慢性腎臟病之臨床營養支援系統開發與研究

根據衛生署的統計資料，自2002年至2008年止，腎炎、腎徵候群及腎變性病一直高居國人十大死亡原因的第8位、第10位。另一方面，依據2007年美國腎臟病資料登錄系統(United States Renal Data System, USRDS)統計，台灣末期腎病(end stage renal disease, ESRD)的發生率和盛行率，均為世界第一。而目前國內洗腎病患更是年年增加，造成健保龐大支出，已成為健保支出的首位。因此慢性腎臟病早期階段的防治工作更為重要，目前國內已有全國性的慢性腎臟病共同照護網，藉由多專業的照護，慢性腎臟病患者可藉由衛教師和營養師得到更多疾病照護知識和飲食方法，期望可延緩慢性腎臟病進程，更進一步延長國人的壽命和提升生活品質。本研究以營養的觀點，開發一輔助臨床營養師之資訊系統，藉由整合檢驗數據和病患基本資料，更有效的做臨床營養評估和治療。藉由電腦系統可更快速且精確的計算腎絲球過濾率(glomerular filtration rate, GFR)等相關腎臟功能指標，以及蛋白質和熱量等相關需要特別控制的營養成分，並提供相關參考指引做提示。期望藉由營養資訊系統的發展更有效的改善慢性腎臟病患的飲食狀況，並有助於了解長期照護的病患其病程發展和營養改善狀況，進一步改善或延緩病情發展。

關鍵字

慢性腎臟病；營養資訊系統；營養評估

並列摘要

According to the statistics from Department of Health, disease diagnosis nephritis, nephrotic syndrome and nephrosis has been ranked in the 8th or 10th among the top 10 causes of death from 2002 to 2008. On the other hand, according to the 2007 statistics of United States Renal Data System (USRDS), end stage renal disease (ESRD) incidence and prevalence in Taiwan are both 1st in the world. The number of dialysis patients is increasing every year in Taiwan. This issue causes enormous health care spending and has become the top expenditures in the record of National Health Insurance. Therefore, the prevention and control of early stage of chronic kidney disease (CKD) is increasing more important. Now we have a common care network for CKD patient, through much professional care, CKD patients can get more knowledge of diseases care and diet methods by consultations through the health care providers and dietitians. This process is expected to prolong the CKD patients’ lives and improve their quality of life. In this study, an information system that was developed to assists in clinical dietitians. This system integrates the laboratory data and patient’s basic information, and more effectively to do the clinical nutritional assessment and treatment. By the computer system, the glomerular filtration rate (GFR) and other related indicators of kidney function can be calculated more quickly and accurately, as well as protein and calorie control and other related nutrients, and provide relevant information and tips. Clinical Nutrition Support System designed by us is expected to effectively improve the CKD patients’ diet, and help researchers to understand the long-term care of patients whose course development and nutrition, in order to halt the progression of CKD.

並列關鍵字

chronic kidney disease ； nutrition information systems ； nutritional assessment

參考文獻

1.行政院衛生署國民健康局: 國民健康局年報 2008~2009.

30.Lee MS, Lai CJ, Yang FY, Su HH, Yu HL, Wahlqvist ML: A global overall dietary index: ODI-R revised to emphasize quality over quantity. Asia Pac J Clin Nutr 2008, 17 Suppl 1:82-86.

47.林賢怡：隨手可得之營養資訊系統。台北市: 臺北醫學大學醫學資訊研究所，碩士論文；2008.

55.楊惠琄：發展手術全期護理資訊系統及評估其使用成效。台北市：臺北醫學大學醫學資訊研究所，碩士論文；2009。

4.United States Renal Data System 2009 Annual Data Report

國際替代計量

慢性腎臟病之臨床營養支援系統開發與研究

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