急慢性疾病與營養照護

Nutritional Care in Acute and Chronic Illness

"營養對於維持身體健康與疾病預防至關重要，尤其對於罹患急、慢性疾病、傳染性疾病與重症患者，因為飲食攝入的量與質之改變，產生能量恆定紊亂（Richardson & Davidson, 2003）。慢性重症疾病患者身體的新陳代謝是屬於高分解性代謝（hypercatabolic），他們經歷了由於重症疾病的免疫神經內分泌（the immune-neuroendocrine）反應所引發明顯的瘦體損失（Mechanick & Brett, 2005）。因此當個體處於疾病或治療所導致的生理壓力期間的飢餓，會導致身體的基礎代謝率增加、蛋白質分解加速、能量和營養需求的增加以因應組織損傷，感染和炎症所需，會迅速發展為營養不良，或因與疾病和傷害相關的炎症反應和代謝壓力而加劇營養不良（Wortinger & Burns, 2015）。"

Nutrition is essential for maintaining good health and preventing diseases, especially in patients suffering from acute or chronic diseases, infectious diseases, or critical illnesses because dietary intake involves both quantitative and qualitative changes and may disturb energy homeostasis (Richardson & Davidson, 2003). The metabolism of patients with critical illnesses is categorized as hypercatabolic, with significant loss of lean body tissue facilitated by the immune-neuroendocrine response of acute critical illness (Mechanick & Brett, 2005). Therefore, facing hunger during a period of physiological stress because of disease or treatment, results in an increased basal metabolic rate, accelerated protein breakdown, and increased energy and nutritional requirements in response to tissue damage, infection, and inflammation. This situation will develop rapidly into malnutrition or further exacerbate malnutrition because of inflammation and metabolic stress associated with diseases and injuries (Wortinger & Burns, 2015).