间歇经口至食管管饲法在脑卒中合并吞咽障碍患者中的临床应用

Clinical application of intermittent transoral to esophageal tube feeding in stroke patients with dysphagia

目的探讨间歇经口至食管管饲法(IOE)在脑卒中合并吞咽障碍患者的临床应用效果。方法选取收治的43例脑梗死合并吞咽障碍患者,分为观察组22例,对照组21例。观察组患者给予IOE管饲,对照组给予持续经鼻至胃管饲(NGT),评价不同置管方式对2组患者生命体征的影响与治疗2周后吞咽功能及肺部感染的发生率。结果观察组(IOE组)患者置管时心率增加次数平均值为(4.77±0.61)次,对照组(NGT组)患者置管时心率增加次数平均值为(8.05±0.52)次,差异有统计学意义(P<0.05);IOE组患者置管时血氧饱和度(SpO_(2))下降平均值为(1.67±0.19)%,NGT组患者置管时SpO_(2)下降平均值为(2.27±0.21)%,差异有统计学意义(P<0.05);住院期间IOE组患者肺部感染2例,NGT组患者肺部感染9例,差异有统计学意义(P<0.05);治疗2周后IOE组患者吞咽功能改善的总有效率达86.36%,NGT组患者吞咽功能改善的总有效率为57.14%,差异有统计学意义(P<0.05)。结论IOE较NGT刺激小、安全,能明显改善患者的吞咽功能,肺部感染发生率低。对于脑梗死合并吞咽障碍患者,IOE管饲法值得在临床推广应用。

Objective To investigate the clinical effects of intermittent oro-esophageal canal Feeding(IOE)on patients with cerebral apoplexy complicated with swallowing disorders.Methods 43 cases of cerebral infarction combined with swallowing disorder were randomly divided into observation group(n=22)and control group(n=21).Observation group was given IOE tube feeding,the control group was given continuous nasal gastric tube feeding(Nasogastric,NGT).The vital signs of the patients and the swallowing function and the incidence of lung infections were evaluated after 2 weeks of treatment.Results The heart rate increases was(4.77±0.61)times in the observation group(IOE group)and(8.05±0.52)times in the control group(NGT group)(P<0.05).The mean value of SpO_(2)decreased was(1.67±0.19)%in IOE group and(2.27±0.21)%in NGT group(P<0.05).During hospitalization,there were 2 cases of pulmonary infection in IOE group and 9 cases of pulmonary infection in NGT group,and the difference was statistically significant(P<0.05).After 2 weeks of treatment,the total effective rate of swallowing function improvement was 86.36%in IOE group and 57.14%in NGT group,and the difference was statistically significant(P<0.05).Conclusion Compared with NGT,IOE is less stimulated,safer,and it can significantly improve the swallowing function of patients,and the incidence of lung infection is lower.For patients with cerebral infarction and dysphagia,IOE tube feeding is worthy of clinical promotion.