減重手術後病人的營養需求與照護

Nutrition Demand and Care of Patients Undergoing Bariatric Surgery

吳淑芬(Shu-Fen WU) ； 宋天洲(Tien-Chou SOONG) ； 許毓容(Yu-Rong HSU)

《護理雜誌》 68卷3期 (2021/06) Pp. 21-25

https://doi.org/10.6224/JN.202106_68(3).04

摘要

全球肥胖症及與其相關之合併症正不斷持續上升，減重手術已被確立為中重度肥胖病人最具成本效益的治療方法。減重手術後病人因手術胃腸道解剖和生理改變，可能出現某些胃腸道症狀和蛋白質及微量營養素之缺乏，如：鐵、葉酸，維生素B1及B12等，然而，許多肥胖病人在減重手術前即存在著營養不足之問題，因而手術前的篩檢及微量營養素之補充是非常重要的，若未處理則常導致手術後營養缺乏更嚴重。均衡飲食是減重成功關鍵，因此，手術後病人應吃低熱量且富含蛋白質之食物，食物形態上應選擇大小和黏稠度適當之食物，並喝適量之液體，正確的飲食習慣，將使病人避免手術後的不適感及改善營養需求不足之現象。

關鍵字

減重手術 ； 營養需求 ； 肥胖症

並列摘要

The increasing prevalence of obesity and comorbid conditions worldwide requires the development of effective strategies for both treatment and prevention. In recent years, bariatric surgery has emerged as the most effective weight-loss therapy for individuals affected by moderate and morbid obesity. Behavioral alterations in eating patterns and anatomical and physiological modifications to the gastrointestinal organs may result in significant deficiencies in protein and micronutrients such as iron, folate, Vitamin B12, and thiamin. Many individuals with obesity have already-existing nutritional deficiencies before receiving bariatric procedures. The preoperative screening for and correction of micronutrient deficiencies preoperatively are crucial, as these deficiencies may be further exacerbated by the bariatric procedures. Because a balanced diet is key to successful weight loss at all stages of treatment, after the operation, patients should consume a diet that is low calorie and rich in protein, choose foods of the proper volume and consistency, and drink an appropriate amount of fluids. Maintaining a proper diet will enable patients to avoid unpleasant sensations after surgery and improve the phenomenon of inadequate nutritional needs.

並列關鍵字

bariatric surgery ； nutrition demand ； obesity

參考文獻

Ahuja, M., Sathiyaseelan, T., Wani, R. J., & Fernandopulle, P. (2020). Obesity, food insecurity, and depression among females. Archives of Public Health, 78(1), Article 83. https://doi.org/10.1186/s13690-020-00463-6

Bjørklund, G., Semenova, Y., Pivina, L., & Costea, D.-O. (2020). Follow-up after bariatric surgery: A review. Nutrition, 78, Article 110831. https://doi.org/10.1016/j.nut.2020.110831

Blüher, M. (2019). Obesity: Global epidemiology and pathogenesis. Nature Reviews Endocrinology, 15(5), 288–298. https://doi.org/10.1038/s41574-019-0176-8

Hasan, N. A., Freije, A., Abualsel, A., Al-Saati, H., & Perna, S. (2020). Effect of bariatric surgery on weight loss, nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations: A retrospective cohort study from Bahrain. Sultan Qaboos University Medical Journal, 20(3), e344–e351. https://doi.org/10.18295/squmj.2020.20.03.015

Hung, K.-C., Wu, S.-C., Chang, Y.-J., Chiang, M.-H., Chen, I.-W., Sun, C.-K., & Soong, T.-C. (2019). Impact of preoperative anemia on postoperative kidney function following laparoscopic bariatric surgery. Obesity Surgery, 29(8), 2527–2534. https://doi.org/10.1007/s11695-019-03869-6