本文關(guān)鍵詞： 間歇口腔營養(yǎng)管管飼法 腦外傷 吞咽障礙 營養(yǎng)狀況　出處：《鄭州大學》2017年碩士論文　論文類型：學位論文

【摘要】：背景:腦外傷是指由于受到鈍擊傷、貫通傷或加/減速力而引起的顱腦創(chuàng)傷,一般可引起嚴重的后果[1]。腦外傷常常發(fā)生于青年人和老年人之中,尤其是30歲以下的青年人是腦外傷發(fā)生的高發(fā)人群,嚴重影響社會的發(fā)展[2]。腦外傷可導致嚴重的神經(jīng)系統(tǒng)損傷,具有致殘性和致死性,是重要的社會問題。吞咽障礙是腦外傷(包括開放性和閉合性頭顱外傷、硬膜下出血等)患者的常見的臨床表現(xiàn)之一,腦外傷患者吞咽障礙的發(fā)生率各家報道不一,大致為30%~68%。主要表現(xiàn)為食物攝入并由口腔轉(zhuǎn)送至胃的過程中發(fā)生障礙[3]。由此所導致的營養(yǎng)不良、吸入性肺炎、電解質(zhì)紊亂以及窒息等并發(fā)癥嚴重降低了患者的生活質(zhì)量,并增加了致殘率和病死率[4]。因此,對腦外傷致吞咽障礙患者行早期介入康復治療具有重要臨床意義。本研究觀察間歇口腔營養(yǎng)管管飼法對腦外傷致吞咽障礙患者吞咽功能和營養(yǎng)狀況的影響。目的:探討間歇口腔營養(yǎng)管管飼法對腦外傷致吞咽障礙患者吞咽功能及營養(yǎng)狀況的影響。方法:選取2014年9月至2016年7月入住鄭州大學第一附屬醫(yī)院康復科的60例腦外傷合并吞咽障礙患者,將入選患者隨機分為治療組和對照組,每組30例。治療組行間歇口腔營養(yǎng)管飼法給予營養(yǎng)支持,對照組使用留置鼻飼管法給予營養(yǎng)支持。觀察兩組患者治療前和治療后4周的各項營養(yǎng)指標及吞咽功能改善情況。結(jié)果:治療4周后,治療組各項營養(yǎng)指標水平均高于對照組,差異具有統(tǒng)計學意義(P0.05)。治療4周后,兩組患者吞咽功能較治療前均有不同程度提高,但治療組患者較對照組改善更明顯(P0.05)結(jié)論:在綜合康復治療的基礎(chǔ)上給予間歇口腔營養(yǎng)管管飼法治療,能促進腦外傷患者吞咽功能改善,降低誤吸風險,同時改善腦外傷患者的營養(yǎng)狀況,縮短病程,促進腦外傷愈合。
[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.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R651.15
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本文編號：1447407