護理師照護一位急性胰臟炎病人。在急性期應提供哪項飲食指導？
The nurse is caring for a client with acute pancreatitis. Which dietary instruction should the nurse provide during the acute phase?
- AStrict NPO (nothing by mouth) status✓ 正解嚴格禁食 (NPO, nothing by mouth) 狀態
- BHigh-carbohydrate, low-fiber diet高碳水化合物、低纖維飲食
- CSmall, frequent liquid meals少量多餐的流質飲食
- DLow-fat, high-protein diet低脂、高蛋白飲食
急性胰臟炎（Acute pancreatitis）是一種胰臟的急性發炎反應，通常由膽結石或酒精濫用引起。當胰臟發炎時，胰臟細胞會釋放消化酶，這些酶本應在小腸中活化以消化食物，但在胰臟內活化則會開始「自我消化」胰臟組織，導致劇烈疼痛、發炎和組織損傷。為了減輕胰臟的負擔，停止其分泌消化酶，並促進胰臟的休息與恢復，嚴格的禁食（NPO, nothing by mouth）是急性期最核心的治療措施之一。透過禁食，可以減少胰臟的刺激，降低酶的釋放，從而緩解疼痛和發炎反應，為胰臟的修復創造條件。
Acute pancreatitis is an acute inflammatory response of the pancreas, most often caused by gallstones or alcohol abuse. When the pancreas becomes inflamed, pancreatic cells release digestive enzymes that should be activated in the small intestine to digest food; activation within the pancreas itself causes autodigestion of pancreatic tissue, resulting in severe pain, inflammation, and tissue damage. To reduce the workload on the pancreas, stop digestive enzyme secretion, and promote pancreatic rest and recovery, strict NPO (nothing by mouth) status is one of the most central treatments in the acute phase. By withholding food, pancreatic stimulation and enzyme release are decreased, easing pain and inflammation and creating conditions for pancreatic repair.
急性胰臟炎的急性期處理原則在美國和台灣的臨床實踐中基本一致，都強調嚴格禁食（NPO）作為核心治療措施，以讓胰臟休息。對於水分和營養的補充，兩地都會優先考慮靜脈輸液，並在必要時提供全靜脈營養（TPN）。在疼痛控制方面，美國的臨床指引可能更傾向於早期使用鴉片類止痛劑，而台灣則可能更謹慎，會先評估其他止痛方式。然而，NPO 的重要性在兩地皆是無庸置疑的。