基于V-VST评估的个性化喂养应用于神经源性吞咽功能障碍患者的效果分析

Effect Analysis of Individualized Feeding Based on V-VST Evaluation in Patients with Neurogenic Swallowing Dysfunction

目的:分析基于容积-黏度吞咽试验(V-VST)评估的个性化喂养应用于神经源性吞咽功能障碍患者的效果。方法:选取2018年1月-2020年12月华中科技大学协和深圳医院收治的71例神经源性吞咽功能障碍患者,按照随机数字表法将患者分为对照组(n=35)和观察组(n=36)。对照组给予以洼田饮水试验为基础的饮食指导,观察组予以基于V-VST评估的个性化喂养。比较两组留置胃管情况、吞咽功能、营养状况及并发症发生情况。结果:观察组留置胃管人数少于对照组,留置时间短于对照组,差异均有统计学意义(P<0.05)。观察组吞咽功能优于对照组,差异有统计学意义(P<0.05)。干预前,两组三头肌皮褶厚度(TSF)、上臂围(MAC)、体质量指数(BMI)比较,差异均无统计学意义(P>0.05);干预后,两组TSF、AMC、BMI均优于治疗前,且观察组均优于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为11.11%,低于对照组的31.43%,差异有统计学意义(P<0.05)。结论:基于V-VST评估的个性化喂养通过改善神经源性吞咽功能障碍患者的一般情况,调节吞咽功能,进而改善其营养状况且并发症发生率更低。

Objective:To analyze the effect of individualized feeding based on volume viscosity swallowing test (V-VST) in patients with neurogenic swallowing dysfunction.Method:A total of 71 patients with neurogenic swallowing dysfunction admitted to Huazhong University of Science and Technology Union Shenzhen Hospital from January 2018 to December 2020 were selected,they were divided into control group (n=35) and observation group (n=36) according to random number table method.The control group was given dietary guidance based on the water swallow test,and the observation group was given personalized feeding based on the V-VST assessment.The gastric tube indwelling condition,swallowing function,nutritional status and complications were compared between two groups.Result:The number of gastric tube indwelling in the observation group was less than that in the control group,and the indwelling time was shorter than that in the control group,the differences were statistically significant (P<0.05).The swallowing function in the observation group was better than that in the control group,the difference was statistically significant (P<0.05).Before intervention,there were no statistically significant differences in triceps skin fold thickness (TSF),upper arm circumference (MAC),body mass index (BMI) between two groups (P>0.05);after intervention,TSF,AMC and BMI in both groups were better than those before intervention,and those in the observation group were better than those in the control group,the differences were statistically significant (P<0.05).The incidence of complications in the observation group was 11.11%,which was lower than 31.43% in the control group,the difference was statistically significant (P<0.05).Conclusion:Individualized feeding based on V-VST evaluation can improve the general condition of patients with neurogenic swallowing dysfunction,regulate the swallowing function,and then improve their nutritional status,with lower incidence of complications.