肠内营养中应该考虑的几个问题.ppt

********肠内营养乳剂是华瑞肠内营养产品的通用名，肠内营养合剂是茚沛的通用名。含大豆纤维的产品指瑞代和瑞能。**强调六种膳食纤维的优点********************************《欧洲肠外肠内营养学会(ESPEN)肠内营养指南》******************************安素粉剂可作为唯一营养来源或部分营养补充，适用于成人及四岁或四岁以上儿童，可口服或管饲。************Theliningofthesmallintestineiscalledthemucosa.Themucosacontainsfinger-likeprojectionscalledthevilli;hair-likeprojectionsonthevilliarecalledthemicrovilli.Thevilliandmicrovilliperformallnutrientabsorptivefunctionsofthesmallbowel.Additionally,theykeepthenormalbacteriathatliveintheGItractfromenteringthebloodstream.ThevilliandmicrovilliaredependentuponnutrientsgoingthroughtheGItracttomaintaintheirhealth.Afterabout3dayswithoutnutrition,themicrovillibegintoatrophyandmalabsorptioncanoccur.Overthelong-term,thisbecomesaseriousissueastheabsorptiveandbarrierfunctionsdeclinewithtimeandtheentireGItractbecomescompromised.SinceelementalformulascanbereadilyabsorbedandthuswelltoleratedbypatientswithGIimpairment,theyallownutritionalsupportthroughtheGItractforpatientswhowouldotherwiserequireTPN.Freeaminoacidsandshort-chainpeptidescanbeabsorbeddirectly.Thus,theproteinsourceofelementalformulasdoesnotrequiredigestion.Thelowfatcontentofelementalformulasmeanslessworkforthepancreasinproducingenzymestoaidinfatdigestion.Lowfatformulasshouldalsoleavethestomachmorequicklyandhelptodecreaseresiduals.Peptinex?DTprovidesacombinationoffreeaminoacidsandprimarilyshort-chainpeptides.PeptinexDTisthefirstformuladesignedtooptimizetheuseoftheDualTransportSystem.Examplesof100%freeaminoacidformulasare:Vivonex?RTF,Vivonex?Plus,Vivonex?T.E.N.,Vivonex?Pediatric,Tolerex?andf.a.a.?.Mildlyhydrolyzedandintactproteinsrequiremultiplestepsindigestionof