吞嚥障礙者營養照護之現況與展望

Current Status and Prospects for Nutritional Care of Patients With Dysphagia

10.6142/VGHN.201803_35(1).0001

蕭玉霜(Yu-Shuang Hsiao)；葉淑惠(Shu-Hui Yeh)

吞嚥障礙 ； 營養照護 ； dysphagia ； nutritional care

榮總護理

35卷1期（2018 / 03 / 01）

2 - 9

繁體中文

在全球老化的趨勢下，因退化性疾病、中風或手術治療後造成之吞嚥障礙者也日益增加。吞嚥障礙常導致個案營養不良、脫水、體重減輕、食物逆流及吸入性肺炎，甚至增加死亡的機率。國內在吞嚥障礙的醫療處置多數採取留置鼻胃管，以灌食方式來維持個案之營養及水分補充。但是鼻胃管長期留置容易發生合併症，導致鼻子與喉部損害、慢性鼻竇炎、胃食道逆流或吸入性肺炎等，而且影響身體心像、自尊及生活品質。因此，本文彙整國際照護咀嚼吞嚥障礙病人的經驗，並探討國內咀嚼吞嚥障礙照護的現況與展望。期望依此借鏡他國經驗，為國內咀嚼吞嚥障礙個案照護提供具體建議，來降低鼻胃管留置的人數，改善吞嚥障礙者的營養照護與進食的尊嚴。

Because societies around the world have become aged, cases of dysphagia have increased due to degenerative diseases, stroke, or surgical treatment. Dysphagia often results in malnutrition, dehydration, weight loss, food reflux, or aspiration pneumonia and can lead to increased mortality. Most medical care for patients with dysphagia in Taiwan is conducted using an indwelling nasal gastric tube for maintenance of nutrition and water supplements. However, long-term use of indwelling nasal and gastric tubes can cause complications, including nose and throat damage, chronic sinusitis, gastroesophageal reflux, and aspiration pneumonia, along with affecting body image, self-esteem, and quality of life. This article presents the experiences of caring for patients with dysphagia in the United States and Japan and discusses the current status and future prospects for the care of such patients in Taiwan. By examining the experiences of developed countries, we have provided specific advice for the care of patients with dysphagia in Taiwan to reduce the use of indwelling nasal and gastric tubes, which can improve patients' nutritional care and quality of life.

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