Nogami Tatsuya, Kurachi Motonari, Hukushi Tsugumi, Iwasaki Koh
Department of Kampo Medicine, Tokai University School of Medicine, Isehara City, Kanagawa, Japan.
Miyama Hospital, Ohshu City, Iwate, Japan.
J Family Med Prim Care. 2020 Aug 25;9(8):3977-3980. doi: 10.4103/jfmpc.jfmpc_567_20. eCollection 2020 Aug.
In Japan, many patients who cannot consume food orally are managed using external tube feeding over long periods. Although helpful in nutritional management, tube feeding significantly reduces a patient's quality of life.
We examined the factors that affected the transition from tube to oral feeding in elderly people.
Single-center, retrospective, pilot study conducted from January 1, 2018 to December 28, 2019.
We recruited patients who attempted to return to oral intake following tube feeding for >12 months at Miyama Hospital. Fourteen participants (male-to-female ratio = 6:8; age = 83.9 ± 2.6 years) attempted to resume oral feeding. We investigated patient diagnoses, duration of tube feeding, sex, swallowing reflex time, and Kohnan consciousness score. Patients with a swallowing reflex >4 s were administered banxia houpu tang.
Of the 14 patients, seven managed to resume oral feeding (group 1), while the remaining seven failed (group 2). The two groups of patients showed no significant difference in terms of mean age, duration of tube feeding, swallowing reflex time, and sex. However, the consciousness level of group 1 was significantly higher than that of group 2.
Higher consciousness level in patients who successfully resumed oral feeding suggests that oral feeding should be considered in patients with adequate consciousness.
在日本，许多无法经口进食的患者长期采用鼻饲管喂养。尽管鼻饲管喂养有助于营养管理，但会显著降低患者的生活质量。
我们研究了影响老年人从鼻饲管喂养过渡到经口进食的因素。
2018年1月1日至2019年12月28日进行的单中心回顾性试点研究。
我们招募了在宫山医院接受鼻饲管喂养超过12个月后试图恢复经口进食的患者。14名参与者（男女比例=6:8；年龄=83.9±2.6岁）试图恢复经口进食。我们调查了患者的诊断、鼻饲管喂养持续时间、性别、吞咽反射时间和小南意识评分。吞咽反射>4秒的患者服用半夏厚朴汤。
14名患者中，7名成功恢复经口进食（第1组），其余7名失败（第2组）。两组患者在平均年龄、鼻饲管喂养持续时间、吞咽反射时间和性别方面无显著差异。然而，第1组的意识水平明显高于第2组。
成功恢复经口进食的患者意识水平较高，这表明意识清醒的患者应考虑经口进食。
