管饲肠内营养联合冰刺激治疗颅脑损伤术后吞咽障碍病人的临床研究  

Clinical study of tube-fed enteral nutrition combined with ice stimulation in the treatment of patients with postoperative dysphagia after craniocerebral injury

作　　者：王姗 薛梦童 于娟 李璐 徐磊 WANG Shan;XUE Meng-tong;YU Juan;LI Lu;XU Lei(Department of Rehabilitation Medicine,The First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠医科大学第一附属医院康复医学科,安徽蚌埠233000

出　　处：《肠外与肠内营养》2024年第3期167-171,共5页Parenteral & Enteral Nutrition

基　　金：安徽高校自然科学重点研究项目(2023AH051912);蚌埠医学院自然类科技重点项目2020byzd087。

摘　　要：目的:探讨肠内营养对改善冰刺激治疗颅脑损伤术后吞咽障碍的治疗效果。方法:纳入2021年5月至2022年11月蚌埠医科大学第一附属医院康复医学科收治的颅脑损伤术后伴有吞咽障碍的病人,采用随机数字表法将病人随机分为治疗组(31例)和对照组(30例)。治疗组采用留置鼻肠营养管输注肠内营养+冰刺激的方法;对照组采用经口进食+冰刺激的方法。比较两组病人吞咽功能恢复情况、治疗期间并发症发生情况以及两组病人治疗前后营养指标(血红蛋白、血清白蛋白、前清蛋白)改善情况。结果:治疗后,两组病人吞咽功能评定量表(SSA和VFSS)评分比较未见显著性差异(P>0.05),治疗后治疗组血红蛋白、血清白蛋白和前清蛋白水平均显著高于对照组病人(P<0.05)。治疗组病人治疗期间并发症(误吸、呛咳和肺部感染)发生率显著低于对照组病人(P<0.05)。结论:在冰刺激治疗颅脑损伤术后吞咽功能障碍中,联合使用管饲肠内营养不能显著提升吞咽功能的恢复,可以改善病人营养状况并减少误吸等并发症的发生。Objective:To investigate the therapeutic effect of enteral nutrition on improving ice stimulation for postoperative dysphagia after craniocerebral injury.Methods:Patients with dysphagia after craniocerebral injury admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Bengbu Medical University from May 2021 to November 2022 were included.The patients were randomly divided into treatment group(31 cases)and control group(30 cases)by random number table method.The treatment group adopted the method of infusion of enteral nutrition and ice stimulation through nasoenteral nutrition tube;the control group adopted oral diet and ice stimulation.Comparison of the two groups with the recovery of swallowing function,the occurrence of complications during the treatment period,and changes in nutritional indexes(hemoglobin,serum albumin,pre-serum protein)before and after the treatment of the two groups of patients.Results:After treatment,no significant difference was observed in the comparison of the scores of Swallowing Function Scale(SSA and VFSS)between the two groups(P>0.05),but the levels of hemoglobin,serum albumin and pre-serum protein of the treatment group were significantly higher than those of the control group after treatment(P<0.05).The treatment group of complications(aspiration,choking and lung infection)during treatment in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:In ice stimulation treatment of postoperative swallowing dysfunction after craniocerebral injury,the combined use of nasoenteral tube-fed enteral nutrition can improve the nutritional status and reduce the occurrence of complications such as misaspiration,although it cannot significantly enhance the recovery of swallowing function.

关 键 词：肠内营养 冰刺激 颅脑损伤 吞咽障碍 

分 类 号：R459.3[医药卫生—治疗学] R563.1[医药卫生—临床医学]