癌症化學及放射線治療副作用的營養照護

10.6666/ClinMed.201812_82(6).0134

蔡旻君；邱哲琳；楊雀戀

癌症(cancer) ； 黏膜炎(mucositis) ； 腹瀉(diarrhea) ； 味覺異常(dysgeusia)

臨床醫學月刊

82卷6期（2018 / 12 / 28）

730 - 733

繁體中文

癌症的治療方法中以化學治療及放射線治療最常伴隨著多種副作用，如黏膜炎、腹瀉及味覺改變等，進而造成攝食量與體重減少的營養問題，嚴重時可能造成治療中斷及影響生活品質。化學治療引起黏膜炎的原因為加速黏膜細胞凋亡導致上皮細胞缺失或壞死，因此也可能增加腹瀉的發生；放射線治療引起的黏膜炎，起因於輻射累積引致一系列發炎反應，因照射部位不同，可能造成口腔黏膜炎或腹瀉的發生，至於味覺改變的發生機制與預防尚需更多研究佐證。不同的治療副作用，有不同營養照護目標及介入方法，一般改善黏膜炎為以每公斤體重達熱量35大卡與蛋白質1.5公克作為營養介入目標；對同步放化學治療的頭頸癌病人可服用麩醯胺酸以改善口腔黏膜炎；化學治療前補充ω-3脂肪酸可減少腸胃黏膜炎及腹瀉的發生。放射線治療誘發的腹瀉可補充麩醯胺酸減輕症狀。味覺方面已證實可透過飲食營養諮詢、調整飲食攝取足夠營養素，以改善長期的味覺改變問題。

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