定義:
本飲食是一種視患者肝臟病變的程度,而予以適當修正飲食中蛋白質、鈉、鉀含量的飲食。
目的:
提供適當的營養,使肝臟的實質細胞再生能力增強,幫助肝功能的恢復。
適用症狀:
1.慢性肝病(肝硬化)。
2.肝昏迷。
一般原則:
1. 對於初期且沒有任何水腫或腦性病變情形的病人,可給予高蛋白、低鈉的均衡飲食。
2. 對於常有肝昏迷傾向的病人,每人可供給蛋白質50公克,熱量1600大卡,一週後若有情況穩定,則可每週增加10~15公克蛋白質,直達到每公斤體重供給1公克蛋白質為止。一旦有肝性腦病變的症狀產生,應即刻將蛋白質的供給量降至每日25~35公克。如有昏迷情況產生,則不可供應蛋白質。
3. 植物性蛋白質因含有較高的支鏈胺基酸,及膳食纖維質,有利於病情的控制,可適量食用。
4. 為減輕水腫及腹水的症狀,每日應嚴格限制鈉的攝取量,每日以200~300毫克鈉為宜(請參閱限鈉飲食)。為預防水腫及腹水的發生,每日也應適當地限制鈉的攝取量,並注意水分的攝入與排出是否平衡。
5. 病人的血鉀如低於3.5毫克當量/公升時,可以10%的氯化鉀水溶液補充數日。
6. 病人如合併有食道靜脈曲張,必須注意細嚼慢嚥,並避免攝食過於粗糙、堅硬、大塊及油炸、油煎的食物(請參閱低纖維飲食)。但需注意避免便秘之發生。
7.酒精應絕對禁止。咖啡、紅茶、綠茶等可適量使用。
8.營養師應指導病人使其了解各類食物中的蛋白質含量,使其學習自我選擇與控制蛋白質的攝取量。若有神智逐漸模糊的傾向,應即刻就醫,以免延誤醫治。
9.病人如有脂瀉情形,應減少脂肪的供應量(每日30公克),並配合食用中鏈三甘油酯。
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