摘要
再餵食症候群常發生於營養不良的病患。長期禁食後再次進食時，血中葡萄糖突然增加，胰島素大量分泌，逆轉原本的分解作用變成合成代謝，使得原本就不足的電解質和微量元素更形缺乏。臨床上遇到這類病人時，需要注意的嚴重症狀包括低血磷造成的心衰竭、橫紋肌溶解；低血鎂導致的混亂、抽搐；低血鉀引發的心律不整、肌肉麻痺等等，甚至可能有致命的危險。處置上我們給予營養要採漸進式增加，並小心評估臨床症狀及監測各項電解質及生化檢驗，幫助這些病人度過這段危險期。
並列摘要
The patients with undernutrition are high risk group for refeeding syndrome. Refeeding after long term starvation makes serum glucose increase and insulin secretion abruptly, reversing catabolism to anabolism, which needs much electrolytes and micronutrients. However, those are already in shortage and worse during this change. We should notice symptoms and signs, such as hypophosphatemia induced congestive heart failure and rhabdomyolysis; hypomagnesemia caused delirium and cramps; arrhythmia and paralysis due to hypokalemia, etc. Sometimes the result may be lethal. When we take care of those patients, the feeding amount had better start low and go slow. It is necessary to monitor clinical condition and check biochemistry data and electrolytes frequently.
並列關鍵字
無資料延伸閱讀
- Yang, C. C., Chan, K. S., Yang, H. H., Tan, C. K., Cheng, K. C., & Hou, C. C. (2009). 復食症候群：病例報告. 中華民國急救加護醫學會雜誌, 20(4), 210-216. https://doi.org/10.30018/JECCM.200912.0007
- Ho, J. Y., Cheng, F. J., & Liu, B. M. (2009). 吞嚥困難在重症肌無力爲唯一的初次表現：罕見疾病的罕見表現. Journal of Emergency Medicine, Taiwan, 11(3), 86-89. https://www.airitilibrary.com/Article/Detail?DocID=15623386-200909-200911170037-200911170037-86-89
- 黃鈺婷、曾詩方、邱昱婷、李銘櫻、陳麗貞（2022）。降低新生兒加護病房早產兒餵食不耐受之發生率。護理雜誌，69(3)，77-84。https://doi.org/10.6224/JN.202206_69(3).11
- 劉偉仕、葉恩琪（2014）。台灣精神醫學會年會DSM-5工作坊：餵食與和飲食障礙症。DSM-5通訊，4(2)，38-39。https://www.airitilibrary.com/Article/Detail?DocID=P20140807001-201406-201501120030-201501120030-38-39
- Khan, L. U. R., Ahmed, J., Khan, S., & MacFie, J. (2011). Refeeding Syndrome: A Literature Review. Gastroenterology Research and Practice, 2011(), 175-180. https://doi.org/10.1155/2011/410971