Ciroza hepaticaBuruciuc Anca

Tratament nutritional

Plan dietetic individual Renuntarea completa la alcool Mese mici si repetate →cresc

toleranta alimentara; ciroticii prezinta o evacuare gastrica reduca, tranzit intestinal incetinit.

Aport crescut de fibre

Este necesara gustare bogata in glucide inainte de culcare pt a evita hipoglicemiile in timpul noptii.

Aport redus de sare =2 g.(pt a reduce retentia hidrica, preventia ascitei si a edemelor)

Aportul hidric trebuie incurajat in lipsa ascitei si a edemelor

Apar deficiente de tiaminca, folati, vitamina B6, riboflavina →este necesare suplimentarea cu vitamine si minerale

↓ vitaminei K →cresterea riscului de sangerare digestiva.

Pacient B, V-61 ani, G=60 kg T=1,72 m A inregistrat o scadere in greutate de 10 kg

in 6 luni) Diagnisticat cu ciroza hepatica carential

toxica, bazata pe consum excesiv de alcool (~30 ani, maxim 1l bere/vin/zi)

A.f usoara, sedentar, pensionar, locuieste in mediul urban.

Nu prezinta edeme, ascita sau steatoree.

IMC= 20 (SUBPONDERAL) G.I= 66.5 KG NC=66.5*30=1995 (~2000 KCAL) P=15%=75g(300 kcal) L=30%=67 g(600 kcal) G=55%=275g(1100 kcal)

Impartirea pe mese % Kcal P G L

MD 20 400 15 55 13.4G1 15 300 11.25 41.25 10P 20 400 15 55 13.4G2 15 300 11.25 41.25 10C 15 300 11.25 41.25 10G3 15 300 11.25 41.25 10

Mic dejunkcal P L G Fibre

Ou fiert 62 5 4 12 f paine integr.

127 6.2 2.2 23.5 6

10 g unt 55 0.5 6.5 110 g gem capsuni

24 - - 6

Total 268 11.7 12.7 31.6 6

Gustarea 1Kcal P L G Fibre

250 ml lapte integral

150 7.5 8.7 12.5

50 g fulgi ovaz

123 8.5 3.5 33 8

1 l miere 32 - - 8Total 305 16 12.2 53 8

Pranz Kcal P G L Fibre

Cartof 40g

35 1 8 0

Ceapa 20g

8.5 1 2 0

Morcov 20g

1 8 0

Telina20g 3.5 0.5 2 0Ulei10g 88 0 0 10Piept de pui 70g

105 11 0 2

Rosii100g

18 1 4 0

Castraveti50g

6 0.5 1 0

Ardei rosu50g

14 1 3 0

Spanac 100g

23 3 3.5 0.5 2

Paine 50g

126 5 25 0 4

Total 414 34 56.5 12.5 6

Gustarea 2Kcal p l G Fibre

Suc portocale (200ml)

94 1.8 0.2 23.6 4.8

4 biscuiti ovaz (40g)

168 2 5.8 27.6 2.8

Total 262 4 6 51.2 7.6

Cina Kcal P G L Fibre

100g paste

350 9 72 1.5 3

50g carne tocata de vita

90 9 11

1 l ulei 90 930 g ceapa

12 -

Rosii 150g 27 3 6 1Total 569 18 75 27.5 4

Gustarea 3Kcal P L G Fibre

Compot de mere 100 ml

85 - - 20 2

Total Kcal P G L Fibre

Total teor. 2000 75 275 67Total pr. 2196 73.7(-1.3) 316 (+41) 70.9(+3.9

)