经口间歇性胃管对脑卒中患者吞咽功能的影响

Effect of Intermittent Oral Gastric Tube on Swallowing Function in Patients with Stroke.

目的探讨经口间歇性胃管管饲对脑卒中后吞咽障碍患者吞咽功能的影响。方法选取2020年1月至2021年6月在我医院康复医学科住院部就诊的脑卒中后吞咽障碍患者60例为研究对象,通过数字随机法将患者分为对照组与试验组(各30例)。对照组予以持续经鼻胃管管饲,试验组予以经口间歇性胃管管饲,干预前和4周后对比两组患者进食评估问卷调查-10评分(EAT-10)、洼田饮水试验等级(WST)、标准吞咽功能评价量表评分(SSA)、脑卒中专用生活质量量表评分(SS-QOL)、患者满意度和不良事件发生率。结果干预前,两组患者各指标差异均无统计学意义(P>0.05)。干预后,两组患者EAT-10评分、WST等级、SSA评分、SS-QOL评分均较干预前明显改善(P<0.05),但试验组改善程度整体优于对照组(P<0.05);试验组满意度明显优于对照组(P<0.01),不良事件发生率较对照组降低,但差异无统计学意义(P>0.05)。结论通过经口间歇式护理方式,能显著提高脑卒中后吞咽障碍患者吞咽功能,改善患者生活质量和提高治疗满意度,并降低不良事件发生率。

Objective To investigate the effect of oral intermittent to gastric tube feeding on swallowing function in stroke patients with dysphagia after stroke.Methods 60 patients with post-stroke dysphagia treated in the inpatient department of rehabilitation medicine of the Affiliated Hospital of Southwest Medical University from January 2020 to June 2021 were selected as the research objects.The patients were divided into control group and observation group by digital random method,with 30 patients in each group.The control group was given continuous nasogastric tube feeding,and the observation group was given intermittent oral gastric tube feeding.Before the intervention and after 4 weeks of intervention,the Eating Assessment Tool-10(EAT-10),the level of the Water Swallow Test(WST),the Standardized Swallowing Assessment(SSA),the stroke-specific quality of life scale(SS-QOL),the patient satisfaction score,and the incidence of adverse events were compared between the two groups.Results Before intervention,there was no statistical difference in the indicators between the two groups of patients(P>0.05).After intervention,the EAT-10,the WST,the SSA,and the SS-QOL between the two groups was significantly higher than that before the intervention(P<0.05),but the improvement degree of experimental group was better than that of control group(P<0.05).The satisfaction of experimental group was significantly better than that of control group(P<0.01),and the incidence of adverse events was lower than that of control group,but the difference was not statistically significant(P>0.05).Conclusion Intermittent oral care can greatly improve the swallowing function of post-stroke patients with dysphagia,the quality of life of patients,the patient satisfaction with treatment,and greatly reduce the incidence of adverse events.