What is clinical nutrition? What is the relationship between enteral nutrition and parenteral nutrition?

Clinical nutrition is a comprehensive subject that uses the characteristics of food to relieve symptoms, promote rehabilitation and improve the quality of life after rehabilitation by regulating the metabolism of the body in pathological state. According to the principle of nutrition, dietary nutrition measures are called therapeutic diet, which can be divided into therapeutic diet and experimental diet according to its function.

Basic information

Clinical nutrition should include integral parts such as enteral nutrition (nutrition catering and patient's diet management), parenteral nutrition (intravenous nutrition), nutrition clinic, scientific research teaching and knowledge education. In China, clinical nutritionists are mainly responsible for enteral nutrition, and parenteral nutrition is used and managed by clinicians in most hospitals.

Related reading: Parenteral Nutrition: What is Parenteral Nutrition? What is the difference between enteral nutrition and parenteral nutrition?

Enteral nutrition: the function and choice of different enteral nutrition preparations

Special doctor in Dong Ze: the significance of enteral nutrition support for clinical nutrition of patients with nervous system diseases

The specific field of nutrition, which is also a part of clinical medicine, has gradually differentiated into a marginal discipline in recent years. Its task is to enhance the clinical effect of other treatment measures and accelerate the recovery of patients by treating diet, treating or alleviating diseases according to the principles of nutrition. Clinical nutrition plays an important role in the treatment of diseases. The nutritional status of patients directly affects wound healing and disease recovery. Good nutritional status can delay the occurrence and development of some diseases, and nutrition can also be used as a treatment for some diseases. Clinical nutrition is achieved through diet therapy.

Just like Li Dongze Dongze, a special medicine food of Dong Ze Special Medicine (), has been applied to clinical nutrition.

Form and function

Dietotherapy can be divided into two categories according to its function, namely therapeutic diet and experimental diet.

food therapy

Various recipes for specific diseases and different situations. There are three basic forms:

① General diet therapy. There are ordinary meals, soft meals, semi-liquid meals and liquid meals. Ordinary adult meals contain about 2,200 ~ 2,400 calories and are nutritious, which is suitable for patients with no fever, normal digestive organs, no special dietary restrictions and some recovery. Three soft rice for 65,438+0 days, chopped, cooked, soft and easy to digest. Soft rice for adults contains about 2000 kilocalories of heat every day, which contains enough nutrients and needs extra vitamin C. Suitable for patients with low fever, bad teeth or poor digestive function and early recovery, 1 4 meals a day. Semi-liquid diet is mainly used for patients with fever, digestive tract diseases and inability to chew after operation. Absolutely avoid rough, hard and fibrous foods. Adult semi-liquid diet has a maximum daily heat energy of 2,000 kilocalories, and protein is not less than 60g, which is rich in various nutrients. 6 ~ 7 meals a day. Liquid diet is characterized by complete liquid, easy to swallow, and the nutrients can't meet the needs. If necessary, it can only be used for a short time. It is suitable for patients with high fever, weak body, serious illness, limited oral cavity or gastrointestinal rest. The daily heat energy of adult liquid diet is only 1000 ~ 1500 kcal, of which protein is about 40g. Take it every 2 ~ 3 hours 1 time.

② Nasal feeding and tube feeding. People who are unconscious or unable to eat by mouth but have no throat and esophageal diseases and vomiting can eat through the nose. If food can't pass through the throat and esophagus, but is directly sent into the gastrointestinal tract through gastrostomy intubation, it is called gastrostomy tube feeding.

③ Necessary diet. Also known as chemical element diet or compound diet. The solution or suspension prepared with pure nutrients does not need to be digested and has little residue. It can provide 1000kcal of heat energy every day, which can basically meet the needs of various nutrients. Simple and convenient, and will not cause infection. It is very popular in clinic and develops rapidly. China and other countries have provided stereotyped basic meals. It is mainly suitable for patients with digestive tract fistula, severe enteritis, chronic diarrhea, short bowel syndrome, pancreatitis or dysfunction, hypermetabolism and chronic malnutrition, as well as preoperative preparation and postoperative care under severe trauma and burn. But it is not suitable for infants within 3 months, early patients with short residual body after enterotomy, early patients with metabolic stress and intestinal obstruction, and other extremely weak patients. The basic diet is usually in powder form, packed in 80 grams of small packages. According to the patient's condition, 1 ~ 8 packs can be given every day. The Chinese-made essence diet consists of powder bag and fat emulsion, which are mixed and prepared when used. The necessary diet can be taken orally, nasal feeding or ostomy drip according to the patient's condition.

④ Intravenous nutrition. Or parenteral nutrition, that is, providing nutrition to patients through intravenous injection. The key is to accurately understand the nutritional needs of patients, establish the preparation method of nutrient solution, and master the technology of intravenous intubation. The main indications for intravenous nutrition are intestinal fistula, intestinal inflammatory diseases, acute renal failure, heart failure and liver failure. The indications of adjuvant therapy include preoperative nutritional recovery, postoperative adjuvant therapy, inability to take orally, coma, anorexia nervosa or refusal to eat. Generally, intravenous nutrient solution should be prepared in two parts, one is heat source and nitrogen source, including glucose, fat and amino acid injection; The other part is electrolyte, trace elements and vitamins. The methods of intravenous nutrition infusion are oral, nasal feeding or ostomy, peripheral vein and central vein, and the former is the main one. Intravenous nutrition should be monitored by clinical examination items in hematology and urology departments. Except the urine specific gravity and liquid inflow and outflow are recorded daily, it is usually 1 ~ 2 weeks or 1 ~ 2 weeks.

Experimental diet

For some special diets prescribed by clinical tests, such as occult blood test diet for gastrointestinal occult blood test (food without heme and chlorophyll), cholecystography diet for checking gallbladder bile duct function (high-fat diet such as fried eggs can stimulate gallbladder contraction during radiography, and the contrast agent is concentrated, which is convenient for taking X-rays and gallbladder contraction and emptying after photography), dry diet for checking urine concentration function (try to choose foods with less water such as rice and steamed bread, etc.)

abstract

Clinical nutrition is becoming more and more important at this stage, and the development of modern society cannot be separated from the support of clinical nutrition.

For more special medicine information, please consult Dong Ze special medicine official website ().