臨牀消化器内科 Vol.21 No.11(7)


特集名 経皮内視鏡的胃瘻造設術 (PEG) の実際
題名 経腸栄養剤の投与法について
発刊年月 2006年 10月
著者 津川 信彦 健生五所川原診療所
【 要旨 】 経腸栄養剤選択時に検討すべき項目がある.投与カロリー,水分追加量,蛋白必要量,ビタミン・ミネラル,微量元素などである.臨床的微量元素欠乏症の報告もあり,モニタリングが必要である.標準的経腸栄養剤は,薬事法に基づく胃瘻経管適応の医薬品経腸栄養剤では半消化態栄養剤と消化態栄養剤がある.食品衛生法に基づく濃厚流動食では「第6次改定日本人の栄養所要量」以後に準拠したものが推奨される.栄養剤の投与法の実際は施設の看護マニュアルに基づき行われている.最近では液体栄養剤の問題点を克服すべく経腸栄養剤固形化が試みられ,胃食道逆流が軽減の報告がある.投与法関連の合併症には種々の代謝性合併症があり,注意が必要である.
Theme Percutaneous Endoscopic Gastrostomy (PEG)
Title Administering Method of the Standard Formula of Enteral Nutrition
Author Nobuhiko Tsugawa Division of Gastroenterology, Department of Internal Medicine, Kenseigosyogawara Clinic
[ Summary ] One item that should be examined when standard formulas are selected is administeration of calories. It is a water addition amount, necessary amounts of protein, vitamins, minerals, and trace elements, are necessary. It is also reported on the clinical trace element deficiency diseases, and do it monitor it. The standard formula of an adjustment based on drug legislation which includes the polymeric formula and the oligomeric formula established by the standards for nutritional medicine. Thick liquid diet in accordance with after nourishment place main point amount of the sixth revision Japanese is recommended in the thick liquid diet based on Food Sanitation Law. It is done about the dispensing method of based on the nursing manual of facilities. The solid of the thick liquid diet making is tried to overcome the problem of the liquid formula recently, and the gastroesophageal reflux is and it reports on the reduction. Complication related to the dispensing method includes various metabolic complications and it is necessary to note it.
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