연하장애 암환자의 영양지원과 경구섭취 이행
Nutrition Support and Transition to Oral Intake in Cancer Patients with Dysphagia
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Dysphagia in cancer patients are mainly caused by brain tumor, head and neck cancer and esophageal cancer. Also both paralytic and mechanical dysphagia may occur with a high rate of malnutrition that has been reported. In cases when oral ingestion is impossible for a long time due to cancer treatments including surgery, decision should be made on if it may be an indication of nutrition support or not. In the case of nutrition support having to be initiated, the route and method of nutrition support must be determined. During enteral nutrition supply, we should predict and monitor probable complications according to the feeding rate depending on the change of patient’s conditions, and if required, medication assistances may be needed. Through VFSE (Video fluoroscopic swallowing exam), when the transition to oral intake is carried out, nutritional supply should be monitored to plan the tapering and discontinuation of nutrition support. Since the effort of international standardization regarding dysphagia stage has been sustained, it is necessary to make the viscosity- and texture-based dysphagia diet standardization on the ground of clinical evidence in Korea, too.
Abstract
Dysphagia in cancer patients are mainly caused by brain tumor, head and neck cancer and esophageal cancer. Also both paralytic and mechanical dysphagia may occur with a high rate of malnutrition that has been reported. In cases when oral ingestion is impossible for a long time due to cancer treatments including surgery, decision should be made on if it may be an indication of nutrition support or not. In the case of nutrition support having to be initiated, the route and method of nutrition support must be determined. During enteral nutrition supply, we should predict and monitor probable complications according to the feeding rate depending on the change of patient’s conditions, and if required, medication assistances may be needed. Through VFSE (Video fluoroscopic swallowing exam), when the transition to oral intake is carried out, nutritional supply should be monitored to plan the tapering and discontinuation of nutrition support. Since the effort of international standardization regarding dysphagia stage has been sustained, it is necessary to make the viscosity- and texture-based dysphagia diet standardization on the ground of clinical evidence in Korea, too.
참고문헌 (27)
- Koera Dietetic Association, "Manuel of medical nutrition therapy", pp.458~466 (2008), MEDrang
- 김정길, "연하장애 환자에 대한 점도조절식이의 순응도 조사", 대한연하장애학회지, 4(2), pp.60~67 (2014), 대한연하장애학회
- Muhle P, "Age-related changes in swallowing. Physiology and pathophysiology", Nervenarzt, 86, pp.440~451 (2015)
- Rainer Wirth, "Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting", Clin Interv Aging, 23, pp.189~208 (2016)
- Rofes L, "Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly", Gastroenterol Res Pract (2011)
- Moses FM, "Squamous cell carcinoma of the esophagus", Gastroenterol Clin North Am, 20, pp.703~716 (1991)
- Maureen B. Huhmann, "Perioperative nutrition support in cancer patients", Nutrition in Clinical Practice, 27, pp.586~592 (2012)
- Bistrian BR, "Cellular immunity in adult marasmus", Arch Intern Med, 137, pp.1408~ (1977)
- Studley HO, "Percentage of weight loss. A basic indicator of surgical risk in patients with chronic peptic ulcer", JAMA, 106, pp.458~ (1936)
- "American Gastroenterological Association medical position statement:parenteral nutrition", Gastroenterology, 121, pp.966~969 (2001)
- Maureen B. Huhmann, "Nutrition support in surgical oncology", Nutrition in Clinical Practice, 24, pp.520~526 (2009)
- C. Odelli, "Nutrition support improves patient outcomes,treatment tolerance and admission characteristics in oesophageal cancer", Clinical Oncology, 17, pp.639~645 (2005)
- Matthew Bower, "Nutritional support with endoluminal stenting during neoadjuvant therapy for esophageal malignancy", Ann Surg Oncol, 16, pp.3161~3168 (2009)
- Bozzetti F, "Rationale and indications for preoperative feeding of malnourished surgical cancer patients", Nutrition, 18, pp.953~959 (2002)
- Tomoko Takesue, "Prospective randomized trial of enteral nutrition after thoracoscopic esophagectomy for esophageal cancer", Ann Surg Oncol, 22, pp.S802~S809 (2015)
- Dvir D, "Computerized energy balance and complications in critically ill patients: an observational study", Clin Nutr, 25, pp.37~44 (2006)
- Casaer M, "Early versus late parenteral nutrition in critically ill adult patients", N Engl J Med, 365, pp.506~517 (2011)
- M. Molly McMahon, "A.S.P.E.N. Clinical guidelines: nutrition support of adult patients with hyperglycemia", Journal of Parenteral and Enteral Nutrition, 37, pp.23~36 (2013)
- Mary Marian, "The A.S.P.E.N Adult nutrition support core curriculum", pp.201~ (2007), American society for parenteral and enteral nutrition
- 류주석, "연하장애 식이 처방의 원칙과 고려할 점: 점도, 크기, 질감, 맛, 온도", 대한연하장애학회지, 4(2), pp.37~44 (2014), 대한연하장애학회
- Leiter A, "Compliance of geriatric dysphagic patients with safe-swallowing instructions", J Med Speech Lang Pathol, 4, pp.289~299 (1996)
- National Dysphagia Diet Task Force, "National dysphagia diet: standardization for optimal care" (2002), American Dietetic Association
- Julie A. Y. Cichero, "The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative", Curr Phys Med Rehabil Rep, 1, pp.280~291 (2013)
- Ben Hanson, "A review of diet standardization and bolus rheology in the management of dysphagia", Curr Opin Otolaryngol Head Neck Surg, 24, pp.183~190 (2016)
- 박진우, "포크 테스트: 연하곤란 치료에 있어 새로운 점도 측정방법 및 기준", 대한연하장애학회지, 4(1), pp.18~22 (2014), 대한연하장애학회
- Varlaan S, "A low caloric, leucine-enriched whey protein oral nutritional supplement affects body composition in sarcopenic older adults", European geriatric medicine, 6S1, pp.S32~S156 (2015)
- 윤화영, "노화에 따른 구강기 연하 장애 환자의 식사 조절", 대한연하장애학회지, 6(1), pp.20~25 (2016), 대한연하장애학회