Abstract:

Objective　To investigate the effect of nasoenteral feeding (EN) by blind insertion of nasoenteric tube in patients with dysphagia after stroke (DAS). Methods　The random number table method was prospectively used to divide 80 cases of DAS patients admitted to Zhumadian Central Hospital from January 2020 to June 2022 into two groups, with 40 patients in each group. In the observation group, there were 23 males and 17 females, aged (62.37±3.69) years. In the control group, there were 22 males and 18 females, aged (62.58±3.87) years. The control group was treated with nasogastric tube EN, and the observation group was treated with EN by blind insertion of nasogastric tube, intervening for 14 days. The nutritional statuses of the two groups before and after intervention were compared, the postoperative complications of the two groups were counted, and the prognosis [Fugl-Meyer Motor Function Assessment (FMA) score and Barthel index] of the two groups were evaluated. χ² test and t test were used. Results　After intervention, the score of Nutrition Risk Screening Score Summary (NRS2002) was lower than that before intervention in both groups, and the score in the observation group was lower than that in the control group [(2.68±0.61) points vs. (4.60±0.53) points] (all P<0.001). After intervention, the levels of hemoglobin (Hb), albumin (Alb), and prealbumin (PA) were higher than those before intervention in both groups, and those in the observation group [(95.06±5.67) g/L, (39.78±4.14) g/L, and (193.46±22.36) mg/L] were higher than those in the control group [(89.73±5.06) g/L, (35.73±4.06) g/L, and (172.38±20.67) mg/L] (all P<0.001). The complication rate of the observation group was lower than that of the control group [2.50% (1/40) vs. 20.00% (8/40)] (χ²=4.507, P=0.034). After intervention, the FMA score and Barthel index were higher than those before intervention in both groups, and the scores in the observation group [(72.68±5.97) points and (72.31±6.54) points] were higher than those in the control group [(63.14±5.37) points and (55.69±6.13) points] (all P<0.001). Conclusion　Nasoenteric tube EN by blind insertion of nasogastric tube for patients with DAS can effectively improve their nutritional status, reduce the risk of complications, and improve the prognosis.

Key words:

Stroke, Dysphagia, Blind insertion of nasoenteric tube, Nasoenteral feeding, Nutritional status, Prognosis

摘要：

目的　探讨脑卒中后吞咽功能障碍（DAS）患者采用盲插鼻肠管法行鼻肠管肠内喂养（EN）的效果。方法　前瞻性采用随机数字表法将2020年1月至2022年6月驻马店市中心医院收治的DAS患者80例分为两组，各40例。观察组男23例，女17例，年龄（62.37±3.69）岁；对照组中男22例，女18例，年龄（62.58±3.87）岁。对照组采用鼻胃管EN，观察组采用盲插鼻肠管法行鼻肠管EN，均干预14 d。比较两组干预前及干预后的营养状况，统计两组术后并发症情况，并评估两组预后［Fugl-Meyer运动功能评定量表（FMA）评分、Barthel指数］。采用χ²检验、t检验。结果　两组干预后营养风险筛查评分简表（NRS2002）评分均比干预前低，且观察组比对照组低［（2.68±0.61）分比（4.60±0.53）分］，血红蛋白（Hb）、白蛋白（Alb）、前白蛋白（PA）水平均比干预前高，且观察组［（95.06±5.67）g/L、（39.78±4.14）g/L、（193.46±22.36）mg/L］比对照组高［（89.73±5.06）g/L、（35.73±4.06）g/L、（172.38±20.67）mg/L］（均P<0.001）。观察组并发症发生率比对照组低［2.50%（1/40）比20.00%（8/40）］（χ²=4.507，P=0.034）。两组干预后FMA评分、Barthel指数均较干预前升高，且观察组［（72.68±5.97）分、（72.31±6.54）分］高于对照组［（63.14±5.37）分、（55.69±6.13）分］（均P<0.001）。结论　DAS患者采用盲插鼻肠管法行鼻肠管EN可有效改善营养状况，降低并发症风险，改善预后。

关键词:

脑卒中, 吞咽功能障碍, 盲插鼻肠管, 鼻肠管肠内喂养, 营养状况, 预后