间歇性经口至食管管饲胃肠营养法联合吞咽训练对脑卒中患者吞咽功能和营养状态的影响

Effects of intermittent oro esophageal tube feeding combined with swallowing training on swallowing function and nutritional status in stroke patients

目的探讨针对脑卒中后存在吞咽功能障碍的患者实施间歇性经口至食管管饲胃肠营养法联合吞咽训练后,其吞咽功能和营养状态的变化情况。方法选取2019年1月-2020年5月于溧阳市人民医院康复科就诊的脑卒中后吞咽功能障碍的患者80例。所有患者均按随机数字表法分类,分为对照组(n=40)和观察组(n=40)。对照组患者实施常规护理和吞咽训练,观察组患者在对照组的基础上实施间歇性经口至食管管饲胃肠营养法,对两组干预前后的吞咽功能和营养状态进行比较。结果干预前,两组间洼田饮水试验和吞咽X线电视透视检查(VFSS)评分的差异均无统计学意义(P值均>0.05);千预后,两组间的差异均有统计学意义(P值均<0.05)。干预前,两组间渗透-误吸量表(PAS)分级和吞咽障碍特异性生活质量量表(SWAL-Q0L)评分的差异均无统计学意义(P值均>0.05);干预后,两组间的差异均有统计学意义(P值均<0.05)。干预前,两组间血清总蛋白(TP)、白蛋白(Alb)、血红蛋白(Hb)的差异均无统计学意义(P值均>0.05);干预后,观察组均显著高于对照组(P值均<0.05)。结论间歇性经口至食管管饲胃肠营养法联合吞咽功能训练的方式可改善脑卒中后吞咽功能障碍患者的吞咽功能障碍问题,提高患者的生存质量和营养水平,值得推广。

Objective Intermittent oro-esophageal feeding combined with swallowing organ function training was carried out for patients with swallowing dysfunction after stroke,and its effect on swallowing function and nutritional status of patients was analyzed.Methods 80 patients with post-stroke swallowing dysfunction who were admitted to Department of Rehabilitation of Liyang People's Hospital from January 2019 to May 2020 were selected as the research objects.All patients were classified according to the random number table method and divided into control group(n=40)and observation group(n=40).The control group received routine nursing and swallowing organ function training,and the observation group implemented intermittent oro-esophageal tube feeding on the basis of the control group.The swallowing function and nutritional status of the two groups before and after intervention were compared.Results;There were no significant differences in the scores of the W atian drinking water test and video fluoroscopic swallowing study(VFSS)of swallowing between the two groups before the intervention(both P>0.05),and the above scores of the observation group after the intervention were significantly different from those of the control group(both P<0.05).There were no significant differences in the scores of penetration-aspiration scale(PAS)and swallowing quality of life(SWAL-QOL)questionnaire between the two groups before the intervention(both P>0.05),and the above scores of the observation group after the intervention were significantly different from those of the control group(both P<0.05).There were no significant difference in serum total protein(TP),albumin(Alb),hemoglobin(Hb)and other nutritional indicators between the two groups before intervention(all P>0.05).The levels of the above indicators in the observation group after intervention were significantly higher than those in the control group(all P<0.05).Conclusion Intermittent oro-esophageal tube feeding and enteral nutrition combined with swallowing organ function training can improve the swallowing function of patients with swallowing dysfunction after stroke,improve their quality of life and can also promote the improvement of nutritional levels.It is worthy of promotion.