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日本老年人长期管饲后经口进食的恢复:宫间医院面临的一项挑战

Recovery of oral feeding in Japanese elderly people after long-term tube feeding: A challenge in Miyama Hospital.

作者信息

Nogami Tatsuya, Kurachi Motonari, Hukushi Tsugumi, Iwasaki Koh

机构信息

Department of Kampo Medicine, Tokai University School of Medicine, Isehara City, Kanagawa, Japan.

Miyama Hospital, Ohshu City, Iwate, Japan.

出版信息

J Family Med Prim Care. 2020 Aug 25;9(8):3977-3980. doi: 10.4103/jfmpc.jfmpc_567_20. eCollection 2020 Aug.

Abstract

CONTEXT

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.

AIMS

We examined the factors that affected the transition from tube to oral feeding in elderly people.

SETTINGS AND DESIGN

Single-center, retrospective, pilot study conducted from January 1, 2018 to December 28, 2019.

METHODS AND MATERIALS

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.

RESULTS

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.

CONCLUSIONS

Higher consciousness level in patients who successfully resumed oral feeding suggests that oral feeding should be considered in patients with adequate consciousness.

摘要

背景

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。

目的

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。

设置与设计

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。

方法与材料

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a45d/7586527/6d3a08587e69/JFMPC-9-3977-g001.jpg

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