鼻饲进食对重度痴呆合并吞咽功能障碍患者的影响  

The influence of nasogastric feeding to severe dementia patients who combined with swallowing dysfunction

作　　者：王婷[1] 张欣[2] 刘振国[3] 王甜[1] 

机构地区：[1]陕西省人民医院西院一病区,西安710068 [2]陕西省人民医院神经内3科,西安710068 [3]陕西省人民医院ICU,西安710068

出　　处：《脑与神经疾病杂志》2017年第12期742-745,共4页Journal of Brain and Nervous Diseases

基　　金：陕西省自然科学基础研究计划项目(S2016YFJM1489)

摘　　要：目的探讨鼻饲进食对重度痴呆合并吞咽功能障碍患者的住院次数、病死率、住院费及照料者压力的影响。方法选择本科2013年1月-2016年1月住院的重度痴呆患者68例,其中38例给予鼻饲进食,30例未予鼻饲进食。记录所有患者留置胃管时及留置胃管后表现,喂食时间,1年内住院次数、每次住院费、死亡人数,对所有患者与分别于初诊时(0个月)及3个月后行照料者负担量表测试(ZBI)。对比两组患者进食时间,1年内住院次数、病死率、平均单次住院费,对比两组患者第0个月及第3个月ZBI评分。结果 (1)鼻饲组患者,鼻饲后出现烦躁,第1周拔管次数(4.20±2.47)·w^(-1);(2)与非鼻饲组相比,鼻饲组喂食时间明显缩短[(32.45±4.76)min VS(65.37±12.57)min,P=0.000,t=11.326],1年内住院次数[(1.92±0.97)次VS(10.25±3.55)次,P=0.000,t=12.885],病死率(10.52%VS 40.00%,P=0.004,t=0.894)、平均单次住院费[(8152.15±4972.82)元VS(33632.50±33273.07)元,P=0.000,t=4.326]均显著降低;(3)与非鼻饲组相比,第3个月鼻饲组ZBI评分显著下降[(66.45±9.95)VS(80.75±6.15),P=0.000,t=7.348]。结论 (1)鼻饲进食可减少重度痴呆合并吞咽功能障碍患者1年内住院次数、病死率、住院费,可短期改善照料者负担;(2)鼻饲进食可增加患者不适感。Objective To investigate the influence of nasogastric on in-ward frequency, fatality rate, hospitalization cost and caregiver stress to severe dementia patients who combined with swallowing dysfunction. Method Sixty-eight dementia patient＇s who combined with swallowing dysfunction were recruited in the study in our department from Jan 2013 to Jan 2016. Thirty-eight cases were given nasogastric feeding, thirty cases were not given nasogastrie feeding. The time of feeding in-ward frequency, hospitalization cost, death toll of all the patient＇s for one year were recorded. Zarit caregiver burden interview （ ZBI ） was used to caregiver when first visit （ 0 month ） and three months later. The time of feeding, in-ward frequency, the average single hospitalization cost, death toll and the score of ZBI were Compared between two groups. Results （1） There was a fidgeting after the nasal feeding ,the first week tube drawing number is （ 4.20 ±2.47 ） t; （2） Compared with non-nasal feeding group, the feeding time of nasal feeding group were significantly shortened [ （ 32.45±4.76 ） minVS （ 65.37 ±12.57 ） min, P=0.000, t=11.326 ] ,the in- ward frequency [ （ 1.92±0.97 ） t VS （ 10.25 ± 3.55 ） t, P=0.000, t=12.885 ] , fatality rate （ 10.52% VS 40.00%, P=0.004, t=0.894 ） and the average single hospitalization cost of nasal feeding group in one year [ （ 8152.15 ± 1972.82 ） y VS （ 33632.50 ±33273.07 ） y, P=0.000, t=4.326 ] were decreased significantly; （3） Compared with non-nasal feeding group, the ZBI grade [ （ 66.45 ± 9.95 ） VS （ 80.75± 6.15 ）, P=0.000, t=7.348 ] of nasal feeding group were decreased significantly. Conclusion Nasogastric feeding can decrease the in-ward frequency, fatality rate and hospitalization cost of dementia patients who combined with swallowing dysfunction in one year, and also can decreased Caregiver stress.

关 键 词：鼻饲进食 痴呆 住院次数 病死率 住院费 照料者负担 

分 类 号：R743[医药卫生—神经病学与精神病学]