糊状饮食对中度吞咽障碍老年患者营养状态及吞咽功能的影响

Effect of Paste Diet on Nutritional Status and Swallow Function in Elderly Patients with Moderate Dysphagia

目的探讨糊状经口饮食对中度吞咽障碍老年患者营养状况及吞咽功能的影响。方法成立多学科团队小组,对老年吞咽障碍患者进行吞咽功能评估及安全进食宣教和训练,将符合入选标准的长期住院老年中度吞咽障碍患者,根据自愿原则和配对原则,分为观察组和对照组各20例,对照组根据吞咽状况,兼顾患者的口味、意愿,进食半固体软食、浓流质、部分糊状饮食等;观察组将所有食物和液体,按专业的方法制成全糊状饮食,两组患者均自行经口进食或喂食。观察比较干预前后两组患者进食情况、营养状况和吞咽障碍程度。结果干预90 d后,观察组营养素摄入量、营养生化指标均高于对照组(P<0.05);才滕氏吞咽障碍程度评估,观察组级数有1例上升,无下降;对照组有5例下降,差异有统计学意义(P<0.05)。结论糊状饮食能改善老年中度吞咽障碍患者的营养状况,延缓吞咽障碍的进展,是便于推广的方法。

Objective To investigate the effects of oral paste diet on nutritional status and swallowing function of elderly patients with moderate dysphagia. Methods A multidisciplinary team was established to assess the swallowing function of elderly patients with dysphagia, and to provide education and training of eating security for them. With matching principle, the long-term hospitalized elderly volunteer patients with dysphagia meeting the inclusion criteria were divided into observation group and control group, each of which had 20 cases. According to swallowing conditions, with oral diet or feeding, patients in control group had semi-solid soft food, thick liquid and partly paste diet and so on but those in observation group had paste diet only. Patients ＇ eating, nutritional status and the degree of swallowing dysphagia before and after intervention were compared. Results After 90 days＇ intervention, the nutrient intake, nutritional and biochemical indicators in observation group were higher than those in control group（P〈0.05）. According to the Teng＇s degree of swallowing dysphagia, in control group, the degree of five cases decreased while the degree of one case in observation group increased and no case decreased and the difference was statistically significant（P〈0.05）. Conclusion Paste diet can improve the nutritional status of elderly patients with moderate dysphagia and slow down the progression of dysphagia.