早期带管摄食管理对老年吞咽障碍患者拔管成功率及并发症影响.docVIP

早期带管摄食管理对老年吞咽障碍患者拔管成功率及并发症影响 　　[摘要] 目的 探讨早期带管摄食管理对老年吞咽障碍患者拔管成功率及并发症的影响。 方法 选取本科2013年2月～2014年8月收治的老年患者，将符合入选标准的住院吞咽障碍老年患者80例随机分为对照组和治疗组，各40例。对照组采用常规的鼻饲护理和吞咽功能训练方法。治疗组进行为期4周的早期带管摄食管理和4周的拔管摄食管理，包吞咽障碍动态评估、每餐进食前吞水试验、经口进水辅导、经口进食辅导、进食监测、误咽的预防、呛咳的处理、对照护者技能的培训。统计两组患者拔除胃管的成功率和并发症发生率。 结果 2个月后，治疗组的拔管成功率明显高于对照组（P0.05），电解质紊乱、泌尿系感染等并发症发生率明显低于对照组（P0.05）。 结论 早期带管摄食管理能有效提高老年吞咽障碍患者拔除胃管成功率，降低拔管后发生误吸的风险，降低并发症发生率，从而大大减少因并发症增加的住院费用，并减轻因置管时间过长而带来的痛苦，提高了患者的生存质量。 　　[关键词] 早期带管摄食；老年患者；吞咽障碍 　　[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2015）09（c）-0180-04 　　Influence of early stage tubefeeding management on extubation success rate and complications of elderly patients with swallowing disorder 　　WU Yuan CHEN Shu-di LIANG La-mei 　　Department of Neurology，the Fifth Hospital Affiliated to Guangzhou Medical University，Guangzhou 510700，China 　　[Abstract] Objective To investigate the influence of early stage tube feeding management on the extubation success rate and complications of elderly patients with swallowing disorder. Methods The elderly patients admitted into our department from February 2013 to August 2014 were selected，among them，80 hospitalized elderly patients swallowing disorder meeting the inclusion standard were randomly divided into control group and treatment group，and there were 40 patients in each group.Control group was given conventional nasal feeding nursing and swallowing function training method.Treatment group was given 4 weeks of early tube feeding management and 4 weeks of extubation feeding management including dynamic evaluation of dysphagia，water ingestion test before feeding at each meal，transoral water guidance，transoral feeding coaching，feeding monitoring，prevention of abnormal swallowing，bucking treatment and skills training for caregivers.The success rate and incidence rate of complication for stomach tube extubation of two groups was calculated respectively. Results After 2 months，the treatment group was higher than the control group in the extubation success r