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研究生(外文):Szu-Jung Lee
論文名稱(外文):The relevance between nutritional intervention on cancer patients’ nutritional status and their continual process of accepting anti-cancer treatment
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癌症病人因疾病分期及治療過程會造成營養的流失及攝食量減少,易有營養不良情況發生。研究指出利用病人主觀性整體營養評估表(Patient-Generated Subjective Global Assessment,PG-SGA)進行早期篩檢、評估癌症病患營養狀況,以作為營養需求之依據。本研究於台中某醫學中心化學治療室進行,受試者179位癌症病人,經由營養介入,包括:營養師針對初次到院進行抗癌治療之病人進行營養評估及飲食指導、針對體重及進食量減少之營養不良高風險病人進行持續追蹤及問題解決、如有進食障礙,教導腸道供給營養品使用、灌食配方製作及正確食用量,以提升癌症病人營養狀況。結果發現,癌症病人經由營養衛教介入後一個月,在醣類、脂肪、蛋白質及熱量攝取上顯著增加,進一步探討營養攝取與營養指標相關性,發現醣類、脂肪、蛋白質及熱量之攝取與體重顯著正相關;醣類及熱量攝取與血紅素顯著正相關,另外針對衛教前營養攝取及營養指標狀況較差之癌症病人,營養衛教介入有助於其營養指標—白血球及持續接受化學治療指標—嗜中性白血球之維持。本結論,經由營養衛教介入可增加營養攝取狀況,進而改善白血球及化學治療指標。

Due to cancer stages and harsh treatment process, cancer patients lose nutrients and reduce dietary intake, which easily causes malnutrition. The relevant researches indicate that Patient-Generated Subjective Global Assessment (PG-SGA) can be a tool to do early screening and assess nutritional status of cancer patients. In this study, subjects are 179 cancer patients who accept chemotherapy in a medical center’s chemotherapy room in Taichung. These cancer patients are given nutritional interventions as follows, including nutritional assessment and dietary guidance on those who accept anti-cancer treatment for the first time and dietitian’s regular follow-up and problem-solving on those who are high-risk malnutrition patients due to body weight loss and factors reducing dietary intake. If some of cancer patients have oral intake problems, dietitian will give nutritional education about enteral nutrition through intestinal supply, or about formula preparation as well as proper consumption through tube feeding in order to improve their nutritional status. The study found that those cancer patients had significant increase in carbohydrate, fat, protein and calorie intake through nutritional intervention and education. When further discussion is about the relevance between nutritional intake and nutritional indicators, it’s found that carbohydrate, fat, protein and calorie intake are highly positive correlated with body weight. It’s also found that carbohydrate and calorie intake have significant correlation with hemoglobin. In conclusion, cancer patients can improve nutrition intake through nutritional interventions, which further make nutritional indicators better.

誌 謝 I
中文摘要 II
第一章 緒 論 1
第一節 研究背景 1
第二節 研究動機 2
第三節 研究目的 3
第二章 文獻探討 4
第一節 癌症流行病學、診斷及治療 4
第二節 治療副作用 11
第三節 營養篩選及評估 14
第四節 飲食評估方法簡介 16
第五節 營養支持 17
第三章 研究方法 18
第一節 研究設計 20
第二節 研究流程 21
第三節 研究進行方法 22
第四節 統計方法 24
第四章 研究結果 25
第五章 討 論 41
第六章 參考文獻 43
附錄 48

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