IOE与IOG对脑卒中后吞咽障碍患者营养状况、吞咽功能及肺部感染发生率的影响

Effects of IOE and IOG on Nutritional Status,Swallowing Function and Incidence of Pulmonary Infection in Patients with Dysphagia after Stroke

目的:探讨间歇经口至食管管饲(IOE)和间歇经口至胃管饲(IOG)对脑卒中后吞咽障碍患者营养状况、吞咽功能及肺部感染发生率的影响。方法:将2021年1—12月于德兴市人民医院就诊的100例脑卒中后吞咽障碍患者按随机数字表法分为IOE组(33例)、IOG组(33例)和对照组(34例)。对照组给予持续性经鼻至胃管饲治疗;IOE组给予IOE法;IOG组给予IOG法。比较三组营养状况、吞咽功能及肺部感染发生率。结果:干预4周后,三组血清总蛋白(TP)、血红蛋白(Hb)及白蛋白(ALB)含量均显著升高(P<0.05),但IOE组和IOG组升高更显著,其TP、Hb、ALB含量均高于对照组(P<0.05);IOE组与IOG组的TP、Hb、ALB含量差异均无统计学意义(P>0.05)。干预4周后,三组吞咽功能分级均优于组内干预前(P<0.05);IOE组及IOG组的吞咽功能分级均优于对照组(P<0.05)。对照组肺部感染发生率为32.35%,IOE组与IOG组肺部感染发生率分别为6.06%和12.12%,均低于对照组(P<0.05),IOE组的肺部感染发生率低于IOG组,但差异无统计学意义(P=0.392)。结论:IOE和IOG可以显著改善脑卒中后吞咽障碍患者的营养状况和吞咽功能,降低肺部感染发生率,其中IOE的肺部感染发生率略低。

Objective:To investigate the effects of intermittent oro-esophageal tube feeding(IOE)and intermittent oro-gastric tube feeding(IOG)on the nutritional status,swallowing function and incidence of pulmonary infection in patients with dysphagia after stroke.Method:One hundred patients with dysphagia after stroke attending Dexing City People's Hospital from January to December 2021 were divided into IOE group(33 patients),IOG group(33 patients)and control group(34 patients)according to the random number table method.The control group was given continuous nasal-to-gastric tube feeding;IOE group was given IOE;IOG group was given IOG.The three groups were compared in terms of nutritional status,swallowing function and incidence of pulmonary infections.Result:Four weeks after intervention,the serum total protein(TP),haemoglobin(Hb)and albumin(ALB)levels in all three groups increased significantly(P<0.05),but the increases were more significant in the IOE group and IOG group,and the levels of TP,Hb and ALB in IOE group and IOG group were higher than those in control group(P<0.05);there were no significant differences in the TP,Hb and ALB levels between the IOE group and IOG group(P>0.05).Four weeks after intervention,the swallowing function grades of the three groups were better than those before intervention(P<0.05);the swallowing function grades of the IOE group and the IOG group were better than that of the control group(P<0.05).The incidence of pulmonary infection in the control group was 32.35%,and the incidence of pulmonary infection in the IOE and IOG groups was 6.06%and 12.12%,respectively,those in IOE group and IOG group were lower than that in the control group(P<0.05),and that in the IOE group was lower than that in the IOG group,but the difference was not statistically significant(P=0.392).Conclusion:IOE and IOG can significantly improve the nutritional status and swallowing function of patients with dysphagia after stroke,and reduce the incidence of pulmonary infection,among which IOE has a lower incidence of pulmonary infection.