A táplálásterápia hatékonyságának vizsgálata gyulladásos bélbetegségben szenvedők gondozása során | nvestigating the efficacy of nutrition therapy for outpatients with inflammatory bowel diseases

Absztrakt: Bevezetes: A gyulladasos belbetegsegben szenvedő betegeknel koros taplaltsagi allapot alakulhat ki (gyulladasos citokinek termelődese, műtetek utani katabolizmus, beszűkult etrend miatt), amit taplalasterapia elrendelese mellett is nehez hatekonyan kezelni. Celkitűzes: A taplalasterapia hatekonysaganak vizsgalata. Modszer: Kombinalt taplaltsagi allapot rizikoszűrese (kerdőives felmeressel es bioimpedancias testosszetetel-analizissel) a vizsgalat elejen es az egyeves vizsgalati periodus vegen. Eredmenyek: A 205 betegből 82 bizonyult veszelyeztetettnek. Osszesen 44-en reszesultek hosszu tavu taplalasterapiaban, 45%-uknak elegendő volt a dietamodositas, 50% oralis es 5% parenteralis taplalast is igenyelt. A mindket meresi eljaras alapjan magas rizikojunak minősulők szama a beavatkozasokkal 31-ről 21 főre csokkent, a teljes es a zsirmentes testtomeg nyolc, illetve kilenc esetben 10%-ot meghaladoan novekedett, a tomegindexek (∆BMI: +1,3 kg/m 2 , p = 0,035, s.; ∆FFMI: +0,5 kg/m 2 , p = 0,296, n. s.) szinten novekedtek. A kutatas korlatai az alacsony esetszam es a monocentrumos bevonas. Kovetkeztetesek: Koros taplaltsagi allapot kialakulasanak magas kockazata miatt javasoljuk a kombinalt rizikoszűrest es a taplalasterapia hatekonysaganak vizsgalatara a bioimpedancias testosszetetel-analizist. Orv Hetil. 2017; 158(19): 731–739. | Abstract: Introduction: Inflammatory bowel diseases can cause malnutrition (due to inflammatory cytokine production, catabolic states after surgery, restricted diet), which is difficult to treat by nutritional therapy. Aim: Investigating the efficacy of nutrition therapy. Method: Combined malnutrition risk screening (questionnaires and body composition analysis), at the beginning of the research and after a 1 year period. Results: 205 patients were screened, 82 were malnourished. A total of 44 received nutritional intervention for 1 year, for 45% dietary management was satisfactory, 50% needed oral nutritional supplements and 5% received home parenteral nutrition. These interventions reduced the number of patients considered by both measuring methods in high risk from 31 to 21, increased the body weight and fat-free mass in 8 and 9 cases significantly (i.e., with more than 10%), and improved the indices as well (ΔBMI: +1.3 kg/m 2 , p = 0.035 s., ΔFFMI: +0.5 kg/m 2 , p = 0.296 n.s.). The main limitations of our research are the relatively low number of cases and the mono-centric involvement. Conclusions: We recommend combined malnutrition risk screening for all patients with inflammatory bowel disease due to the high risk of malnutrition, and follow-up of the malnourished patients to monitor the efficacy of their nutrition therapy. Orv Hetil. 2017; 158(19): 731–739.