吞嚥困難個案於飲食質地調整與市售增稠劑之應用狀況

Application of Texture Modification Diet and Commercial Thickener for Patients with Dysphagia

臨床醫療對吞嚥困難的定義為「難以將食物以及液體由口腔移動至胃部」。原因可分為兩大類，一是因年齡老化造成的功能退化，二是因中風、腦部受傷、口腔或食道癌、癌症治療、神經肌肉病變等疾病所造成。吞嚥困難可能導致的問題包括：營養不良、缺水、異物進入肺部、吸入性肺炎及其他嚴重的呼吸問題甚至影響生活品質，因此，臨床上會供應不同階段的質地調整飲食；另外，常使用增稠劑改變液體的黏度及流速，幫助吞嚥困難病人飲用液體時的安全性。本篇文章將近年來國際上對於增稠劑以及吞嚥困難飲食於臨床上應用以及相關研究做統整，並結合臨床上照顧吞嚥困難病人的經驗，希望可藉由此進一步了解如何由飲食方面調整，增進吞嚥困難老人的營養狀況以及水份攝取狀況。

Dysphagia is defined as difficulty in moving food and liquid from mouth to stomach. The most common causes of dysphagia are: 1) aging: loss of strength and range of motion with advancing age. 2) illness: stroke, brain injury, oral and esophageal cancer, cancer treatment-related and others neuromuscular disorders. The consequences of dysphagia include malnutrition, dehydration, aspiration, asphyxiation and negative impact on quality of life. Thus, different stages of texture modified diet have been used to take care of dysphagia patients and thickeners are used to modify liquid viscosity and flow velocity in order to improve swallowing safety. The propose of the following article is to review recent researches about clinical use of thickeners and dysphagia diet, combine the experience about taking care of dysphagia patients in order to understand how to improve nutrition status and fluid intake of dysphagia elderly by diet modification.