IOE在促进脑卒中后吞咽功能障碍康复中的应用

Application of IOE in promoting rehabilitation of swallowing dysfunction after stroke

目的探讨间歇经口食管管饲(IOE)在促进脑卒中后吞咽功能障碍康复中的应用。方法选择2019年3月至2020年4月我院接收的脑卒中患者60例,随机分成观察组(n=30例)和对照组(n=30例)。对照组采用留置鼻胃管(NG)治疗,观察组采用间歇经口食管管饲(IOE)治疗。治疗后,对患者的临床效果进行评估,比较两组患者的吞咽障碍疗效、患者的满意度和治疗前后患者生活质量及营养状况各指标的变化以及并发症的发生率。结果治疗前,两组患者的洼田饮水试验、FOIS分级以及患者的满意度比较差异无统计学意义(P>0.05);治疗后,观察组洼田饮水试验分级低于对照组,FOIS分级以及患者的满意度均高于对照组(P<0.05);治疗前,两组患者生活质量SWAL-QOL评分及营养指标Hb、ALB、TP比较差异无统计学意义(P>0.05),治疗后,观察组SWAL-QOL评分、Hb、ALB、TP均高于对照组(P<0.05);治疗后,观察组的吸入性肺炎、胃食管反流、呕吐、出血的总发生率低于对照组(P<0.05)。结论在促进脑卒中后吞咽功能障碍康复中使用IOE治疗患者,可以改善患者的吞咽障碍,提高患者的治疗满意度,提高患者的生活质量以及患者的营养状况,减少患者置管术后并发症发生率,保证了患者的安全,临床效果显著,值得推广使用。

Objective To explore the application of intermittent oro-esophageal tube feeding(IOE)in promoting the rehabilitation of swallowing dysfunction after stroke.Methods Sixty stroke patients in the hospital from March 2019 to April 2020 were selected and randomly divided into the observation group(n=30)and the control group(n=30).The control group was treated with an indwelling nasogastric tube(NG),and the observation group was treated with intermittent oro-esophageal tube feeding(IOE).After treatment,the clinical effects of the patients were evaluated.The efficacy of dysphagia,the satisfaction of the patients,the changes in various indicators of the patient's quality of life and nutritional status before and after treatment,and the incidence of complications were compared between the two groups.Results Before treatment,there was no statistical difference in the watian drinking water test,FOIS classification,and patient satisfaction between the two groups of patients(P>0.05).After treatment,the watian drinking water test classification of the observation group was lower than that of the control group,FOIS classification and the satisfaction of patients in the observation group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in the SWAL-QOL scores and nutritional indicators Hb,ALB,TP between the two groups(P>0.05).The SWAL-QOL score,Hb,ALB,and TP of the observation group were higher than those of the control group after the treatment(P<0.05).After treatment,the total incidence of aspiration pneumonia,gastroesophageal reflux,vomiting,and bleeding in the observation group was lower than that of the control group(P<0.05).Conclusion The use of IOE in the treatment of patients with swallowing dysfunction after stroke can improve patients′dysphagia,increase patient satisfaction with treatment,improve the quality of life and nutritional status of patients,and reduce postoperative complications rate.It also ensures the safety of patients,and has a significant clinical effect,which is worthy of popularization.