Lee Hye-Ok, Lee Jung-Joo
Nutrition Team, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea.
Clin Nutr Res. 2015 Jan;4(1):63-7. doi: 10.7762/cnr.2015.4.1.63. Epub 2014 Dec 8.
In this case study, the process of nutritional diagnosis and intervention conducted at a hospital on a malnourished patient who underwent treatment for a chronic illness (chemotherapy for cancer treatment) was recorded. The patient received his first round of chemotherapy for colorectal cancer, and then a second round after the cancer metastasized to the liver. The patient was malnourished and had experienced weight loss (17% loss in the most recent 3 months) due to side effects of chemotherapy including stomatitis, nausea, and vomiting. Nutritional diagnosis and intervention via the nutrition care process were implemented through two screening rounds, and the quantity of oral intake increased from 28% to 62% of the recommended daily intake. The patient required continuous monitoring and outpatient care after hospital discharge. It is speculated that if a more active patient education and dietary regimen with respect to chemotherapy side effects had been offered after the patient's first chemotherapy cycle, it might have been possible to treat ingestion problems due to stomatitis during the second cycle of chemotherapy and prevent the weight loss. Henceforth, patients receiving chemotherapy should be educated about nutrition management methods and monitored continuously to prevent malnutrition.
在本案例研究中,记录了一家医院对一名因慢性病(癌症治疗化疗)接受治疗的营养不良患者进行营养诊断和干预的过程。该患者接受了第一轮结直肠癌化疗,癌症转移至肝脏后又接受了第二轮化疗。患者因化疗副作用(包括口腔炎、恶心和呕吐)而营养不良并出现体重减轻(最近3个月体重减轻17%)。通过营养护理流程进行的营养诊断和干预分两轮筛查实施,口服摄入量从推荐每日摄入量的28%增加到62%。患者出院后需要持续监测和门诊护理。据推测,如果在患者第一个化疗周期后提供更积极的关于化疗副作用的患者教育和饮食方案,可能有可能在第二个化疗周期治疗因口腔炎引起的摄入问题并防止体重减轻。从今往后,应向接受化疗的患者传授营养管理方法并持续监测,以预防营养不良。