早期胃管留置对合并吞咽障碍脑卒中患者预后的影响  

Early nasogastric tube effect on the prognosis of stroke patients with dysphagia

作　　者：张谊平[1] 王大荣[1] 

机构地区：[1]江苏省泰州市第三人民医院康复医学科,江苏高港225321

出　　处：《中国现代医生》2014年第34期151-153,共3页China Modern Doctor

基　　金：江苏省泰州市市级社会发展项目(TS2013017)

摘　　要：目的探讨早期胃管留置对合并吞咽障碍脑卒中患者并发症及预后的影响。方法 2012年4月～2013年10月收治脑卒中伴吞咽功能障碍患者98例,随机分为治疗组和对照组。治疗组予以早期胃管留置、神经科常规治疗和护理;对照组予以神经科常规治疗和护理。观察患者发病1周、2周时卒中相关性肺炎、电解质紊乱发生率及血浆白蛋白指标以及发病初及发病1个月日常行为能力评定。结果发病1周时治疗组患者卒中相关性肺炎、电解质紊乱发生率低于对照组（P〈0.05）,继续治疗1周后卒中相关性肺炎的好转率高于对照组（P〈0.05）。发病1周对照组患者白蛋白指数低于对照组（P〈0.05）,发病2周时对照组患者白蛋白指数远低于对照组（P〈0.01）。发病2周时两组白蛋白指数均有下降,对照组差异有统计学意义（P〈0.05）。发病后1个月治疗组患者日常行为能力优于对照组（P〈0.05）。结论早期留置胃管可大大减少卒中相关性肺炎、电解质紊乱、营养不良的发生率,有助于患者的远期功能康复。Objective To investigate the effect of early nasogastric tube for stroke patients with dysphagia complications and prognosis of brain. Methods From April 2012 to October 2013 98 cases treated with stroke patients with swallowing dysfunction were randomly divided into treatment group and control group. The treatment group was given early nasogastric tube, neurological routine treatment and nursing. The control group was given routine treatment and nursing.In the two groups of patients the incidence of stroke associated pneumonia,electrolyte disorder incidence rate,plasma albumin index and the score of modified Barthel index（MBI） were compared. Results After 1 week stroke associated pneumonia incidence rate and electrolyte disorder incidence rate of treatment group were lower than those of control group,the difference was statistically significant（P〈0.05）. The stroke associated pneumonia better rate of treatment group was higher than that of control group after 2 weeks,the difference was statistically significant（P〈0.05）.The plasma albumin index of control group was significantly lower than that of treatment group（P〈0.05） 2 weeks later.1 month later the score of MBI were significantly different between treatment group and control group（P〈0.05）. Conclusion Stroke associated pneumonia,electrolyte disorder and malnutrition incidence in stroke patients may be reduced by treatment with early nasogastric tube,and it may be helpful for rehabilitation.

关 键 词：吞咽障碍 胃管留置 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]