????????
  • 3?????????????,???crohn??
  • 4??????

32
TPN????
33
TPN????
  • ????
  • ????

34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
TPN??????
  • 1?????????2530kcal/kg/d?
  • 2???? 5060 (????)
  • ???? 3035
  • ??? 1015
  • 3?RI/GLU1/810
  • 4?????????????
  • 5?3????

38
(No Transcript)
39
TPN???????
  • 1??????????????
  • ?????????????????????????
  • 2???????
  • 3??????????????????????????????????????????????

40
??????????????
  • ???????????????????????
  • ?????????????????????????
  • ????????????????
  • ??????????????????????????
  • ????????????????????

41
????????

???
????
?????? ??????
????
????TEN,ENPN,TPN(CVC, PICC)
??????,C/F,NPCKcal ????????,????
????
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