神经系统疾病伴吞咽困难患者基于容积黏度吞咽试验的喂养管理

Feeding management based on the volume-viscosity swallow test for dysphagia patients with neurological diseases

目的探讨基于容积黏度吞咽试验对神经系统疾病伴吞咽障碍患者进行喂养管理的效果。方法采用类实验研究方法,选择神经系统疾病伴吞咽困难住院患者,按照入院时间分为对照组(n=47)与观察组(n=61)。对照组实施常规护理,对洼田饮水试验2级患者给予饮食指导,3级及以上留置胃管实施管饲饮食;观察组在常规护理基础上采用容积黏度吞咽试验评估患者吞咽障碍的风险,根据评估结果实施个体化的喂养方案。结果观察组管饲饮食实施率显著低于对照组(24.59%与44.68%,P<0.05),胃管留置时间显著短于对照组(10.13 d与14.05 d,P<0.05),经口进食患者临床误吸征象发生率显著低于对照组(17.39%与42.13%,P<0.05)。结论根据容积黏度吞咽测试可以为吞咽障碍患者提供精准的喂养方案,减少不必要的胃管留置,缩短管饲饮食时间。

Objective To explore the effect of feeding management based on the volume-viscosity swallow test for dysphagia patients with neurological diseases.Methods A quasi-experimental research design was utilized, and the dysphagia patients with neurological diseases were selected and divided into a control group(n=47) and an observation group(n=61) chronologically. The control group received routine nursing, the patients with grade 2 in Water swallow test were given dietary guidance, and the patients with grade 3 or above were indwelled with gastric tube and were given tube feeding, while the observation group were additionally assessed for the risk of dysphagia according to the volume-viscosity swallow test, then received individualized feeding based on the assessment results. Results The implementation rate of tube feeding in the observation group was significantly lower than that of the control group(24.59% vs.44.68%,P<0.05), the tube retention time was significantly shorter than that of the control group(10.13 days vs.14.05 days, P<0.05), and the incidence of aspiration signs for the patients with oral feeding was significantly lower than that of the control group(17.39% vs. 42.13%,P<0.05).Conclusion The feeding management based on the volume-viscosity swallow test could provide a precise feeding plan for dysphagia patients, decrease unnecessary tube placement, shorten tube feeding time, and ensure feeding safety.