不同营养摄入方式在脑卒中后吞咽障碍中的临床应用  

Clinical Application of Different Nutritional Intake Patterns in Dysphagia after Stroke

作　　者：王芳 易珲 邱青青 徐晓涓 邹蒙蒙 WANG Fang;YI Hui;QIU Qingqing;XU Xiaojuan;ZOU Mengmeng(Ganzhou Municipal Hospital,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市立医院,江西赣州341000

出　　处：《中国医学创新》2023年第29期131-134,共4页Medical Innovation of China

基　　金：赣州市指导性科技计划项目(GZ2021ZSF379)。

摘　　要：目的:探讨间歇经口至食管管饲(IOE)和经鼻留置胃管管饲(NGT)两种营养摄入方式在脑卒中后吞咽障碍中的应用效果。方法:选取2022年1—11月赣州市立医院收治的70例脑卒中后吞咽障碍患者作为研究对象,采用随机抽签分组的方式将研究对象分为研究组和对照组,各35例。两组均给予常规干预,对照组行NGT,研究组行间歇IOE,比较两组的临床效果。结果:治疗14 d后,研究组治疗有效率为97.14%,高于对照组的77.14%;研究组鼻胃管综合征(NGTS)发生率为5.71%,低于对照组的25.71%,差异均有统计学意义(P<0.05)。两组治疗前标准吞咽功能评定量表(SSA)评分差异无统计学意义(P>0.05),治疗30 d后,研究组SSA评分高于对照组(P<0.05)。血清检测显示,两组治疗前前白蛋白(PA)、白蛋白(ALB)、转铁蛋白(TRF)指标差异均无统计学意义(P>0.05),研究组治疗30 d后,三项指标均高于对照组(P<0.05)。两组治疗前吞咽生命质量量表(SWAL-QOL)评分比较,差异无统计学意义(P>0.05),治疗30 d后,研究组评分高于对照组(P<0.05)。结论:在脑卒中后吞咽障碍患者的治疗中,IOE较之NGT能够更好地规避NGTS的发生,在改善吞咽及气道功能方面效果更加理想。Objective:To investigate the clinical effect of intermittent oro-esophageal tube feeding(IOE)and nasal indwelling gastric tube feeding(NGT)in dysphagia after stroke.Method:A total of 70 patients with poststroke dysphagia admitted to Ganzhou Municipal Hospital from January to November 2022 were selected as the research objects.The research objects were divided into the study group and the control group by random drawing method,with 35 cases each group.Both groups were given routine intervention,the control group was given NGT,the study group was given intermittent IOE,and the treatment effects of the two groups were compared.Result:14 days after treatment,the effective rate of the study group was 97.14%,which was higher than 77.14% of the control group,the incidence of nasogastric tube syndrome(NGTS)in the study group was 5.71%,which was lower than 25.71% in the control group,the differences were statistically significant(P<0.05).There was no significant difference in standard swallowing assessment(SSA)score between the two groups before treatment(P>0.05).After 30 days of treatment,the SSA score of the study group was higher than that of the control group(P<0.05).Serum tests showed that there were no significant differences in prealbumin(PA),albumin(ALB),and transferrin(TRF)indexes between the two groups before treatment(P>0.05),and the three indexes in the study group were higher than those in the control group 30 days after treatment(P<0.05).There was no statistically significant difference in swallowing quality-of-life questionnaire(SWAL-QOL)score between the two groups before treatment(P>0.05);after 30 days of treatment,the score of the study group was higher than that of the control group(P<0.05).Conclusion:In the treatment of patients with dysphagia after stroke,intermittent IOE can better avoid the occurrence of nasogastric tube syndrome than NGT,and has a more ideal effect in improving swallowing and airway function.

关 键 词：脑卒中 吞咽障碍 经口至食管管饲 经鼻留置胃管管饲 鼻胃管综合征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]