不同管饲方法对脑卒中后吞咽障碍患者营养状况、吞咽功能及并发症的影响

Comparison of the effects of different tube feeding methods on nutritional status,swallowing function and complications in patients with dysphagia after stroke

目的:探讨间歇口-胃管管饲法(IOE)和持续鼻-胃管管饲法(NGT)对脑卒中后吞咽障碍患者营养状况、吞咽功能及并发症的影响。方法:按照治疗方法不同将120例脑卒中后吞咽障碍患者分为IOE组和NGT组,每组各60例。两组采取相应管饲法,均连续干预14 d。比较两组营养状况[体质量指数(BMI)、血红蛋白(Hb)、白蛋白(ALB)、总蛋白(TP)]、吞咽功能[功能性经口摄食量表(FOIS)]、管饲舒适度及并发症发生情况。结果:干预后,IOE组BMI、Hb、ALB、TP水平及FOIS评分均高于NGT组(P<0.05)。IOE组鼻腔不适、口腔干燥、吞咽不适发生率均低于NGT组(P<0.05)。IOE组并发症总发生率低于NGT组(8.33%vs.26.67%,P<0.05)。结论:相比于NGT,IOE可以更好地改善对脑卒中后吞咽障碍患者营养状况、吞咽功能,且IOE的管饲舒适度更高、并发症发生率更低。

Objective:To compare the effects of intermittent orogastric tube feeding(IOE)and continuous nasogastric tube feeding(NGT)on nutritional status,swallowing function and complications in patients with dysphagia after stroke.Methods:120 patients with dysphagia after stroke were divided into IOE group and NGT group according to the different treatment methods,60 cases in each group,and took corresponding tube feeding method,continuous intervention for 14 d.The nutritional status[body mass index(BMI),hemoglobin(Hb),albumin(ALB),total protein(TP)],swallowing function[functional oral intake scale(FOIS)],tube feeding comfort and complications were compared between the two groups.Results:After treatment,the levels of BMI,Hb,ALB,TP,and FOIS score in IOE group were higher than those in NGT group(P<0.05).The incidence of nasal discomfort,dry mouth and swallowing discomfort in IOE group were lower than those in NGT group(P<0.05).The total incidence of complications in the IOE group was lower than that in the NGT group(8.33%vs.26.67%,P<0.05).Conclusion:Compared with NGT,IOE can better improve the nutritional status and swallowing function of patients with dysphagia after stroke,and IOE has higher tube feeding comfort and lower complication rate.