癌症生存者的康复、营养与运动

晴天sun · 发表于 2014-2-17 18:24:28

谢谢马哥我爸肾盂癌，最近卧床不起，起不来，也懒得起，晚上我就和他说每天卧室溜达5~10分钟，多吃水果，感谢！

晴天sun · 发表于 2014-2-17 18:26:37

”可能影响肾功能的保健品 “很给力啊，太周到了！

深海 · 发表于 2014-3-3 12:33:40

生命在于运动。要制订一套运动方案。

costa_na · 发表于 2014-4-2 00:08:05

Nutrition in the Acute Phase of Critical Illness
危重患者急性期的营养

Michael P. Casaer, M.D., Ph.D., and Greet Van den Berghe, M.D., Ph.D.

Critically ill patients requiring vital organ support in the intensive care unit (ICU) commonly have anorexia and may be unable to feed volitionally by mouth for periods ranging from days to months. Unless such patients are provided with macronutrients in the form of enteral or parenteral nutrition, they accumulate an energy deficit that rapidly reaches proportions that contribute to lean-tissue wasting and that are associated with adverse outcomes. The catabolic response to acute critical illness is much more pronounced than that evoked by fasting in healthy persons, since the energy deficit in acutely ill patients is often superimposed on immobilization and pronounced inflammatory and endocrine stress responses. Severe skeletal-muscle wasting and weakness occurring during critical illness are associated with a prolonged need for mechanical ventilation and rehabilitation.

In many studies, the degree of energy deficit accumulating in critically ill patients is strongly associated with the duration of stay in the ICU, which, in turn, is associated with an increased incidence of infectious complications and risk of death.1 Until recently, however, the causality of these associations remained unclear, since the majority of studies that formed the basis of published recommendations for feeding ICU patients were either observational or small interventional studies. Recently, the field of critical care nutrition has been revived by the findings of several randomized, controlled trials, which have opened a new debate on nutritional practice in the ICU.

For this review, we focus on evidence from randomized, controlled studies that met the following criteria: study-group assignments were made in a blinded fashion, the sample size was sufficiently large to detect a prespecified treatment effect, there was a clear delineation of the way in which patients were selected and followed, there was a statistical analysis plan with end points defined a priori, and there was an intention-to-treat analysis with adequate handling of competing risks (Table 1). In this review, we integrate this newer evidence with older high-level evidence to provide suggestions for feeding during the acute phase of critical illness. In cases in which such evidence does not exist, we identify areas of uncertainty that require further investigation.

危重患者急性期的营养.pdf (534.86 KB, 下载次数: 289)

costa_na · 发表于 2014-4-2 00:29:58

【药品名称】
商品名称：瑞能
通用名称：肠内营养乳剂(TPF-T)
英文名称：Enteral Nutritional Emulsion(TPF-T)
【成份】
本品为复方制剂，其组分为：蛋白质、铬、脂肪、钼、碳水化合物、硒、纤维、维生素A、水、维生素D3、钠、维生素E、钾、维生素K1、氯、维生素B1、钙、维生素B2、镁、烟酰胺、磷、维生素B6、铁、维生素B12、锌、泛酸、铜、生物素、锰、叶酸、碘、维生素C、氟、胆碱。
【性状】
本品为浅灰黄色至淡棕色的乳状液体，有淡淡的水果香味。
【适应症】本品适用于营养不良的肿瘤患者，包括恶病质、厌食症、咀嚼及吞咽障碍等病况，也适用于脂肪或ω－3脂肪酸需要量增高的其它疾病患者，为患提供全部营养或营养补充。病人胃肠道功能应适用肠内营养。【规格】
200毫升/瓶(水果味)
【用法用量】
本品通过管饲或口服使用，应按照患者体重和营养状况计算每日剂量。
1.以本品为唯一营养来源的患者：患者非恶病质时，推荐剂量为按体重一日20～25ml（约30kcal）/kg。对于恶病质患者，推荐剂量为按体重一日30～40ml(约40～50kcal)/kg 。
2.以本品补充营养的患者：推荐剂量为一日400～1200ml（520～1560kcal）。管饲给药时，应逐渐增加剂量，第一天的速度约为20ml/小时。以后逐日增加20ml/小时，最大滴速为100ml/小时。通过重力或泵调整输注速度。
【不良反应】输入过快或严重超量时，可能出现恶心、呕吐或腹泻等胃肠道反应。【禁忌】
以下患者禁用：胃肠张力下降、急性胰腺炎；胃肠道功能衰竭、严重消化不良或吸收不良；肠梗阻、消化道出血；严重肝肾功能不全；对本品所含营养物质有先天性代谢障碍。
【注意事项】使用前摇匀。有效期内使用。【特殊人群用药】
儿童注意事项：
本品根据成年人的营养需求量制定处方，主要应用于成年患者，较少儿童应用的临床经验。

妊娠与哺乳期注意事项：
处于妊娠期前三个月的孕妇和育龄妇女每日摄入维生素A不应超过10000IU。本品与含维生素A的其它营养制剂一起使用时，应考虑这一因素。

老人注意事项：
本品适用于老年患者。
【药物相互作用】
本品含维生素K，对使用香豆素类抗凝剂的患者应注意药物相互作用。
【药理作用】
本品是一种高脂肪、高能量、低碳水化合物含量的肠内全营养制剂，特别适合于癌症患者的代谢需要。本品所含ω-3脂肪酸以及维生素A、维生素C和维生素E能够促进免疫功能，增强机体抵抗力。此外，膳食纤维有助于维持胃肠道功能。本品所合营养成分来源于天然食品，与正常人普通饮食成分相类似，对人体无毒性作用。
【贮藏】
25 ℃以下，不得冰冻，密闭保存。
【有效期】
暂定18个月
【批准文号】
国药准字H20040722
【批准日期】
2010-9-30 0:00:00
【说明书修订日期】
核准日期：2006年12月14日修改日期：2008年2月1日
【生产企业】
企业名称：华瑞制药有限公司
生产地址：江苏省无锡市滨湖区马山北闸路16号