间歇性经口至食管管饲法对脑卒中后吞咽障碍患者病耻感的影响

Effect of Intermittent Oral to Esophageal Feeding on Stigma in Patients with Dysphagia after Stroke

目的:了解间歇性经口至食管管饲(IOE)法对脑卒中后吞咽障碍患者病耻感的影响。方法:脑卒中后吞咽障碍患者80例随机分为IOE组和持续经鼻至胃管饲(NGT)组,各40例。于治疗前、后,分别采用简明健康调查表(SF-36量表)、抑郁自评量表(SDS)和慢性疾病病耻感量表(SSCI)评价2组生活质量、抑郁状态和病耻感。结果:治疗后,2组各维度的生活质量评分均较治疗前明显提高(均P<0.05),IOE组生活质量更高于NGT组(P<0.05);治疗后,NGT组和IOE组的SDS评分均低于同组治疗前(均P<0.05),且IOE组低于NGT组(均P<0.05);治疗后,2组SSCI病耻感总分、内在病耻感、外在病耻感得分均较治疗前降低(均P<0.05);IOE组SSCI病耻感总分、内在病耻感、外在病耻感得分低于NGT组(均P<0.05)。结论:与NGT相比,IOE更有助于改善脑卒中后吞咽功能障碍患者的生活质量、同时降低其抑郁情绪及慢病病耻感。

Objective:To investigate the effect of intermittent oral esophageal feeding (IOE) on stigma of patients with dysphagia after stroke. Methods: Eighty patients with dysphagia after stroke were randomly divided into IOE group (n=40) and NGT (nasogastric tube) group (n=40). Short form 36 health survey questionnaire (SF-36), self-rating depression scale (SDS) and stigma scale for chronic illness (SSCI) were used to assess all the cases before and after treatment. Results: After 4 weeks of treatment, SF-36 scores of two groups were higher than those before (P<0.05) and scores of IOE group were higher than those of NGT group (P< 0.05). After 4 weeks of treatment, SDS scores of two groups were lower than those before (P<0.05) and scores of IOE group were lower than those of NGT group (P<0.05). After 4 weeks of treatment, the total scores of stigma, scores of internal stigma and external stigma in the SSCI scale of two groups were lower than those before (P< 0.05) and these scores of IOE group were lower than those of NGT group (P<0.05). Conclusion: Compared with NGT, IOE could more effectively improve the quality of life in patients with dysphagia after stroke and reduce their depression and stigma.