基于V-VST的精准摄食管理在老年期精神分裂症吞咽障碍患者中的应用研究

Application of precise feeding management based on V-VST inelderly patients with dysphagia of schizophrenia

目的探讨基于容积-黏度吞咽测试(V-VST)的精准摄食管理方案在老年期精神分裂症吞咽障碍患者中的应用,以提高患者饮食的安全性和有效性。方法选取2022年6月至2023年5月在广州医科大学附属脑科医院精神科住院的老年期精神分裂症吞咽障碍Ⅱ~Ⅲ级(均经洼田饮水试验证实)患者116例,采用随机数字表法将患者分为对照组和观察组,每组58例。对照组患者给予常规护理和饮食指导,观察组在洼田饮水试验基础上联合V-VST,为患者提供安全有效的精准摄食方案。干预30 d,对2组患者误吸发生率、吞咽功能改善情况、营养水平和生活质量进行对比分析。结果干预30 d后,观察组患者的误吸发生率低于对照组,吞咽障碍改善有效率,血清前蛋白(PA)和清蛋白(ALB)等营养指标水平均明显高于对照组,同时其生活质量也显著高于对照组,差异均有统计学意义(P<0.05)。结论基于V-VST的精准摄食管理可降低老年期精神分裂症吞咽障碍患者误吸发生率,使其吞咽功能及营养状况得到有效改善,从而提高其生活质量。

Objective To explore the application of precise feeding management program based on Volume-Viscosity Swallowing Test(V-VST)in elderly patients with dysphagia due to schizophrenia,so as to improve the safety and effectiveness of patients′diet.Methods From June 2022 to May 2023,116 elderly schizophrenic patients with dysphagia gradeⅡ-Ⅲ(all confirmed by Kubota drinking water test)hospitalized in the Department of Psychiatry,the Affiliated Brain Hospital of Guangzhou Medical University were selected.The patients were divided into control group and observation group by random number table method,with 58 cases in each group.The patients in the control group were given routine nursing and dietary guidance,and the patients in the observation group were combined with V-VST on the basis of Kubota drinking water test to provide a safe and effective accurate feeding plan for patients.After 30 days of intervention,the incidence of aspiration,improvement of swallowing function,nutritional level and quality of life were compared between the two groups.Results After 30 days of intervention,the incidence of aspiration in the observation group was lower than that in the control group,the effective rate of dysphagia improvement,the levels of serum preprotein(PA)and albumin(ALB)and other nutritional indicators were significantly higher than those in the control group,and the quality of life was also significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion The precise feeding management based on V-VST can reduce the incidence of aspiration in elderly patients with dysphagia and effectively improve their swallowing function and nutritional status,thus improving their quality of life.