32例重度老年痴呆病人家庭留置胃管鼻饲的临床研究

The Clinical Study on 32 cases of Serious Senile Dementia with Inwelling Gastrogavage at Home

目的探讨家庭留置胃管鼻饲营养支持对重度老年性痴呆患者的有效性,提高他们的生活质量,延长他们的生命,减少并发症的发生,减轻患者和家属的经济负担。方法将32例脑卒中合并重度老年性痴呆患者按出院顺序单双号分为两组,即试验组和对照组,试验组(16例)进行家庭留置胃管鼻饲,对照组(16例)采用静脉营养支持方法。21天后,分别进行营养指标的比较,观察其并发症的发生率。结果经21天治疗后,试验组患者的营养指标好于对照组,两组比较差异具有统计学意义(P<0.05)。试验组16例家庭留置胃管鼻饲患者中,5例脱管自主进食,占护理人数的31%;7例恢复呑咽功能暂置胃管(有时会出现呛咳),占护理人数的44%;4例继续依赖胃管鼻饲,占护理人数的25%。分析了影响老年痴呆家庭胃管鼻饲效果的几种因素。结论家庭留置胃管鼻饲是一种简单易行的营养支持手段,加强家庭留置胃管鼻饲的指导与护理,不仅有效延缓患者的痴呆进程,提高其生存质量,维持和恢复部分生理功能。同时,为患者提供舒适的康复休养环境,方便家人对患者的护理,节约了卫生资源,节省了住院费用。

Objective To explore the affectivity of nutrition supporting by indwelling gastrogavage for senile dementia at home, improve the nutritional condition of senile dementia, promote their living quality, prolong their life, decrease complications, relieve economy burden of patients and their relatives. Methods 32 cases are divided into two groups, experiment group and contract group, experiment group with indwelling gastrogavage for nutrition supporting, Contract group with i. v. for nutrition supporting. We compared the nutrition parameters after 21 days, observe the occurrence rate of complications. Results the nutritional parameters of experiment group is more improved than contract group after 21days, the difference between two group is reasonable for statistic （P 〈 0.05 ）. in group of indwelling gastrogavage, 5 cases are able to take foods by oral account for 31% and 7 cases recovery the ability of swallowing,44%. 4 cases still depend on indwelling gastrogavage,25%, analysis on influence factors on effects of indwelling gastrogavage at home for senile dementia. Conclusion indwelling gastrogavage is simple method of support therapy, this method do not only slow the progress of dementia but also improve life quality, maintenance and recovery part functions of physiology, meanwhile, provide easy and quite environment for patients, home nursing conveniently, save medical resources and the cost of hospitalization.