一位急性胰臟炎病患入院。下列哪項飲食衛教最適當?
A client is admitted with acute pancreatitis. Which dietary instruction is most appropriate for the client?
- AHigh-protein, low-fat diet高蛋白、低脂飲食
- BNPO (Nothing by mouth) to rest the pancreas✓ 正解禁食(NPO)以讓胰臟休息
- CSmall, frequent high-calorie meals少量多餐之高熱量飲食
- DClear liquid diet with added fiber添加纖維之清流質飲食
急性胰臟炎(Acute pancreatitis)是一種嚴重的胰臟發炎,其發病機制與胰臟分泌的消化酵素(如脂肪酶、澱粉酶)在胰臟內部被活化並開始消化胰臟組織有關。為了讓發炎的胰臟得到休息,停止進一步的自我消化和破壞,最核心的治療原則是「禁食」(NPO, Nothing by mouth)。透過禁食,可以有效抑制胰臟分泌消化酵素,減輕胰臟的負擔,從而緩解發炎反應,促進組織修復。因此,在急性胰臟炎的初期照護中,維持病人的空腹狀態是首要的飲食指導。 隨著病情的穩定和症狀的緩解,通常會在數天後,當病人疼痛減輕、血清澱粉酶和脂肪酶恢復正常時,才開始逐漸恢復進食。恢復進食的順序通常是從清流質(clear liquids)開始,然後進展到低脂、高醣、高蛋白的半流質或固體食物。高蛋白質和高熱量的飲食(High-protein, low-fat diet, Small, frequent high-calorie meals)是在病人恢復期才考慮的,並非急性期的飲食指導。同樣地,在急性期就增加纖維素(fiber)或高熱量攝取(high-calorie meals)會增加胰臟的消化負擔,是不適當的。
In the acute phase of pancreatitis, the priority is to rest the pancreas to minimize enzyme secretion and prevent further self-digestion of pancreatic tissue. Therefore, the client should be kept NPO (nothing by mouth) to suppress pancreatic secretions and reduce inflammation. Dietary intake is gradually reintroduced only after symptoms resolve and enzyme levels normalize.