Effect of intermittent oral to esophageal tube feeding combined with swallowing training on nutritional status and prognosis in stroke patients with dysphagia

doi:10.3877/cma.j.issn.2095-123X.2023.02.006

Abstract

Abstract:

Objective

To analyze the effect of intermittent oral to esophageal tube feeding combined with swallowing training on nutritional status and prognosis of patients with dysphagia.

Methods

One hundred and six patients with dysphagia in the Third Hospital of Xingtai City from January 2019 to May 2020 were divided into control group (53 cases, continuous indwelling nasal feeding + swallowing training) and study group (53 cases, intermittent oral to esophageal tube feeding + swallowing training) by a random digital table, and all patients were treated for 4 weeks. The swallowing function, nutritional status [including body mass index (BMI), triceps skinfold thickness (TSF), arm circumference (AC), total protein (TP), prealbumin (PA), albumin (ALB)] before treatment and after treatment were compared between the two groups. The clinical effect, the incidences of complications and adverse events during treatment and prognosis were compared.

Results

There were statistically significant differences in swallowing function grades between the two groups before and after treatment (P<0.05), and there was a statistically significant difference between the two groups after treatment (P<0.05). After treatment, BMI, TSF, AC, serum TP, PA, ALB levels in the study group were higher than those before treatment, which were higher than those in the control group, with statistically significant differences (P<0.05). There was a statistically significant difference in the grading of clinical effect between the two groups after treatment (P<0.05), and the total effective rate in the study group was higher than the control group (P<0.05). The incidences of aspiration pneumonia, electrolyte disturbance and complications were lower than those of the control group, with statistically significant differences (P<0.05). There was no statistically significant difference in the incidences of adverse events between the two groups (P>0.05). NIHSS score of the study group was lower than that of the control group, and BI score was higher than that of the control group, with a statistically significant difference (P<0.05).

Conclusion

Intermittent oral to esophageal tube feeding combined with swallowing training can significantly improve the swallowing function and nutritional status of patients with dysphagia, enhance clinical effect, reduce complications and improve the prognosis.

Key words: Intermittent oral to esophageal feeding, Swallowing training, Dysphagia, Nutritional status, Prognosis

Jinchao Guo, Xinjie Zhang, Lu Yang, Guiling Wang. Effect of intermittent oral to esophageal tube feeding combined with swallowing training on nutritional status and prognosis in stroke patients with dysphagia[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(02): 102-107.

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References 17

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项目	研究组（n=53）	对照组（n=53）	χ²/t/Z值	P值
性别[例（%）]			0.344	0.558
男	31（58.49）	28（52.83）
女	22（41.51）	25（47.17）
年龄（岁，Mean±SD）	59.52±7.81	58.75±7.04	0.533	0.595
入院时BMI（kg/m²，Mean±SD）	20.11±2.09	20.25±2.05	0.348	0.728
吞咽障碍病程（月，Mean±SD）	1.27±0.21	1.25±0.20	0.502	0.617
洼田饮水试验分级[例（%）]			0.164	0.685
3级	20（37.74）	18（33.95）
4级	25（47.17）	25（47.17）
5级	8（15.09）	10（18.87）
原发病[例（%）]			0.229	0.632
急性脑梗死	43（81.13）	41（77.36）
高血压脑出血	10（18.87）	12（22.64）
NIHSS评分（分，Mean±SD）	14.64±2.61	14.51±2.58	0.258	0.797

项目	研究组（n=53）	对照组（n=53）	χ²/t/Z值	P值
性别[例（%）]			0.344	0.558
男	31（58.49）	28（52.83）
女	22（41.51）	25（47.17）
年龄（岁，Mean±SD）	59.52±7.81	58.75±7.04	0.533	0.595
入院时BMI（kg/m²，Mean±SD）	20.11±2.09	20.25±2.05	0.348	0.728
吞咽障碍病程（月，Mean±SD）	1.27±0.21	1.25±0.20	0.502	0.617
洼田饮水试验分级[例（%）]			0.164	0.685
3级	20（37.74）	18（33.95）
4级	25（47.17）	25（47.17）
5级	8（15.09）	10（18.87）
原发病[例（%）]			0.229	0.632
急性脑梗死	43（81.13）	41（77.36）
高血压脑出血	10（18.87）	12（22.64）
NIHSS评分（分，Mean±SD）	14.64±2.61	14.51±2.58	0.258	0.797

组别	例数	治疗前			治疗后
组别	例数	3级	4级	5级	1级	2级	3级	4级	5级
研究组	53	20（37.74）	25（47.17）	8（15.09）	18（33.96）	22（41.51）	10（18.87）	2（3.77）	1（1.89）
对照组	53	18（33.95）	25（47.17）	10（18.87）	10（18.87）	14（26.42）	12（22.64）	9（16.98）	8（15.09）
Z值		0.164			5.621
P值		0.685			0.021

组别	例数	治疗前			治疗后
组别	例数	3级	4级	5级	1级	2级	3级	4级	5级
研究组	53	20（37.74）	25（47.17）	8（15.09）	18（33.96）	22（41.51）	10（18.87）	2（3.77）	1（1.89）
对照组	53	18（33.95）	25（47.17）	10（18.87）	10（18.87）	14（26.42）	12（22.64）	9（16.98）	8（15.09）
Z值		0.164			5.621
P值		0.685			0.021

组别	对照组（n=53）				研究组（n=53）
组别	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
BMI（kg/m²）	20.25±2.05	20.03±2.09	0.547	0.585	20.11±2.09	21.68±2.04^a	3.914	<0.001
TSF（mm）	14.43±2.01	13.79±1.92	1.676	0.097	14.52±1.98	15.85±2.07^a	3.380	0.001
AC（cm）	19.48±2.10	19.05±2.11	1.052	0.295	19.52±2.15	22.47±2.58^a	6.395	<0.001
TP（g/L）	63.46±7.09	62.17±7.04	0.940	0.349	63.58±7.14	68.50±7.91	3.361	0.001
PA（g/L）	0.19±0.03	0.20±0.04	1.456	0.148	0.20±0.03	0.25±0.05	6.243	<0.001
ALB（g/L）	33.60±5.14	32.89±5.05	0.717	0.475	33.52±5.05	37.96±5.41^a	4.368	<0.001

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