含乳清蛋白及難消化麥芽糊精之管灌配方對長期照護住民營養改善之研究

研究顯示長期照護機構中利用管路灌食的住民，容易因為餵食量不足、多重藥物合併使用，長期臥床及活動量不足而引起腸胃道相關副作用導致之營養狀況不佳，進而提高感染率、再住院率、死亡率及延長住院天數。本研究主要探討藉由灌食含乳清蛋白及難消化麥芽糊精之管灌營養品配方對長期照護機構住民營養改善之成效。本研究納入使用管灌餵食至少有六個月以上的受試者共30位，平均年齡約80歲。研究介入期間為8週，在營養品配方介入前後（第0週、第8週）評估血液生化值、尿液、體位、臨床症狀及餵食狀況，在介入期間受試者每日依建議熱量及灌食量，灌食5餐營養品配方。介入8週後，受試者的BMI有極顯著增加（p＜0.01），而皮下脂肪厚度、中臂圍、小腿圍則沒有顯著差異。在生化分析方面，餵食8週營養品配方後，血清白蛋白有顯著增加（p＜0.05），三酸甘油酯、總膽固醇、鉀沒有顯著變化，而血糖有顯著下降（p＜0.01），鈉有下降但沒有統計上差異。分析灌食記錄得知，灌食8週營養品配方，受試者的實際熱量攝取量與灌食前沒有顯著差異，但碳水化合物的攝取量有顯著增加，而蛋白質的攝取量則有顯著下降（p＜0.01）。在臨床生理症狀方面，對腸胃道功能沒有顯著影響。綜合上述，餵食含乳清蛋白及難消化麥芽糊精之管灌營養品配方，可以改善長期照護機構住民營養狀況，並有效降低血糖。

Studies show that nursing home residents accepting long term tube feeding could easily cause gastrointestinal problems because of insufficient supplementation. The main objective of this study was to understand the effect of tube feeding formula containing whey protein and resistant maltodextrin on the improvement of nutritional status of nursing home residents. 30 subjects (average 80 years old) with at least six months of tube feeding history were included in this study. The experimental period was 8 weeks. Biochemical analyses, physiological symptoms and dietary condition were measured before and after 8 weeks of intervention of tube feeding. Results showed that very significant difference was found in anthropometric measurements including body mass index(BMI) (p＜0.01), but no significant difference was found in triceps skinfold、mid-upper-arm circumference and calf circumference.Serum albumin was significantly increased (p＜0.05) and blood glucose was significantly decreased (p＜0.05). Serum triglycerol, serum cholesterol and potassium showed no difference.Sodium was decreased but no statistical difference. Dietary record showed that the daily energy intake was not statistically significant, but the intake of carbohydrate was significantly increased and protein was significantly decreased after the intervention (p＜0.01). The effect on distention, poor digestion, constipation and diarrhea were not found. In conclusion, the intervention of this tube feeding formula could greatly improve the nutritional status and decrease the blood glucose.