食物粘稠度对卒中后吞咽障碍患者误吸、营养状况及生活质量的影响

Effects of Food Viscosity on Aspiration,Nutritional Status and Quality of Life in Patients with Dysphagia after Stroke

目的探讨食物粘稠度对卒中后吞咽障碍患者误吸、营养状况和生活质量的影响。方法2018年1月至12月抽取于我院治疗的卒中后吞咽功能障碍患者100例,随机分为两组,对照组进行常规健康教育,饮食由患者家属遵医嘱执行,观察组则先进行容积-黏度吞咽测试,根据测试结果利用增稠剂调节食物性状和粘稠度,干预3个月后观察两组患者误吸等症状发生情况、营养相关指标及生活质量指标。结果①观察期内对照组呛咳、误吸和吸入性肺炎发生率高于观察组[呛咳:(2.3±0.6)vs.(1.2±0.4)次/d;误吸:(3.7±1.5)vs.(1.5±0.6)例次/周;吸入性肺炎:(12.5±3.6)vs.(7.7±2.4)例次,P<0.05]。②对照组治疗后营养相关指标呈不同程度下降,而观察组仅SGA评分治疗前后差异有统计学意义(P<0.05);治疗后观察组各项指标(体质量、BMI、TSF、SGA评分、热量和蛋白质摄入量)均优于对照组,差异有统计学意义(P<0.05)。③两组患者治疗前后比较,治疗后EDQo L总分有不同程度降低,观察组下降更明显,差异有统计学意义(P<0.05);治疗后观察组显著低于对照组(P<0.05)。结论根据患者吞咽功能情况调整食物粘稠度有利于减少误吸,纠正患者营养状况,提高患者生活质量,值得在吞咽障碍患者临床治疗和院外营养管理中推广。

Objective To explore the effects of food viscosity on aspiration,nutritional status and quality of life in patients with dysphagia after stroke.Methods 100 patients with swallowing dysfunction after stroke in our hospital from January to December 2018 were randomly divided into two groups.The control group received routine health education and the diet was performed by the patient’s family according to the doctor’s advice.In the observation group,the volume-viscosity swallowing testing was first performed,and the thickener was used to adjust the food traits and viscosity according to the test results.After 3 months of intervention,the incidence of symptoms of aspiration,nutrition related indicators and quality of life indicators were observed in the two groups.Results①During the observation period,the incidence of cough,aspiration and aspiration pneumonia in the control group was higher than that in the observation group[cough:(2.3±0.6)vs.(1.2±0.4)times/d;aspiration:(3.7±1.5)vs.(1.5±0.6)cases/week;aspiration pneumonia:(12.5±3.6)vs.(7.7±2.4)cases,P<0.05].②After treatment,the nutrition related indicators decreased in different degrees in the control group,while only difference of SGA score before and after treatment in the observation group was statistically significant(P<0.05).After treatment,indicators(body weight,BMI,TSF,SGA score,calorie and protein intake)in the observation group were superior to those in the control group(P<0.05).③Before and after treatment,the total score of EDQo L decreased after treatment,and the decrease was more obvious in the observation group(P<0.05).The observation group was significantly lower than the control group(P<0.05).The two groups of patients were compared before and after treatment.The total score of EDQo L after treatment decreased in different degree,and the decline in the observation group was more obvious(P<0.05);The observation group was significantly lower than the control group after treatment(P<0.05).Conclusion Adjusting food viscosity according to the patient’s swallowing function is beneficial to reduce aspiration,correct the nutritional status of patients,and improve the quality of life of patients.It is worthy of promotion in clinical treatment and out-of-hospital nutrition management of patients with dysphagia.