特集名 | 合併症を伴った維持透析患者の栄養管理 | |
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題名 | 内科系慢性疾患 (2) 脳卒中・脳血管障害 | |
発刊年月 | 2007年 11月 | |
著者 | 渡辺 美鈴 | 脳血管研究所美原記念病院栄養科・管理栄養士 |
著者 | 谷崎 義生 | 脳血管研究所美原記念病院救急部 |
【 要旨 】 | 脳卒中では,その病期により栄養管理の目的が異なる.急性期には疾患そのものの治療が,亜急性期にはリハビリテーションの円滑な実施が,慢性期には再発のリスクファクターである生活習慣病の改善がそれぞれ重要な目的となる.脳卒中では,25 - 50 %の患者に一過性の摂食・嚥下障害が出現する.経腸栄養の早期開始は,合併症の予防やリハビリテーションの進行などを通して,後遺症の軽減や早期退院に大切な役割を果たす.脳卒中を合併した維持透析患者の栄養管理は,慢性期の栄養管理に該当する.本稿では経腸栄養を中心とした栄養管理について概説した. |
Theme | Nutritional Managements for Maintenance Dialysis Patients with Clinical Complications | |
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Title | Nutritional treatment for hemodialysis patients with stroke | |
Author | Misuzu Watanabe | Dietician, Institute of Brain and Vessels, Mihara Memorial Hospital |
Author | Yoshio Tanizaki | Department of Emergency Medicine, Institute of Brain and Vessels, Mihara Memorial Hospital |
[ Summary ] | Nutritional treatment for patients with stroke is different according to the course of their disease processes. In the acute phase, treatment of stroke is the target goal. In the subacute phase, acceleration of rehabilitation is important. In the chronic phase, treatment of recurrence risk factors, such as metabolic syndrome, is a problem which must be resolved. Incidence of transient swallowing disturbances is 25 % - 50 % in stroke patients. Beginning parenteral nutrition within 3 days after onset plays an important role in shortening hospitalization by preventing complications and accelerating rehabilitation. Nutritional treatment for hemodialysis patients with stroke is compatible with treatment for chronic phase stroke patients. An outline for parenteral nutritional treatment for dialysis patients with stroke is described. |