脑卒中病人饮食管理.pptVIP

01根据患者营养和能量需求均衡搭配食物种类，满足患者能量需要。02有合并症患者，如糖尿病患者需根据血糖情况配制糖尿病饮食；肾功能损害患者予以低盐优质蛋白饮食；心功能不全患者予以低盐饮食，控制水分摄入。喂食护理饮水实验5级的患者采用鼻饲饮食(EN)喂食护理BA正确选择喂养途径鼻胃管饲否鼻肠管饲是高度肺吸入风险鼻胃(肠)管饲否胃造口术否空肠造口术是高度肺吸入风险胃肠造口术是预测时间6周?管饲喂养鼻胃管管饲肠内营养管的固定提倡胃管S型固定法脑梗死急性期死亡率很高，卒中发作后7天的死亡率是12％，1个月的死亡率高达19％Casefatalityisgenerallyacceptedtobe12%withinthefirstsevendaysand19%atonemonthforfirst-everstroke.Patientswithprimaryorsubarachnoidcerebralhaemorrhageandthosewithtotalanteriorcirculationinfarctsareathighestriskofdeath.Somepatientsdiewithinhoursasaresultoftheischaemicinsultorcardiaccomplications,otherssuccumbatbetweenfiveand10daystotheeffectsofcerebraloedema.Latedeathsareusuallyduetotheconsequencesofimmobilisationandearlyordelayedstrokerecurrence,especiallyinpatientswithsubarachnoidhaemorrhage,inwhomtheriskofdeathfromre-bleedingisashighas30%.Patientswithbrainsteminvolvement,causedeitherbytheprimaryischaemicprocessorbycompressionduetoraisedintracranialpressure,areathighriskofdeath.Theriskofdeathfallsafterthefirst30daystoabout9%perannum,twicethatforthepopulationatlarge.卒中首次发作后30天的卒中复发率是2－3％，6个月的复发率是9％，1年的复发率是10－16％。是普通人群的9倍，是同年龄和性别人群的15倍Strokerecurrencehasbeendivided,onthebasisofrecentclinicaltrials,intoearly(withintwoweeks)anddelayed(oftenbeyondthreemonths)recurrence.Regardlessofcause,theriskofstrokerecurrenceishighestearlyafterfirst-everstrokeanddelayminimisesthebenefitofanyintervention.About2–3%ofpatientshaverecurrentstrokewithinthefirst30daysafterstroke,9%inthefirstsixmonthsand10–16%inthefirstyear.Thatis,strokepatientshavearisk15timesthatofanage-andsex-matchedpopulation.Thereaftertheriskbecomeslowerandisaboutninetimesthatofthegeneralpopulation.脑梗死是人类健康的巨大威胁，根据WHO2002年的数据，全球每年死亡人口中脑梗死（卒中）占10％，共550万人，是全世界第三位死亡原因。我国更加严重，每年因