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題名 | 住院管灌病患營養狀況及胃腸併發症對營養攝取量之影響=The Effects of Nutritional Status and Gastrointestinal Complications on the Nutrient Intake among the Inpatients with Tube Feeding |
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作者 | 黃素華; 陳珮蓉; 張啟仁; 賴鴻緒; 鄭金寶; 劉秀英; 楊榮森; Huang, Su-hua; Chen, Pey-rong; Chang, Chee-jen; Lai, Hong-shiee; Cheng, Chin-pao; Liu, Hsiu-ying; Yang, Rong-sen; |
期刊 | 臺灣醫學 |
出版日期 | 20050700 |
卷期 | 9:4 2005.07[民94.07] |
頁次 | 頁467-474 |
分類號 | 411.3 |
語文 | chi |
關鍵詞 | 灌食; 營養狀態; 併發症; 腹瀉; Tube feeding; Nutritional status; Complications; Diarrhea; |
中文摘要 | 當病患無法以口進食時,經由鼻胃管或胃造口術等灌食方式,以提供病患足夠的營養支持,對於住院灌食病患之營養狀況、灌食之腸胃併發症的發生率是否造成對營養攝取量之影響,則尚待研究探討。本研究收集台大醫院九十年四月至八月間使用灌食患者共1385位,並做營養攝取量評估,包括總熱量及蛋白質;營養狀況評估包括:體重、白蛋白;腸胃併發症的評估包括:腹瀉、消化不良、便祕、噁心、嘔吐、腹漲等。結果發現45.1%患者之熱量攝取未達每日需要量的90%。血中白蛋白濃度與熱量(r=0.2514, p<0.0001)及蛋白質(r=0.2213, p<0.0001)的攝取量皆具有正相關性。血中白蛋白<3.5mg/dl的患者,熱量與蛋白質的攝取情形均明顯地較白蛋白≧3.5mg/dl者為差[OR(Odd Ratio)=2.48(熱量),P<0.05;OR=2.57(蛋白質),P<0.05]。腸胃併發症的發生率與熱量和蛋白質的攝取量之間呈負相關[r=0.254(熱量),P<0.0001;r=-0.2365(蛋白質),P<0.0001]。發生腸胃併發症者之熱量及蛋白質攝取不足情況較無腸胃併發症者嚴重[OR=5.69(熱量),OR=4.05(蛋白質),P<0.05],併發症中以發生腹瀉的情形最多,且腹瀉者的熱量和蛋白質攝取量均較無腹瀉者差[OR=2.83(熱量),P<0.05;OR=2.17(蛋白質),P<0.05]。另外,白蛋白<3.5mg/dl者相對於白蛋白≧3.5mg/dl者出現腹瀉的情形較為嚴重(OR=3.68, p<0.05)。結論:灌食患者於第一週內約有一半患者無法攝取足夠熱量與蛋白質,且血中白蛋白低及腸胃併發症皆與營養攝取不足有關。 |
英文摘要 | For patients on nothing-per-os (NPO) status, tube feeding through nasogastrointestinal (NG) tube or gastrostomy tube can supply the adequate nutritional requirements. This study investigated the nutritional status, the incidence of feeding-related complications, as well as their effects on the nutritional intake in the inpatients undergoing tube feeding. This study recruited 1385 patients from NTUH through April to August in 2001, the assessment items of nutritional intake included total energy and protein. The nutritional status assessed by body weight and albumin level. The gastrointestinal complication items included diarrhea, malabsorption, constipation, nausea, vomiting, and abdominal distension, etc. The results showed that 45.1% of patients had their energy intake less then 90% of daily requirements. The serum albumin condition was positively correlated to the energy intake (r=0.2514, p<0.0001) and protein intake (r=0.2213, p<0.0001). The patients with low concentrations of serum albumin <3.5mg/dl had a less energy and protein intake than those of patients with high concentrations of serum albumin ≧3.5mg/dl [OR (Odd Ratio)=2.48 (energy), p<0.05; OR=2.57 (protein), p<0.05]. The incidence of gastrointestinal complication was reversely correlated with energy intake and protein intake [r=-0.254 (energy), p<0.0001; r=-0.2365 (protein), p<0.0001]. Those patients with gastrointestinal complications had a more severe energy insufficiency and protein insufficiency compared with those without gastrointestinal complications [OR=5.69 (energy), OR=4.05 (protein), p<0.05]. Among them diarrhea was the most common complications, they had worse energy and protein intake as compared with those without diarrhea [OR=2.83 (energy), p<0.05 OR=2.17 (protein), p<0.05]. Furthermore, patients with low serum albumin <3.5mg/dl suffered from more serious diarrhea as compared with those having higher serum albumin (OR=3.68, p<0.05). Conclusion: About one half of patients undergoing tube feeding had inadequate energy and protein intake in the first week. These situations were related to the hypoalbuminemia and gastrointestinal complications. |
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