急性球麻痹患者早期经鼻胃管进食预防肺炎的效果分析

Effect of taking food by early detaining nasogastric tube on preventing pneumonia in acute bulbar paralysis

目的探讨急性脑卒中球麻痹患者早期经鼻胃管进食预防肺炎的效果以及对近期预后的影响。方法球麻痹吞咽困难评估在3级和4级的急性脑卒中患者196例，按吞咽困难级别随机分成鼻胃管组和非鼻胃管组，鼻胃管组在常规治疗基础上早期经鼻胃管进食，非鼻胃管组在常规治疗基础上经口进食。观察两组误吸及肺炎的发生率，并对患者人院时及病程第3～4周的神经功能缺损进行评分。结果两组人院时神经功能缺损评分比较无统计学意义，病程第3～4周鼻胃管组神经功能缺损评分明显低于非鼻胃管组，有统计学意义（P〈0．01）；鼻胃管组肺炎发生率明显低于非鼻胃管组。结论急性脑卒中球麻痹患者早期经鼻胃管进食，能明显降低肺炎发生率，有利于神经功能的恢复。

Objective To discuss the effect of taking food by early detaining gastric tube on preventing pneumonia and prognosis in the near future in poststroke patients with acute Bulbar Paralysis. Method 196 acute poststroke patients, whose dysphagia of bulbar paralysis were 3 or 4 level, were randomly divided into nasogastric tube group and non - nasogastric tube group. The former group took food from the early detaining gastric tube on the base of routine therapy, while the other group from mouth. Two groups＇ pneumonia rate of occurrence was observed and the scores of neural function - deficit when admitting to hospital and the 3rd or 4th week of the course of diseases were evaluated. Result Two groups＇ scores of neural function - deficit when admitting to hospital had no statistical significance, while scores of the nasogastric tube group were significantly lower than the non- nasogastric tube group during the 3rd or 4th week of the course of diseases （P〈0.01）. The nasogastric tube group＇s pneumonia rate of occurrence were significantly lower than the non - nasogastric tube group. Conclusion Taking food from the early detaining nasogastric tube can remarkably reduce the pneumonia rate of occurrence and is good for the healing of neural function for acute poststroke patients who suffer dysphagia induced by bulbar paralysis.