中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (35): 5682-5689.doi: 10.3969/j.issn.2095-4344.1891

• 组织构建学术探讨 tissue construction academic discussion • 上一篇    下一篇

糖尿病足病医学营养治疗指南

中华预防医学会组织感染与损伤预防与控制专业委员会,中华医学会肠外肠内营养学分会,中国中西医结合学会周围血管疾病专业委员会糖尿病足学组
  

  • 收稿日期:2019-08-05 出版日期:2019-12-18 发布日期:2019-12-18

Medical nutrition treatment guideline for diabetic foot

Society for Prevention and Control of Tissue Inflammation and Injury of Chinese Preventive Medicine Association; Society of Parenteral and Enteral Nutrition of Chinese Medical Association; Diabetic Foot Group, Committee of Peripheral Vascular Disease, China Society of Integrated Traditional Chinese and Western Medicine   

  • Received:2019-08-05 Online:2019-12-18 Published:2019-12-18

摘要:

文章快速阅读:

文题释义:

糖尿病足病:指糖尿病患者因下肢远端神经异常和不同程度的血管病变导致的足部感染、溃疡和(或)深层组织破坏,是糖尿病最严重和治疗费用最高的慢性并发症之一。
医学营养治疗:是糖尿病及其并发症的基础治疗手段,包括对患者进行个体化营养评估、营养诊断、制定相应营养干预体制,并在一定时期内实施营养及监测。
摘要
背景:
糖尿病足病作为糖尿病最严重和治疗费用最高的慢性并发症,其治疗应倡导多学科综合治疗。其中,医学营养治疗应引起足够重视。
目的:通过提出医学营养治疗建议,指导临床工作者在实践过程中,科学营养评估及有效干预,使糖尿病足病患者通过科学医学营养治疗显著获益。
方法:通过营养评估量表评估、营养治疗目的、膳食方式选择、能量要求、宏量及微量营养素建议、随访及危重患者营养肠内肠外营养支持等几个方面,参考国际与国内相关指南及文献,提出医学营养治疗建议.
结果与结论:①对于糖尿病足病患者营养状况的评估,主要应用患者主观整体评估患者主观整体评估及微营养评估,另外,还可应用老年营养风险指数评估;②综合国际与国内相关指南,提出医学营养治疗目标;③各种膳食方式,均有助于患者体重控制及改善血糖,推荐在各类饮食方式的基础上,经临床营养师指导,制定个体化饮食方案;④所有糖尿病足病患者均应接受经临床营养师专业评估后制定的个体化能量平衡计划,根据病程时期及时调整;⑤综合最新研究,提出三大宏量营养素摄入要求;⑥针对糖尿病足病患者,特异性补充微量营养素可促进其临床获益;⑦医学营养治疗应充分重视糖尿病足病患者随访;⑧针对危重糖尿病足病患者,提出医学营养治疗建议。

关键词: 糖尿病足病, 医学营养治疗, 营养治疗目标, 微量营养素, 宏量营养素, 饮食方式, 个体化饮食方案, 危重糖尿病足病

Abstract:

BACKGROUND: Diabetic foot is most serious and costly chronic complication of diabetes mellitus. Multidisciplinary comprehensive treatment should be advocated for its treatment. Among them, medical nutrition treatment should be paid enough attention.
OBJECTIVE: By putting forward medical nutrition treatment suggestions, guiding clinical workers in the process of practice, scientific nutrition assessment and effective intervention, diabetic foot patients can benefit significantly through scientific medical nutrition treatment.
METHODS: By referring to relevant international and domestic guidelines and literature, this paper puts forward suggestions for medical nutritional treatment on the evaluation of nutritional assessment scale, the purpose of nutritional therapy, dietary choice, energy requirements, macronutrient and micronutrient recommendations, follow-up and parenteral nutrition support for critical patients.
RESULTS AND CONCLUSION: (1) For the assessment of nutritional status of diabetic foot patients, patient-generated global assessment and mini nutritional assessment are mainly used. In addition, Geriatric Nutritional Risk Index can also be used to assess the nutritional status of elderly patients. (2) To synthesize the relevant international and domestic guidelines and put forward the goal of medical nutrition treatment. (3) All kinds of dietary methods are helpful for patients’ weight control and blood sugar improvement. It is recommended that individualized dietary plans be formulated on the basis of various dietary methods and under the guidance of clinical nutritionists. (4) All diabetic foot patients should accept the individualized energy balance plan formulated after professional evaluation by clinical nutritionists, and adjust it in time according to the course of disease. (5) Based on the latest researches, three macronutrients intake requirements were proposed. (6) For patients with diabetic foot disease, specific micronutrients supplementation can promote their clinical benefits. (7) Medical nutrition treatment should pay more attention to the follow-up of patients with diabetic foot disease. (8) Specific medical nutrition treatment was suggested for patients with critical diabetic foot disease.

Key words: diabetic foot, medical nutrition treatment, nutritional treatment objective, micronutrients, macronutrients, dietary modes, individualized dietary plans, critically diabetic foot

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