间歇胃管置管喂养法对脑卒中中重度吞咽障碍患者误吸及营养状态的影响  

Effect of intermittent gastric tube feeding on aspiration and nutritional status in stroke patients with moderate to severe dysphagia

作　　者：袁景红[1] 黄小琼[1] 凌东波[1] 马荣[1] 陈仰昆[1] YUAN Jinghong;HUANG Xiaoqiong;LING Dongbo;MA Rong;CHEN Yangkun(Department of Neurology,Dongguan People's Hospital,Dongguan,Guangdong,523059,China)

机构地区：[1]东莞市人民医院神经内科,广东东莞523059

出　　处：《中西医结合护理（中英文）》2021年第12期9-12,共4页Journal of Clinical Nursing in Practice

基　　金：2019年东莞市社会科技发展(一般)项目(201950715001512)。

摘　　要：目的探究间歇胃管置管喂养法对脑卒中中重度吞咽障碍患者误吸及营养状态的影响。方法将2019年11月至2021年1月东莞市人民医院收治的91例脑卒中中重度吞咽障碍患者进行回顾性分析,根据置管喂养方法的不同分为对照组(48例)和观察组(43例)。对照组给予留置鼻胃管喂养法,观察组给予间歇胃管置管喂养法。对比2组患者的吞咽功能、误吸发生率、营养指标及舒适度。结果2组在护理3个月、6个月后的吞咽功能均优于护理前(P均<0.05),且观察组均优于同期对照组(P均<0.05)。护理3个月、6个月后,2组的血红蛋白(Hb)水平均低于护理前、上臂肌围(AMC)均小于护理前(P均<0.05);观察组在护理3个月、6个月后的Hb水平均高于同期对照组(P均<0.05),在护理6个月后的AMC大于对照组(P<0.05)。护理3个月、6个月后,2组的舒适度得分均较护理前下降(P均<0.05);观察组在护理1个月、3个月、6个月后的舒适度得分均较同期对照组更低(P均<0.05)。观察组的误吸发生率(34.88%)低于对照组(64.58%,P<0.05)。结论间歇胃管置管喂养法能促进脑卒中中重度吞咽障碍患者的吞咽功能恢复,有效改善其营养状态和舒适度,且降低误吸发生率。Objective To study the effect of intermittent gastric tube feeding on aspiration and nutritional status in stroke patients with moderate to severe dysphagia.Methods A retrospective analysis of 91 stroke patients with moderate to severe dysphagia admitted to Dongguan People's Hospital from November 2019 to January 2021 was carried out.They were assigned into a control group(48 cases)and an observation group(43 cases)according to different feeding methods.The control group was given indwelling nasogastric tube feeding,and the observation group was given intermittent gastric tube feeding.The swallowing function,incidence of aspiration,nutritional indicators,and comfort level were compared between the two groups.Results After 3 and 6 months of nursing,the swallowing function of the two groups were better than those before nursing(all P<0.05),and the observation group was better than the control group(both P<0.05).After 3 and 6 months of nursing,the level of hemoglobin(Hb)and arm muscle circumference(AMC)in the two groups were lower than those before nursing(all P<0.05).The level of Hb in the observation group after 3 and 6 months of nursing was higher than that in the control group on the corresponding period(both P<0.05),and the AMC after 6 months of nursing was higher than that in the control group(P<0.05).After 3 and 6 months of nursing,the comfort scores of the two groups were lower than those before nursing(all P<0.05).The comfort scores of the observation group after 1,3,and 6 months of nursing were lower than those of the control group on the corresponding period(all P<0.05).The incidence of aspiration in the observation group(34.88%)was lower than that in the control group(64.58%,P<0.05).Conclusion Intermittent gastric tube feeding can promote the recovery of swallowing function in stroke patients with moderate to severe dysphagia,effectively improve their nutritional status and comfort level,and reduce the incidence of aspiration.

关 键 词：脑卒中 吞咽障碍 间歇胃管置管喂养 营养状态 误吸 

分 类 号：R473.5[医药卫生—护理学]