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重症病人的灌食與營養

Enteral Feeding and Nutrition for Patients With Critical Illnesses

摘要


臨床上,重症病人因治療上的需要或無法主動維持適當營養攝取,常需使用到鼻胃管灌食法來補充其營養與熱量。鼻胃管灌食法主要分為連續式灌食法、循環式灌食法、間歇式灌食法與批式灌食法四種,不同方式各有其適合的使用時機與優缺點。本文藉由回顧重點相關文獻,用以強化臨床醫護人員對重症病人鼻胃管灌食與營養照護的正確概念,提升重症照護品質。

並列摘要


Patients with critical illnesses often require nasogastric tube feeding (NG feeding) to support their nutritional and caloric-intake needs because of therapeutic issues and an inability to self-maintain proper nutritional intake. The four primary NG feeding methods include continuous feeding, cyclic feeding, intermittent feeding, and bolus feeding. Each method is unique in terms of timing and relative advantages and disadvantages. In this article, the related literature is reviewed to strengthen the correct concepts of clinical medical staff with regard to NG feeding and nutritional care for patients with critical illnesses with the ultimate goal of improving the quality of care provided to this vulnerable patient population.

參考文獻


王采芷、吳淑芳、梁淑媛、童恒新、林玉萍(2012).重症病人腸胃道管灌常見合併症之預防.護理雜誌,59(4),18–23。[Wang, T.-J., Wu, V. S.-F., Liang, S.-Y., Tung, H.-H., & Lin, Y.-P. (2012). Preventing common enteral feeding complications in critically ill adult patients. The Journal of Nursing, 59(4), 18–23.] https://doi.org/10.6224/JN.59.4.18
吳虹諗、張巧惠、陳麗貞、林梅香、謝春蘭(2015).加護病房護理人員鼻胃管灌食照護完整性之改善專案.長庚護理,26(1),53–65。[Wu, H.-S., Chang, C.-H., Chen, L.-C., Lin, M.-H., & Hsieh, C.-L. (2015). Improving the comprehensiveness of nursing care for nasogastric tube feeding of patients in an intensive care unit. Chang Gung Nursing, 26(1), 53–65.] https://doi.org/10.3966/102673012015032601006
陳建志、陳登郎、鄒永恩(2016).標準經鼻胃管置放術的修正:經口咽處操作導引法.台灣家庭醫學雜誌,26(3),162–168。[Chen, J.-J., Chen, D.-L., & Tsou, Y.-A. (2016). A modification of standard nasogastric tube insertion: Trans-oropharyngeal manipulation guiding method. Taiwan Journal of Family Medicine, 26(3), 162–168.] https://doi.org/10.3966/168232812016092603004
黃素芬、楊琳琪、邵學方、許正義、吳杏真(2014).提升重症病人72小時內腸道灌食理想熱量達成率之改善專案.護理雜誌,61(2,附冊),5–13。[Huang, S.-F., Yang, L.-C., Shao, H.-F., Hsu, J.-Y., & Wu, H.-C. (2014). Project to attain the ideal caloric intake level in critical patients within a 72-hour period. The Journal of Nursing, 61(2, Suppl.), 5–13.] https://doi.org/10.6224/JN.61.2S.5
黃素華、陳珮蓉、張啟仁、賴鴻緒、鄭金寶、劉秀英、楊榮森(2005).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.台灣醫學,9(4),467–474。[Huang, S.-H., Chen, P.-R., Chang, C.-J., Lai, H.-S., Cheng, C.-P., Liu, H.-Y., & Yang, R.-S. (2005). The effects of nutritional status and gastrointestinal complications on the nutrient intake among the inpatients with tube feeding. Formosan Journal of Medicine, 9(4), 467–474.] https://doi.org/10.6320/FJM.2005.9(4).04

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