间歇口腔营养管管饲法对脑外伤致吞咽障碍患者吞咽功能及营养状况的影响

发布时间：2018-01-20 07:40

  本文关键词： 间歇口腔营养管管饲法 脑外伤 吞咽障碍 营养状况　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景:脑外伤是指由于受到钝击伤、贯通伤或加/减速力而引起的颅脑创伤,一般可引起严重的后果[1]。脑外伤常常发生于青年人和老年人之中,尤其是30岁以下的青年人是脑外伤发生的高发人群,严重影响社会的发展[2]。脑外伤可导致严重的神经系统损伤,具有致残性和致死性,是重要的社会问题。吞咽障碍是脑外伤(包括开放性和闭合性头颅外伤、硬膜下出血等)患者的常见的临床表现之一,脑外伤患者吞咽障碍的发生率各家报道不一,大致为30%~68%。主要表现为食物摄入并由口腔转送至胃的过程中发生障碍[3]。由此所导致的营养不良、吸入性肺炎、电解质紊乱以及窒息等并发症严重降低了患者的生活质量,并增加了致残率和病死率[4]。因此,对脑外伤致吞咽障碍患者行早期介入康复治疗具有重要临床意义。本研究观察间歇口腔营养管管饲法对脑外伤致吞咽障碍患者吞咽功能和营养状况的影响。目的:探讨间歇口腔营养管管饲法对脑外伤致吞咽障碍患者吞咽功能及营养状况的影响。方法:选取2014年9月至2016年7月入住郑州大学第一附属医院康复科的60例脑外伤合并吞咽障碍患者,将入选患者随机分为治疗组和对照组,每组30例。治疗组行间歇口腔营养管饲法给予营养支持,对照组使用留置鼻饲管法给予营养支持。观察两组患者治疗前和治疗后4周的各项营养指标及吞咽功能改善情况。结果:治疗4周后,治疗组各项营养指标水平均高于对照组,差异具有统计学意义(P0.05)。治疗4周后,两组患者吞咽功能较治疗前均有不同程度提高,但治疗组患者较对照组改善更明显(P0.05)结论:在综合康复治疗的基础上给予间歇口腔营养管管饲法治疗,能促进脑外伤患者吞咽功能改善,降低误吸风险,同时改善脑外伤患者的营养状况,缩短病程,促进脑外伤愈合。
[Abstract]:Background: brain trauma refers to traumatic brain injury caused by blunt injury, penetrating injury or acceleration / deceleration force. [1]. Brain trauma often occurs among young people and the elderly, especially young people under 30 years of age, who have a high incidence of brain trauma, which seriously affects the development of society. [2]. Traumatic brain injury can lead to severe nervous system injury, with disability and mortality, is an important social problem. Dysphagia is brain trauma (including open and closed head trauma). One of the common clinical manifestations of patients with subdural hemorrhage is the incidence of dysphagia in patients with brain injury. It is mainly manifested in the process of food intake and transmission from the mouth to the stomach. [3. The resulting complications of malnutrition, aspiration pneumonia, electrolyte disorders and asphyxia have seriously reduced the quality of life of patients and increased the rate of disability and mortality. [4]. Accordingly. The effect of intermittent oral nutrition tube feeding on swallowing function and nutritional status of patients with dysphagia caused by brain injury is of great clinical significance. :. To investigate the effect of intermittent oral nutrition tube feeding on swallowing function and nutritional status of patients with swallowing disorder caused by brain injury. From September 2014 to July 2016, 60 patients with brain trauma complicated with dysphagia were enrolled in the Department of Rehabilitation of the first affiliated Hospital of Zhengzhou University. The patients were randomly divided into treatment group and control group with 30 cases in each group. The treatment group received intermittent oral nutrition tube feeding to provide nutritional support. The control group was given nutritional support by indwelling nasal feeding tube. The nutritional indexes and the improvement of swallowing function were observed before treatment and 4 weeks after treatment. Results: after 4 weeks of treatment. The levels of nutritional indexes in the treatment group were higher than those in the control group, and the difference was statistically significant (P 0.05). After 4 weeks of treatment, the swallowing function of the two groups were improved in varying degrees. Conclusion: on the basis of comprehensive rehabilitation treatment, intermittent oral nutrition tube feeding can promote the improvement of swallowing function in patients with brain injury. Reduce the risk of aspiration, improve the nutritional status of patients with brain injury, shorten the course of brain injury, promote the healing of brain injury.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.15
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本文编号：1447407