應用實證於肝性腦病變患者蛋白質飲食攝取的臨床決策

Evidence-Based Clinical Decision Making: Dietary Protein Intake Recommendations for Hepatic Encephalopathy Patients

肝硬化患者常因病程進展而有肝性腦病變的合併症，限制飲食蛋白質的攝取是有爭議且缺乏臨床試驗研究的證據支持，本文透過系統性文獻查證，共評析8篇臨床試驗研究，結果顯示嚴格限制蛋白質攝取者，在改善肝性腦病變病程的效果並未優於正常蛋白質或高蛋白質攝取者，依據研究結果整理出肝性腦病變的蛋白質飲食治療決策流程，本文可以做為臨床護理人員在提供肝性腦病變患者飲食指導之參考。

Patients with liver cirrhosis often develop hepatic encephalopathy complications. Reducing a patient's intake of dietary proteins as a preventive strategy is controversial and lacks of evidence support in clinical trials. This article systematically reviewed the findings of 8 clinical trials. In terms of effectiveness, liver cirrhosis patients in these studies who restricted their dietary protein intake had not improved significantly from those who consumed a normal or high protein diet. Based on this review, we developed a decision-making algorithm of protein diet regimens for hepatic encephalopathy. This article can provide a reference to nurses responsible to provide dietary instructions to patients with hepatic encephalopathy.