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脑损伤吞咽困难患者经口-食管管饲成功的临床预测因素

Clinical Predictors of Oro-esophageal Tube Feeding Success in Brain Injury Patients With Dysphagia.

作者信息

Chun Yoon Mok, Chun Min Ho, Do Kyung Hee, Choi Su Jin

机构信息

Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea.

出版信息

Ann Rehabil Med. 2017 Oct;41(5):769-775. doi: 10.5535/arm.2017.41.5.769. Epub 2017 Oct 31.

Abstract

OBJECTIVE

To identify possible clinical predictors of intermittent oro-esophageal (OE) tube feeding success, and evaluate the clinical factors associated with OE tube treatment.

METHODS

A total of 135 dysphagic patients were reviewed, who received OE tube treatment and were hospitalized in the department of rehabilitation medicine between January 2005 and December 2014. The 76 eligible cases enrolled were divided into two groups, based on the OE tube training success. Clinical factors assessed included age, cause of brain lesion, gag reflex, cognitive function and reasons for OE tube training failure.

RESULTS

Of the 76 cases enrolled, 56 study patients were assigned to the success group, with the remaining 20 in the failure group. There were significant differences between these two groups in terms of age, gag reflex, ability to follow commands, and the score of Korean version of Mini-Mental Status Examination (K-MMSE). Location of the brain lesion showed a borderline significance. Multivariable analysis using logistic regression revealed that age, cause of brain lesion, gag reflex, and K-MMSE were the main predictors of OE tube training success.

CONCLUSION

A younger age, impaired gag reflex and higher cognitive function (specifically a K-MMSE score ≥19.5) are associated with an increased probability of OE tube training success in dysphagic patients.

摘要

目的

确定间歇性经口-食管(OE)管饲成功的可能临床预测因素,并评估与OE管治疗相关的临床因素。

方法

回顾了2005年1月至2014年12月期间在康复医学科接受OE管治疗的135例吞咽困难患者。根据OE管训练成功情况,将纳入的76例合格病例分为两组。评估的临床因素包括年龄、脑损伤原因、咽反射、认知功能以及OE管训练失败的原因。

结果

在纳入的76例病例中,56例研究患者被分配到成功组,其余20例在失败组。两组在年龄、咽反射、听从指令能力和韩国版简易精神状态检查表(K-MMSE)评分方面存在显著差异。脑损伤部位显示出临界显著性。使用逻辑回归的多变量分析显示,年龄、脑损伤原因、咽反射和K-MMSE是OE管训练成功的主要预测因素。

结论

年龄较小、咽反射受损和较高的认知功能(特别是K-MMSE评分≥19.5)与吞咽困难患者OE管训练成功的可能性增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4898/5698663/9c23e463b0c2/arm-41-769-g001.jpg

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