间歇性鼻饲联合吞咽功能训练在脑梗死后吞咽障碍患者中的应用效果

Application effects of intermittent nasal feeding combined with swallowing function training in patients with dysphagia after cerebral infarction

目的:观察间歇性鼻饲联合吞咽功能训练在脑梗死后吞咽障碍患者中的应用效果。方法:选取2022-2023年该院收治的74例脑梗死后吞咽障碍患者的进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各37例。两组均接受吞咽功能训练,在此基础上,对照组采取常规留置鼻饲,观察组采取间歇性鼻饲,比较两组康复优良率,干预前后吞咽功能[吞咽造影录像检查(VFSS)、标准吞咽功能评估表(SSA)]评分、营养指标[白蛋白(ALB)、血红蛋白(Hb)、体质量指数(BMI)]水平,以及并发症发生率。结果:观察组康复优良率为97.30%(36/37),高于对照组的78.38%(29/37),差异有统计学意义(P<0.05);治疗后,两组VFSS评分均高于治疗前,且观察组高于对照组,两组SSA评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组ALB、Hb、BMI均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为8.11%(3/37),低于对照组的40.54%(15/37),差异有统计学意义(P<0.05)。结论:间歇性鼻饲联合吞咽功能训练应用于脑梗死后吞咽障碍患者,可提高康复优良率,减轻吞咽障碍程度,改善营养指标水平,降低并发症发生率,效果优于常规鼻饲留置联合吞咽功能训练。

Objective:To observe application effects of intermittent nasal feeding combined with swallowing function training in patients with dysphagia after cerebral infarction.Methods:The clinical data of 74 patients with dysphagia after cerebral infarction admitted to this hospital from 2022 to 2023 were retrospectively studied.According to the random number table method,they were divided into control group and observation group,37 cases in each group.Both groups received swallowing function training.On this basis,the control group was given routine nasal feeding,while the observation group was given the intermittent nasal feeding.The excellent and good rate of rehabilitation,the scores of swallowing function videofluoroscopic swallowing study(VFSS),standardized swallowing assessment(SSA),the nutritional indexes albumin(ALB),hemoglobin(Hb),body mass index(BMI)levels before and after the intervention,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of rehabilitation in the observation group was 97.30%(36/37),which was higher than 78.38%(29/37)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the VFSS scores of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the SSA scores of the two groups were lower than those before the treatment,and that in the observation group was lower than the that in control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of ALB,Hb and BMI in the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 8.11%(3/37),which was lower than 40.54%(15/37)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Intermittent nasal feeding combined with swallowing function training applied to the patients with dysphagia after cerebral infarction can improve the excellent and good rate of rehabilitation,reduce the dysphagia degree,improve the levels of nutritional indexes,and reduce the incidence of complications.Moreover,it is superior to conventional nasal feeding indwelling combined with swallowing function training intervention.