肌少型吞嚥困難患者的營養策略

Nutritional Strategies for Patients With Sarcopenic Dysphagia

人口老化是已開發國家普遍面臨的挑戰，臺灣也將於2025年邁入超高齡社會。在高齡族群中，肌少症和吞嚥困難是普遍存在的問題。這些情況容易提高住院、失能和死亡的風險。肌少型吞嚥困難是近年來引起廣泛關注的新興議題，指的是由於全身肌肉及與吞嚥相關的肌肉減少而導致的吞嚥困難。透過積極的復能計畫和營養策略，有很大的可能性讓這類患者恢復原本的吞嚥功能。營養策略包括選擇合適的營養評估工具，進行營養評估，提供具體的營養支持，包含熱量建議每公斤體重30-38大卡，蛋白質1.0-1.5公克，並確保食物營養密度足夠，依據個別的吞嚥能力，提供合宜的吞嚥困難飲食。定期檢視病患狀況，調整營養計畫，以確保患者能夠安全且有效率地由口進食，降低相關併發症的風險。

Aging poses a significant challenge in developed nations, with Taiwan projected to transition into a super-elderly society by 2025. Among the aging demographic, the prevalence of sarcopenia and dysphagia contributes to an elevated susceptibility to increased hospitalization, disability, and mortality risks. A focal point of recent attention is sarcopenic dysphagia, characterized by swallowing difficulties stemming from a systemic reduction in muscle mass and impairment of muscles involved in the swallowing process. Through a comprehensive rehabilitation regimen and targeted nutritional interventions, there exists the potential for patients to recover their swallowing functionality. Nutritional strategies encompass the provision of ample and specifically tailored nutritional support, energy targeting 30-38 Kcal/kg/day and 1.0-1.5 g/kg/day of protein is recommended. This approach ensures nutrient density without excessive bulk in food items. Simultaneously, the dietary plan should align with the individual’s swallowing capacity. Regular assessments and adjustments to the nutritional program are imperative, contributing to the secure facilitation of oral intake and mitigating associated complications.