不同肠内营养方法联合吞咽康复训练治疗阿尔茨海默病伴吞咽障碍的效果比较  

Different enteral nutrition methods combined with swallowing rehabilitation training for Alzheimer's disease complicated by dysphagia

作　　者：黄建亮 杜晓露 Jianliang Huang;Xiaolu Du(Department of Geriatric Medicine,the Second Hospital of Jinhua,Jinhua 321000,Zhejiang Province,China;Department of Internal Medicine,Jinhua People's Hospital,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]金华市第二医院老年内科,金华321000 [2]金华市人民医院内科,金华321000

出　　处：《中国基层医药》2023年第1期97-101,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省金华市科技计划(2020-4-059)。

摘　　要：目的:比较不同肠内营养方法联合吞咽康复训练治疗阿尔茨海默病伴吞咽障碍的临床效果。方法:选取2019年10月至2021年3月在金华市第二医院老年内科住院的阿尔茨海默病伴吞咽障碍患者120例为研究对象,采用随机数字表法对120例患者进行编号,平均分为四组(A组、B组、C组、D组),分别给予不同的肠内营养方法(A组:鼻胃管;B组:鼻肠管;C组:鼻胃管+吞咽康复训练;D组:鼻肠管+吞咽康复训练)。治疗12周后,比较四组患者的总有效率及营养状况、并发症发生情况。结果:治疗12周后,D组患者总有效率最高(100.0%),与其他三组(A组:13.3%,B组:40.0%,C组:73.3%)比较,差异均有统计学意义(χ^(2)=45.88、25.71、9.23,均P<0.05)。C组和D组治疗后的营养状况[体质量指数(BMI):(21.42±1.85)kg/m^(2)、(23.17±2.03)kg/m^(2)]和满意度(60.0%、100.0%)明显优于A组[BMI:(19.01±1.72)kg/m^(2);满意度:10.0%]和B组[BMI:(19.86±1.69)kg/m^(2);满意度:33.3%];D组的营养状况最好(t=7.01、5.14、1.78,均P<0.05),满意度最高(χ^(2)=49.09、30.00、15.00,均P<0.001)。结论:采用鼻肠管进行肠内营养联合吞咽康复训练治疗阿尔茨海默病伴吞咽障碍的效果最佳,值得推广。Objective To investigate the clinical efficacy of different enteral nutrition methods combined with swallowing rehabilitation training in the treatment of Alzheimer's disease complicated by dysphagia.Methods A total of 120 patients with Alzheimer's disease and dysphagia who received treatment in the Department of Geriatric Medicine,the Second Hospital of Jinhua from October 2019 to March 2021 were included in this study.They were randomly and evenly divided into four groups:A,B,C,and D.Patients in groups A,B,C,and D were given nasogastric tube feeding,naso-intestinal tube feeding,nasogastric tube feeding+swallowing rehabilitation training,and naso-intestinal tube feeding+swallowing rehabilitation training,respectively.After 12 weeks of treatment,total response rate,nutritional status,and complications were compared between the four groups.Results After 12 weeks of treatment,total response rate in group D was the highest(100.0%),which was significantly higher than that in the other three groups(group A:13.3%;group B:40.0%;group C:73.3%;χ^(2)=45.88,25.71,9.23,all P<0.05).After treatment,the nutritional status[body mass index(BMI):(21.42±1.85)kg/m^(2),(23.17±2.03)kg/m^(2)]and patient satisfaction(60.0%,100.0%)in groups C and D were significantly superior to those in group A[BMI:(19.01±1.72)kg/m^(2)];patient satisfaction:10.0% and group B[BMI:(19.86±1.69)kg/m^(2);patient satisfaction:33.3%].Group D had the best nutritional status(t=7.01,5.14,1.78,all P<0.05)and the highest patient satisfaction(χ^(2)=49.09,30.00,15.00,all P<0.001).Conclusion Naso-intestinal tube feeding combined with swallowing rehabilitation training is the best treatment for Alzheimer's disease complicated by dysphagia among the studied enteral nutrition feeding methods and therefore deserves clinical promotion.

关 键 词：阿尔茨海默病 吞咽障碍 肠道营养 吞咽康复训练 鼻胃管 鼻肠管 人体质量指数 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]