《如何合理实施肠外营养支持吴国豪》ppt课件.ppt

 中/长链脂肪乳剂的优点 大量临床与实验结果证实 中/长链脂肪乳剂在临床各 个领域均有其代谢优势！ JPEN, 25 (2) Suppl., 2002  Benefits of Structolipid? (1) Controlled plasma TG and MCFA levels (Nordenstr?m 1995, Flaatten 1995, Kruimel 1997) Reliable source of essential fatty acids As well tolerated as Intralipid? (Nordenstr?m 1995, Sandstr?m 1995, Bellantone 1999) Suitable for long-term PN (Rubin et al 2000)  Benefits of Structolipid? (2) Rapidly available energy (Sandstr?m et al 1995) Improved protein economy compared to LCT and LCT/MCT emulsions  (Kruimel et al 1997, Lindgren et al 2001) Excellent mixing properties A handy non-breakable plastic packaging 结构脂肪临床对照研究资料有限 结构脂肪具有物理混合中/长链脂肪乳剂结构和生化特征并优于后者 从药理角度讲,应用酶学技术,开创了脂肪乳剂新领域,可根据各特殊代谢过程需要设计新型制剂 结构脂肪乳剂临床应用评价 含橄榄油脂肪乳剂具有良好的安全性和有效性 含橄榄油脂肪乳剂应用评价 含橄榄油脂肪乳剂在防止脂质过氧化优于其他长链脂肪乳剂 含橄榄油脂肪乳剂对机体免疫系统影响少,适合于小儿和需长期肠外营养病人 Omegaven? as a supplement Formulation: Lipid emulsion Lipid source: Fish oil Concentration: 10 % Special feature: High content of ?-3 fatty acids Purpose: Supplementation of parenteral nutrition with long-chain  ?-3 fatty acids Packaging: 50 100 ml, glass bottle Storage: 0-25°C Shelf life: 18 months 含鱼油的脂肪乳剂在肠外营养时具有良好的安全性;通过调节炎性介质的产生,下调炎性反应,增强机体免疫功能,可改善外科危重病人愈后 总 结 Optimal proportion of lipids in PN Recommended daily lipid intake: - adult: 1.0 - 2.0 g/kg； - infant: 1.0 - 3.0 g/kg - unstressed patients: 30 - 40% of total calories - stressed patients: 40 - 55% of total calories Factors to consider: glucose resistance， impaired respiratory capacity Monitoring: Serum triglycerides Ensure patient is not intolerant to any component of the lipid emulsion Proteins/Amino acids The only macronutrients containing nitrogen A variety of different functions: Cell and tissue structure: ? structural proteins Functional roles: ? transport proteins  ? blood clo