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研究生:陳夢潔
研究生(外文):Meng-Chieh Chen
論文名稱:胃繞道手術後病患飲食行為與營養問題之研究
論文名稱(外文):The Research of Diet Behavior and Nutrition Problem of Patients after Gastric Bypass SurgeryThe Research of Diet Behavior and Nutrition Problem of Patients after Gastric Bypass Surgery
指導教授:王維康王維康引用關係
指導教授(外文):Wei-Kang Wang
學位類別:碩士
校院名稱:元智大學
系所名稱:管理研究所
學門:商業及管理學門
學類:企業管理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:89
中文關鍵詞:病態性肥胖飲食頻率腹腔鏡胃繞道手術營養問題
外文關鍵詞:Morbid obesity、Dietary frequency、Laparoscopic Gastric Bypass Surgery、Nutrition problem
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胃繞道手術後病患飲食行為及營養問題之研究
研究生:陳夢潔 指導教授:王維康 博士
元 智 大 學 管 理 研 究 所
摘要
〝萬病肥為首〞,肥胖已經成為21世紀各種疾病的源頭。除了引起各式慢性疾病之外,肥胖的級數也進入到病態性肥胖甚至是超級肥胖的門檻,對於動輒上百公斤的病態型肥胖病人來說,過量的體重嚴重影響到身體健康及生命安全,目前安全性較高、手術時間較短、維持效果最長的腹腔鏡胃繞道手術已經成為外科減肥手術最好的選擇之ㄧ。
巨量減重大幅的改善病患術後的生活品質及健康狀況,然而手術後微營養素缺乏的問題也逐一出現,本研究利用飲食頻率問卷與血液生化檢驗值:做分析比較,分別以描述性統計、T-考驗、皮爾森相關及逐步迴歸等統計方法,目的在探討病患術後飲食頻率及飲食頻率與缺鐵性貧血、營養不良及骨質流失等營養問題之相關性。
研究結果顯示胃繞道病患術後血紅素、血清白蛋白及血清鈣值與明顯的低於術前值,而副甲狀腺素則高於術前值,皆達到顯著性差異。飲食頻率中以五穀根莖類及深綠色蔬菜的頻率最高,每週攝食頻率4-6次以上;以高蛋白飲品或市售均衡配方、現打蔬菜汁、鈣片、鐵劑及喝酒的飲食頻率較低,為每月2-3次以下。
在生化檢驗值與飲食頻率的部份,血清白蛋白與綜合維生素呈負相關,血紅素則與高蛋白飲品及市售均衡配方、現打蔬菜汁及運動頻率呈正相關;血清鈣與綜合維生素成負相關與運動頻率則呈正相關;副甲狀腺素與含糖飲料、含咖啡因飲料呈正相關。
因此,為了避免骨質流失、營養不良及缺鐵性貧血等營養方面的問題,在術後營養衛生教育方面,除了給予病人均衡飲食的觀念外,應建議多攝取高蛋白食物或飲品、現打蔬菜汁及增加運動,盡量避免含糖飲料及含咖啡因飲品,補充綜合維生素時應同時注意均衡的營養攝取。
The Research of Diet Behavior and Nutrition Problem of Pations
after Gastric Bypass Surgery.


Student:Meng-Chieh Chen Advisors:Dr.Wei-Kang Wang .


Submitted to Graduate School of Management
Yuan Ze University


ABSTRACT

“Many diseases come from the obesity.” Obesity has become the source of various diseases in the 21st century. In addition, it caused a wide range of chronic diseases. With the rise in the proportion of obese persons, status of obesity became morbid obesity and even the super- obesity. For those patients weight over hundreds of kilograms with morbid obesity, excessive body weight has a serious impact on their health or even safety. Medical intervention is not a quick solution. Currently laparoscopic gastric bypass surgery with higher safety, shorter operation time, and maximum effect is the best weight lost surgery available.

The result of massive weight loss significantly improved postoperative quality of life of patients and health status. But it also brings patients to the problems of micronutrient deficiencies. This study investigated post gastric bypass patients using dietary frequency questionnaire and biochemical test value in serum albumin, hemoglobin, serum calcium and parathyroid hormone to analysis. Statistical analysis methods include descriptive statistics, T-test, Pearson correlation and stepwise regression analysis. The purpose was to explore postoperative patient’s dietary frequency and its relationship with anemia of iron deficiency, malnutrition and bone loss, such as the relevance of nutrition.

The analysis results showed that post gastric bypass patient’s hemoglobin, serum albumin and serum calcium values of are significantly lower than those of patient’s preoperative value, and parathyroid hormone were higher than that of patient’s preoperative values, significant differences were reached. Eating grains, tubers, roots and in green vegetables got the highest dietary frequency, which reached 4-6 times a week or more. High-protein drinks or commercial formulation, mixed vegetable juice, calcium, iron and alcohol was in lower frequency, which was 2-3 times per month.

The following analysis results showed the relationship between the value of biochemical tests and the dietary frequency. Comprehensive vitamin and serum albumin(Alb)was negatively correlated. Hemoglobin (Hb)and high-protein drinks or balanced formula was positive correlated. Dietary frequency of fresh vegetable juice and sports has a positive correlation with hemoglobin(Hb). Serum calcium(Ca)was negatively correlated with synthesis of vitamin, and was positively correlated with the movement frequency. Parathyroid hormone(PTH-i)and sugary beverages, soft drinks containing caffeine were positively correlated.

Therefore in order to avoid bone loss, malnutrition, anemia of iron deficiency and other nutritional problems, nutrition and health education in patients are very important. In addition to strengthen patients’ concept of a balanced diet, patients should also be encouraged of high-protein intake of food or drinks, vegetable juices and increase exercise. Try to avoid caffeinated beverages and sugary drinks. At the same time in the supplementary Vitamins should also pay attention to balanced nutrition.
目錄
書名頁 i
論文口試委員審定書 ii
授權書 iii
中文摘要 iv
英文摘要 v
誌謝 vii
目錄 viii
表目錄 x
圖目錄 xii
第ㄧ章、緒論 1
1.1、研究動機與背景 1
1.2、研究目的 3
1.3、名詞解釋 3
1.4、研究流程 4
第二章、文獻探討 5
2.1、肥胖之定義 5
2.2、肥胖之盛行率 10
2.3、肥胖之外科療法 10
2.4、胃繞道減重手術後之營養問題 14
2.5、其他相關營養因子 21
第三章、研究方法 25
3.1、研究對象 25
3.2、研究設計 25
3.3、研究工具 26
3.4、統計分析方法 36
3.5、研究假說與架構 37
第四章、研究結果分析 39
4.1、受試者基本資料 39
4.2、生化檢驗值 43
4.3、飲食頻率問卷分析 48
4.4、生化檢驗值與飲食頻率之相關性 65
4.5、多元逐步迴歸分析 68
第五章、結論與建議 70
5.1、結論與討論 70
5.2、研究限制 76
5.3、研究建議 76
參考文獻 77
中文部份 77
英文部分 80
附錄一 研究問卷基本資料 86
附錄二 飲食頻率問卷 89
第六章、參考文獻
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