脑卒中重度吞咽障碍患者经鼻饲和胃造瘘的康复效果对比  

Clinical Effect Contrast of the Nasogastric Feeding (NGF) and Percutaneous Endoscopic Gastrostomy (PEG) for Post-stroke Patients with Severe Dysphagia

作　　者：张垣[1] 邵蓓[2] 

机构地区：[1]温州医科大学附属第一医院神经内科,温州325000 [2]温州医科大学神经内科

出　　处：《数理医药学杂志》2017年第1期1-4,共4页Journal of Mathematical Medicine

摘　　要：目的:比较脑卒中重度吞咽障碍患者鼻饲和胃造瘘肠内营养的效果。方法:依据病情将脑卒中后重度吞咽功能障碍共40例患者分为两组,一组20例行经皮内镜下胃造瘘术(percutaneous endoscopic gastrostomy,PEG),另一组20例行鼻胃管喂养(nasogastric feeding,NGF)。给予相同肠内营养液及辅食,比较两组患者体重指数,肺部感染发生次数,消化道出血发生率及平均住院费用。结果:PEG组治疗后体重指数(19.2±0.29),肺部感染发生(1.2±0.6)次,消化道出血发生率10%,平均住院费用(13590±2562)元/月;NGF组治疗后体重指数(18.6±0.38),肺部感染发生率(4.2±0.7)次,消化道出血发生率25%,平均住院费用(16410±3941元)/月。PEG组在维持患者营养,防治并发症及减少住院费用方面均优于NGF组(P<0.05)。结论:PEG较NGF可以更好维持患者营养状态,减少并发症的发生及节省住院费用,对于卒中后重度吞咽障碍的患者应优先选择PEG。Objective： To compare the clinical effect endoscopic gastrostomy（PEG） for post-stroke patients of the nasogastric feeding （NGF） and percutaneous with severe dysphagia. Methods： Accorded the state of illness,all post-stroke patients with severe dysphagia were divided into two group （20 cases in each group ）.Patients in one group were treated with NGF,and patients in the other group were treated with PEG. All patients were fed with same nutrient fluids and other assisted food, then compared the body mass index, incidence of pulmonary infections and hemorrhage of digestive tract,and average hospitalization expenses of two groups.Results. After treatment, the body mass index, incidence of pulmonary infection and hemorrhage of digestive tract,and average hospitalization expenses of PEG group was （19.2±0.29）, （1.2±0.6）, 10% and （13590±2562）yuan/month respectively,while those of NFG group was （18.6±0.38）, （4.2±0.7）, 25% and （ 16410 ± 3941 ） yuan/month respectively. The maintenance level, incidence of complications and average hospitalization expenses of PNG group were better than those of NFG group （P 〈0.05）.Conclusion： Compared with NFG,the PNG can better maintain the nutritional status of patients,and reduce the average hospitalization expenses and the incidence of complications,which is a better choice for post-stroke patients with severe dysphagia.

关 键 词：脑卒中 吞咽障碍 经皮内镜下胃造瘘术 鼻饲 肠内营养 

分 类 号：R743.3[医药卫生—神经病学与精神病学]