克隆氏症病人之營養照護

Nutritional Intervention for Patient with Crohn’s Disease

過去10幾年來，亞洲罹患發炎性腸炎的人口持續增加，其中又以克隆氏症在相關併發症及營養不良的情形尤為嚴重。個案為克隆氏症27歲男性，長期於門診接受藥物治療;此次急性發作，伴隨嚴重腹痛及體重減輕，住院進行內科治療及改善營養狀況，並評估手術必要及可行性。住院期間營養師根據個案臨床症狀，提供階段性營養建議，飲食型態由全靜脈營養搭配流質飲食，進展至全由口進食軟質飲食，且熱量及蛋白質皆達建議量；體重由4 l.8 kg上升至45.4 kg，白蛋白由3.3 g/dL增加至3.8 g/dL。此案示範了透過跨團隊的營養介入，可改善克隆氏病人的營養狀況及病況。

"Incidences of inflammatory bowel diseases (IBD) in Asia has risen over the past decade. Crohn’s disease (CD) had a more complicated course, with a higher incidence of gastrointestinal complications and malnutrition. This case was a 27-year-old male with CD. He regularly followed up in outpatient department with medication control. Due to severe lower abdominal pain and body weight loss, he was admitted for medical treatment, improving nutrition status and possible surgery evaluation. During the hospitalization, Nutrition recommendation according to patient’s clinical and nutrition status was provided by dietitian. Dietary pattern was modified from total parenteral nutrition with liquid diet to regular solid diet in phase. Energy and protein supply met recommendation. His body weight was increased from 41.8 kg to 45.4 kg and serum albumin level was improved from 3.3 g/dL to 3.8 g/dL. In summary, diet education for IBD patients is important and a multidisciplinary team approach for intensive nutrition intervention can improve nutrition status as well as the clinical outcome for CD patients."