早期鼻饲对脑卒中吞咽障碍患者误吸与吸入性肺炎的影响

Influence of Nasal Feeding in Early Stage on Pneumonia for Stroke Patients with Swallowing Disorders

目的探讨脑卒中吞咽障碍患者早期鼻饲对误吸、吸入性肺炎发生率及对神经功能康复的影响。方法收集脑卒中吞咽障碍3～4级的患者120例,随机分为早期鼻饲组和对照组,早期鼻饲组在常规治疗基础上早期经鼻胃管进食,对照组在常规治疗基础上经口进食,观察两组误吸、吸入性肺炎的发生率,并观察神经功能缺损恢复情况和吞咽功能改善情况。结果早期鼻饲组误吸、吸入性肺炎发生率明显低于对照组;两组入院时神经功能缺损程度评分比较差异无统计学意义,入院第28天早期鼻饲组神经功能缺损程度评分明显低于对照组(P<0.05)。结论脑卒中吞咽障碍患者早期鼻饲,能明显降低误吸和肺炎的发生率,有利于神经功能的恢复。

Objective To explore the effects of early nasal feeding on aspiration, aspiration pneumonia and neurological rehabilitation of stroke patients with swallowing disorders. Methods 120 stroke patients with swallowing disorders in grade 3 and 4 were randomly divided into early nasal feeding group and control group. Patients in early nasal feeding group was with early nasogastric tube feeding on the basic of routine treatment and those in control group were treated on the basis of routine treatment through oral intake. The incidences of aspiration and pneumonia, and the recovery of nerve function impairment and improvement of swallowing function in two groups were observed and compared. Results In early nasal feeding group, the incidences of aspiration and pneumonia were significantly lower than those in control group; two neurological functional deficit scores were not significantly different at the very beginning of admission while difference occurred in the 28th day of admission（P〈0.05）. Conclusion Early nasal feeding for stroke patients with swallowing disorders can significantly reduce the incidence of aspiration and pneumonia which is helpful to the recovery of neurological function.