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

The Effects of Nutritional Status and Gastrointestinal Complications on the Nutrient Intake among the Inpatients with Tube Feeding

黃素華(Su-Hua Huang) ； 陳珮蓉(Pey-Rong Chen) ； 張啟仁(Chee-Jen Chang) ； 賴鴻緒(Hong-Shiee Lai) ； 鄭金寶(Chin-Pao Cheng) ； 劉秀英(Hsiu-Ying Liu) ； 楊榮森(Rong-Sen Yang)

《台灣醫學》 9卷4期 (2005/07) Pp. 467-474

https://doi.org/10.6320/FJM.2005.9(4).04

摘要

For patients on nothing-per-os (NPO) status, tube feeding through nasogastrointestinal (NG) tube or gastrostomy tube can supply the adequate nutritional requirements. This study investigated the nutritional status, the incidence of feeding-related complications, as well as their effects on the nutritional intake in the inpatients undergoing tube feeding. This study recruited 1385 patients from NTUH through April to August in 2001, the assessment items of nutritional intake included total energy and protein. The nutritional status assessed by body weight and albumin level. The gastrointestinal complication items included diarrhea, malabsorption, constipation, nausea, vomiting, and abdominal distension, etc. The results showed that 45.1% of patients had their energy intake less then 90% of daily requirements. The serum albumin condition was positively correlated to the energy intake (r=0.2514, p＜0.0001) and protein intake (r=0.2213, p＜0.0001). The patients with low concentrations of serum albumin ＜3.5mg/dl had a less energy and protein intake than those of patients with high concentrations of serum albumin ≧3.5mg/dl [OR (Odd Ratio)=2.48 (energy), p＜0.05; OR=2.57 (protein), p＜0.05]. The incidence of gastrointestinal complication was reversely correlated with energy intake and protein intake [r=-0.254 (energy), p＜0.0001; r=-0.2365 (protein), p＜0.0001]. Those patients with gastrointestinal complications had a more severe energy insufficiency and protein insufficiency compared with those without gastrointestinal complications [OR=5.69 (energy), OR=4.05 (protein), p＜0.05]. Among them diarrhea was the most common complications, they had worse energy and protein intake as compared with those without diarrhea [OR=2.83 (energy), p＜0.05 OR=2.17 (protein), p＜0.05]. Furthermore, patients with low serum albumin ＜3.5mg/dl suffered from more serious diarrhea as compared with those having higher serum albumin (OR=3.68, p＜0.05). Conclusion: About one half of patients undergoing tube feeding had inadequate energy and protein intake in the first week. These situations were related to the hypoalbuminemia and gastrointestinal complications.

關鍵字

灌食 ； 營養狀態 ； 併發症 ； 腹瀉

並列摘要

For patients on nothing-per-os (NPO) status, tube feeding through nasogastrointestinal (NG) tube or gastrostomy tube can supply the adequate nutritional requirements. This study investigated the nutritional status, the incidence of feeding-related complications, as well as their effects on the nutritional intake in the inpatients undergoing tube feeding. This study recruited 1385 patients from NTUH through April to August in 2001, the assessment items of nutritional intake included total energy and protein. The nutritional status assessed by body weight and albumin level. The gastrointestinal complication items included diarrhea, malabsorption, constipation, nausea, vomiting, and abdominal distension, etc. The results showed that 45.1% of patients had their energy intake less then 90% of daily requirements. The serum albumin condition was positively correlated to the energy intake (r=0.2514, p＜0.0001) and protein intake (r=0.2213, p＜0.0001). The patients with low concentrations of serum albumin ＜3.5mg/dl had a less energy and protein intake than those of patients with high concentrations of serum albumin ≧3.5mg/dl [OR (Odd Ratio)=2.48 (energy), p＜0.05; OR=2.57 (protein), p＜0.05]. The incidence of gastrointestinal complication was reversely correlated with energy intake and protein intake [r=-0.254 (energy), p＜0.0001; r=-0.2365 (protein), p＜0.0001]. Those patients with gastrointestinal complications had a more severe energy insufficiency and protein insufficiency compared with those without gastrointestinal complications [OR=5.69 (energy), OR=4.05 (protein), p＜0.05]. Among them diarrhea was the most common complications, they had worse energy and protein intake as compared with those without diarrhea [OR=2.83 (energy), p＜0.05 OR=2.17 (protein), p＜0.05]. Furthermore, patients with low serum albumin ＜3.5mg/dl suffered from more serious diarrhea as compared with those having higher serum albumin (OR=3.68, p＜0.05). Conclusion: About one half of patients undergoing tube feeding had inadequate energy and protein intake in the first week. These situations were related to the hypoalbuminemia and gastrointestinal complications.

並列關鍵字

tube feeding ； nutritional status ； complications ； diarrhea