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长期护理下胃造口术患者经口进食能力的相关预测因素

Predictive Factors Associated with Oral Intake Ability in Gastrostomy Patients Under Long-Term Care.

作者信息

Nakayama E, Tohara H, Sakai K, Hayata M, Ohnishi S, Sekino J, Tsuzuki H, Hirai T, Hayashi A, Ueda K

机构信息

Enri Nakayama, Nihon University School of Dentistry, Japan,

出版信息

J Nutr Health Aging. 2017;21(6):715-720. doi: 10.1007/s12603-016-0796-9.

Abstract

OBJECTIVE

To determine the physical indicators associated with oral intake status and swallowing function in gastrostomy patients under long-term care.

DESIGN

Cross-sectional study.

SETTING

Thirty-one hospitals that perform gastrostomy insertion, replacement and management.

PARTICIPANTS

A total of 117 respondents from 31 hospitals in Japan underwent gastrostomy tube replacement and management between September 2012 and January 2014. Each participant underwent a gastrostomy at least 6 months prior to the study, and received long-term care either at home, a care facility, or a hospital.

MEASUREMENTS

We conducted a questionnaire survey at Japanese hospitals and used the data obtained from 117 respondents for analysis. The survey was conducted using a questionnaire form that collected information about the following items: oral intake status, sex, age, disease history, number of days elapsed since gastrostomy, residence status, modified Rankin Scale score, consciousness, oral hygiene status, articulation and phonation, voluntary saliva swallow, Modified Water Swallow Test, and Food Test.

RESULTS

Results revealed significant differences in modified Rankin Scale scores, sputum production, articulation and phonation, and voluntary saliva swallowing between patients who were orally fed and those who were not. Moreover, sputum production and voluntary saliva swallowing were strongly associated with oral intake status. Finally, sputum production, articulation and phonation, and voluntary saliva swallowing were strongly associated with swallowing function test results.

CONCLUSION

Results from this study suggested that sputum production, articulation and phonation, and voluntary saliva swallowing could be used as indicators for estimating oral intake status and swallowing function in gastrostomy patients under long-term care.

摘要

目的

确定长期护理的胃造口术患者中与经口摄入状态和吞咽功能相关的身体指标。

设计

横断面研究。

地点

31家进行胃造口术插入、更换和管理的医院。

参与者

2012年9月至2014年1月期间,来自日本31家医院的117名受访者接受了胃造口管更换和管理。每位参与者在研究前至少6个月接受了胃造口术,并在家中、护理机构或医院接受长期护理。

测量

我们在日本医院进行了问卷调查,并使用从117名受访者获得的数据进行分析。调查使用问卷形式,收集以下项目的信息:经口摄入状态、性别、年龄、病史、胃造口术后经过的天数、居住状况、改良Rankin量表评分、意识、口腔卫生状况、发音和发声、自主唾液吞咽、改良水吞咽试验和食物试验。

结果

结果显示,经口喂食患者和未喂食患者在改良Rankin量表评分、痰液产生、发音和发声以及自主唾液吞咽方面存在显著差异。此外,痰液产生和自主唾液吞咽与经口摄入状态密切相关。最后,痰液产生、发音和发声以及自主唾液吞咽与吞咽功能测试结果密切相关。

结论

本研究结果表明,痰液产生、发音和发声以及自主唾液吞咽可作为评估长期护理的胃造口术患者经口摄入状态和吞咽功能的指标。

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