摘要
目的 观察痴呆合并吞咽障碍患者采用间歇经口管饲法(IOE)的临床疗效。方法 选取痴呆所致吞咽障碍患者60例,按照随机数字表法将其分为IOE组和鼻饲(NGT)组,每组30例。2组患者均给予常规治疗,其中IOE组采用IOE进食,NGT组采用经鼻管饲进食。入院24 h和治疗30 d后,评估患者的吞咽功能和营养状况;管饲24 h内及第10天,比较2组患者的管饲舒适度;对2组患者30 d内的并发症发生率、平均住院天数、平均住院费用进行比较。结果 治疗前,2组患者营养不足发生情况、营养风险及相关指标、功能性经口摄食量表(FOIS)分级比较,差异无统计学意义(P>0.05)。与组内治疗前比较,2组患者治疗后的营养不足人数减少、营养风险降低,体重指数(BMI)、血清白蛋白(ALB)、血红蛋白(Hb)、血清前白蛋白(PAB)均改善(P<0.05)。与NGT组治疗后比较,IOE组治疗后营养不足发生情况、营养风险及相关指标明显改善,差异有统计学意义(P<0.05)。治疗后,2组患者FOIS分级均较组内治疗前改善(P<0.05),且IOE组改善较为显著(P<0.05)。管饲第30天,IOE组吞咽障碍改善总有效率(90.0%)高于NGT组(70.0%),差异有统计学意义(P<0.05)。IOE组管饲舒适度较高、并发症发生率较低,平均住院日及住院费用较少(P<0.05)。结论 IOE可以改善痴呆所致吞咽障碍患者的营养状况和吞咽功能,提高生活质量,并能降低并发症的发生率、缩短住院日、减少住院费用。
Objective To explore the clinical application of intermttent oro-esphageal(IOE)tube feeding in the treatment of dementia patients with dysphagia.Methods Sixty dementia patients with dysphagia were randomly divided into an IOE group and an nasogastric tube feeding(NGT)group,each of 30.Both groups were given conventional treatment,but the group members were fed through IOE or NGT respectively.Both groups′swallo-wing and nutritional condition were evaluated 24 hours after admission and 30 days after the end of the treatment.The incidence of complications within 30 days,the average hospital stay and hospitalization cost were compared between the 2 groups.Results No significant differences were observed between the two groups in any of the measurements before the intervention.During the intervention,the number of malnourished subjects decreased and the average body mass index(BMI),albumin(ALB)level,hemoglobin(HB)level and FOIS score improved significantly in both groups.Significantly better improvements in the incidence of malnutrition and the FOIS scores was observed in the IOE group.By the 30th day the average effective swallowing rate in the IOE group(90%)was significantly higher than in the NGT group(70%).Conclusions IOE can improve the nutrition and swallowing of dementia patients with dysphagia.It can reduce the incidence of complications,shorten hospital stays and reduce hospitalization cost.
作者
陈念
宫璞
杨东锋
王春茹
Chen Nian;Gong Pu;Yang Dongfeng;Wang Chunru(Department of Neurology,Ninghe District Hospital of Tianjin City,Tianjin 301500,China;Binhai Hospital Affilia-ted to Beijing University,Tianjin 300450,China)
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2020年第2期125-129,共5页
Chinese Journal of Physical Medicine and Rehabilitation
