神經性厭食症併發急性肝炎：個案報告

Case Report: Anorexia Nervosa with Complication of Acute Hepatitis

張毓哲(Yu-Che Chang) ； 李福春(Fu-Chun Lee) ； 葉運強(Yun-Chiang Yeh) ； 楊惠茹(Hui-Ru Yang)

《台灣家庭醫學雜誌》 28卷2期 (2018/06) Pp. 86-93

https://doi.org/10.3966/168232812018062802004

摘要

神經性厭食症(anorexia nervosa)是一種嚴重的飲食失調症(eating disorder)，由於對自己體重或身材過度的在意，藉由節食、運動、催吐等方式讓體重盡可能的遠遠低於正常範圍。常發生在女孩和婦女，初發年齡多在15歲到24歲之間。會引起多重系統異常，包括皮膚、內分泌、心臟血管、消化、神經、肌肉、骨骼系統等。肝功能異常是常見的併發症，但是嚴重的急性肝炎卻是很罕見的。藉由回顧一位24歲罹患神經性厭食症合併急性肝炎的住院的個案，經由跨領域團隊合作照護模式成功的讓病人體重逐漸增加、肝功能逐漸改善、順利出院回到正常生活，來探討本病症的流行病學、臨床徵狀、急性肝炎併發症以及計畫性再灌（進）食的治療建議。

關鍵字

神經性厭食症 ； 神經性厭食症併發症 ； 再灌（進）食 ； 急性肝炎 ； 跨領域團隊合作照護

並列摘要

Anorexia nervosa (AN), both a severe mental illness and a serious eating disorder, drives a person to maintain a dangerously low body weight by relentless measures like strict dieting, vigorous exercise, and intentional vomiting. The groups of people most commonly affected by AN are girls and young women, and the average age of onset for this disorder falls in the range of 15 to 24. AN can lead to abnormalities in multiple systems, including dermatological, endocrine and metabolic, cardiovascular, neurological, digestive, and skeleton-muscular systems. While mildly abnormal liver function is common in AN, severely elevated liver function remains rare. The case report presents a 24-year-old woman admitted to hospital through family medicine OPD due to anorexia nervosa with the complication of acute hepatitis. With the coordinated care of a multidisciplinary team, her liver function, appetite and weight improved gradually and her occupational function recovered after discharge. Epidemiology, clinical manifestations, complications and refeeding treatment of anorexia nervosa were also introduced after literature review.

並列關鍵字

acute hepatitis ； anorexia nervosa ； complication of anorexia nervosa ； multidisciplinary coordination care ； refeeding

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