评论
打印
The educational materials
教育材料
presented here were developed by students
是由爱荷华州立大学食品科学和人类营养系的
and faculty of the department of food science
全体教员和学生开发出来
and human nutrition at Iowa State University.
并呈现在这里的
Funding for this project was provided by grants
这个项目的资金
from the American Cancer Society Midwest
是由美国中西部癌症协会和
and the Lance Armstrong Foundation.
兰斯阿姆斯特朗基金会拨款的
The materials are intended for educational use
这些材料是供教育使用的
and are not meant to provide medical advice.
并不提供医疗建议
We welcome your feedback about these materials;
我们也欢迎你们对这些材料提供反馈
please use the evaluation survey link on the
请使用我们主页上的评估调查连接
home page to provide your comments and suggestions.
提供你们的评论和建议
This presentation will examine
这项陈述将
the prevalence and implications of malnutrition
研究营养不良
in children afflicted with cancer as well as
在患癌儿童中的患病率和对他们的影响
intervention methods for health professionals.
以及健康专业人士对该病的干预措施
There are few things in life that are as tragic
生活中很少有事情像
and heart breaking as a child diagnosed with a life
一个孩子被诊断得了绝症那样让人悲痛和心碎
threatening illness. In the United States alone
2007年仅在美国
approximately 10400 children under the age of 15
就有将近10400个15岁以下的儿童
were diagnosed with cancer in 2007 and approximately
被诊断为患有癌症
1545 of these children passed away from their disease.
其中约有1545个孩子因这种疾病死亡
Although this makes cancer the leading cause of death
尽管在孩子中
by disease among children advances in medical therapy
癌症已经成为药物治疗疾病中的头号杀手
and disease management have made long term survival
但是疾病管理已经
much more achievable. The overall cure rate for
使长期存活成为可能
childhood cancer now exceeds 70% and is projected to
现在儿童患癌的整体治愈率已经超过70%
soon reach 85% in industrialized nations; therefore
预计在工业化的国家将很快达到85%因此
major attention is being placed on reducing the
现在主要精力将集中在降低治疗引起的副作用
side effects of therapy such as malnutrition.
例如，营养不良
Studies actually suggest that up to 46% of children with
实际上，调查显示高达46%的患癌儿童
cancer experience malnutrition. Malnutrition is
患有营养不良
characterized by either a deficiency or an excess of
营养不良的特征是能量缺乏或者能量过剩
energy with measurable adverse effects on clinical
这会对临床结果产生严重的副作用
outcome. It’s also really important to point out
需要指出的是，能量，
that energy, meaning calories, is the key component of
即卡路里是产生营养不良主要的原因
malnutrition, vitamin and mineral deficiencies also
维生素和矿物质缺乏也对
greatly contribute to overall malnutrition and health.
整体营养不良和健康有很大的影响
Children with cancer are particularly vulnerable to
患癌儿童尤其容易患营养不良
malnutrition because they require additional nutrients
因为患儿为了正常成长发育
in order to obtain proper growth and development and
以及与疾病抗争
to fight off their disease.
需要额外的营养物质
Before we take a look at the causes of malnutrition
我认为在检查儿童癌症期
during childhood cancer and the corresponding side
导致营养不良的原因及其副作用之前
effects I think it is important to understand how to
重要的是要懂得如何评估孩子的营养状况
assess the nutritional status of a child. There is
目前，我们对如何界定儿童营养不良一事
currently no consensus on how to define malnutrition
尚未达成共识
in children but the most common practices involved
但最常见的做法就是
plotting weight to height ratios. Weight and height
绘制体重身高比例图
are usually plotted on standardized growth charts.
标准生长曲线图上常常包括体重和身高
Once a child’s placement has been determined on the
一旦一个儿童在生长曲线图上的位置被确定
growth chart this number can be converted to what is
此数字就可以转换成所谓Z
known as a Z score. A Z score is a numerical summary
一个Z就是一个数字摘要
of each child’s placement relative to a reference
它总结了每个儿童相对于参考人口的定位
population and are used to compare and assess data
可以用来比较和评估不同年龄不同性别
between different ages and genders. Once a Z score
之间的数据 一旦Z确定了
is determined a child can be placed on what is
儿童就可定位在
known as a standard, normal distribution graph.
一个标准的正态分布图上
This graph puts the average variable that is being
这个图表的中心是被测量的平均变量
measured in the centre of a chart, any child
任何身高或体重Z 超过2个标准差的儿童
whose height or weight Z score is more than 2
无论其Z值是高于平均值
standard deviations greater or less than the mean is
或者低于平均值
considered to have significant growth abnormalities.
均被视为明显的异常生长
Thus is the child fell 2 standard deviations below the
这就是为什么Z低于平均值的2个标准差
mean he or she would be considered to be malnourished.
的儿童会被视为营养不良
However, studies have shown that simple weight,
然而研究表明 简单的体重和身高测量
height measurements are often inaccurate depending
往往是不准确的其数据也要取决于
on the type of tumor such as large solid tumors.
肿瘤类型，比如大型实体肿瘤
Other practices include tracking voluntary food intake
其他做法有跟踪采食量
and comparing intake to the required or
将其摄入量与所需或推荐准则相比较
recommended guidelines. If the child was eating
如果儿童摄入的能量低于其预计能量
less than 70% of his or her estimated energy
需求的70％那么
requirements then he or she would be considered
将被视为营养不良
malnourished. Another way is to take anthropometric
另一种方法是对肱三头肌皮褶厚度
measures of the tricep skin fold thickness to
进行人体测量，以确定人体内脂肪
determine adipose or fat energy reserves.
或脂肪的能量储备
If less than the 5th percentile for age and
测量值不足其年龄和性别水平
sex the patient would be considered malnourished.
所需脂肪的百分之五的患者 将被视为营养不良
