亲水型双腔导尿管在吞咽障碍患者间歇经口至食管置管管饲中的应用

Application of hydrophilic double-lumen catheter in intermittent oral-esophageal tube feeding for patients with dysphagia

目的探讨亲水型双腔导尿管在功能性吞咽障碍患者间歇经口至食管置管管饲(IOE)中的应用效果。方法选取住院的吞咽障碍患者90例作为研究对象,将其按照随机数字表法等分为观察组和对照组。观察组使用14-16 Fr亲水型双腔导尿管行间歇经口至食管置管管饲,对照组使用普通胃管行间歇经口至食管置管管饲;统计比较两组患者置管时血氧饱和度下降>2%发生次数、注食时和注食后出现食物反流的次数、患者管饲的舒适度、操作者对置管注食方法的方便程度和认可度,以及患者吞咽功能障碍改善情况。结果治疗14 d后统计,观察组患者的置管舒适度、操作者对置管注食方法的方便程度和认可度明显高于对照组(P<0.05),患者置管时血氧饱和度下降发生次数(率)以及注食时和注食后发生食物反流的次数均低于对照组(P<0.05),在吞咽功能障碍改善方面都明显优于间歇置管治疗前,但两组之间差异无统计学意义(P>0.05)。结论间歇经口至食管管饲法是改善脑卒中后吞咽功能障碍的有效方法,但在管路材质型号选择和置管细节上,采用亲水型双腔导尿管更能提高患者舒适度,能减少患者置管时的呛咳抵抗,减少患者注食时或注食后食物反流的发生率,同时也明显提高操作者(护士和培训后的家属)的管饲方便程度和认可度。

Objective To investigate the application of hydrophilic double-lumen catheter(HDLC)on intermittent oral-esophageal(IOE)tube feeding for patients with dysphagia.Methods Ninety patients with dysphagia were selected and divided into observation group and control group according to the random number table method.The observation group was given with 14-16 Fr HDLC for IOE tube feeding while the control group was given with ordinary gastric tube for IOE tube feeding.The occurrence rates of the SpO_(2) decreased by 2% during catheterization,the occurrence rates of the esophageal reflux during and after feeding,the levels of patients′comfort,the levels of operators′convenience and approval and the levels of improvement for the swallowing functions were compared.Results After 14 days treatment,patients′comfort and operators′convenience and approval in the observation group were significantly better than that in the control group(P<0.05),and the occurrence rates of the SpO_(2) decreased by 2% during catheterization and the esophageal reflux during and after feeding in the observation group were lower than those in the control group(P<0.05).Both groups have notably better swallowing functions before IOE tube feeding but the difference between two groups is slight(P>0.05).Conclusion IOE tube feeding is an effective approach to improve patients′swallowing functions after stroke.However,in terms of the selection of tube materials and the details in the catheterization,HDLC is more capable to improve patients′comfort and reduce the bucking during catheterization and the occurrence rates of the esophageal reflux during and after feeding.It also significantly enhances operators′convenience and approval.