【摘要】 目的:探讨凝固剂加肠内营养制剂代替传统流质饮食,在脑卒中吞咽障碍康复中的可行性与效果比较。方法:脑卒中吞咽障碍患者64例,随机分3组。G1组18例,采用凝固剂加肠内营养制剂的混合食物作摄食-吞咽训练;G2组22例,吞咽训练时采用传统流质饮食;G3组24例,未行康复治疗。比较3组拔胃管前后的营养状况、肺部感染及康复情况。结果:G1组拔胃管前后各项营养指标变化差异无显著性意义(P>0.05);G2组拔胃管后初期血清总蛋白、血红蛋白、上臂肌围均较拔胃管前显著下降(t=2.594,2.646,2.060,P均<0.05);而G3组拔胃管后各项营养指标均明显低于鼻饲时(P<0.05)。G2组和G3组吸入性肺炎发生率分别为14%(3/22)和42%(10/24),两组差异有显著性意义(χ2=4.448,P<0.05),而G1组无1例因误吸发生肺部感染。拔胃管后G1组吞咽障碍明显改善(χ2=38.816,P<0.01),康复效果最好(χ2=9.675,P<0.05;χ2=25.936,P<0.01),住院时间明显短于G2,G3组(t=12.490,19.762,P均<0.01)。结论:脑卒中吞咽障碍患者应早期进行吞咽康复训练,采用凝固剂加肠内营养制剂代替传统流质饮食,既减少吸入性肺炎发生,又改善患者营养状况,有利于吞咽功能恢复。更多还原

【Abstract】 AIM:To study the feasibility of coagulan t and enteral nutrition agent instea d of traditional liquid diet in early r ehabilitation program of deglutiti on disor-ders and compare the efficacy betwee n the two therapies.METHODS:Sixty-four patients with dysphagia following stroke were ran-domized into three groups.Eighteen patients in the G 1 group were applied with coagulants and Nutren as a kind o f liquid diet in rehabilitation pro-gram.Twenty-two patients in the G 2 group were applied with the traditio nal liquid diet.Twenty-four patients i n the G 3 group were enrolled as controls without treatment.The rehabilitat ion,changes of nutritional parameters and occurrence of pulmonary infection w ere observed and compared.RESULTS:In the G 1 group,the change of nutritional parameters before removing stomach-tube had no significant difference compared with that of early stage(P>0.05).But in the G 2 group,the serum total protein,hemoglobin and MAMC after removing s tomach-tube were significantly low er(t=2.594,2.646,2.060,P<0.05).The nutritional parameters in the G 3 group were significantly lower.The G 2 and the G 3 inhalation pneumonia occurrence rates were 14%(3/22)and 42%(10/24)respectively,and there were a significant difference between the two groups(χ 2 =4.448,P<0.05).But there were no infectious compli cation in the G 1 group.After stomach-tube removed,there was the obvious improvement in deglutition disorders for patients in the G 1 group(χ 2 =38.816,P<0.01),with the best effect in rehabilitation(χ 2 =9.675,P<0.05;χ 2 =25.936,P<0.01),whose hospitalization time was obviously shorted than that of the patients in the G 2 or in the G 3 group(t=12.490,19.762,P<0.01).更多还原