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预测脑卒中患者鼻胃管拔除的因素。

Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients.

机构信息

Department of Nursing, Taichung Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan.

Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970046, Taiwan.

出版信息

Medicina (Kaunas). 2023 Feb 14;59(2):368. doi: 10.3390/medicina59020368.

Abstract

Stroke patients have different levels of functional impairment, and rehabilitation is essential to achieving functional recovery. Many post-stroke patients transition from acute treatment to post-acute care (PAC) with nasogastric tubes (NGTs) for rehabilitation. However, long-term NGT placement can lead to several complications, and its earlier removal can effectively reduce the incidence of mortality. This study aimed to use a PAC-cerebrovascular disease (CVD) program and physical functional evaluation scale tools to demonstrate the factors associated with NGT removal before post-stroke patient discharge. In this retrospective cohort study, data were collected between January 2017 and August 2022. We divided patients who had NGTs at admission into discharged with and without NGT groups to compare their baseline characteristics and physical functional status. Logistic regression analysis was used to detect the predictive factors for NGT removal. There were 63 participants: 22 without NGT removal and 41 with NGT removal. The NGT removal rate was 65%. Age and scores for the activities of daily living by the Barthel index (BI), Functional Oral Intake Scale (FOIS), Mini-Mental State Examination, and Concise Chinese Aphasia Test were significantly different in terms of NGT removal status, but only the BI and FOIS were significantly correlated with NGT removal. Patients' BI scores indicating severe to moderate dependence (21-90) had a 4.55 times greater chance of NGT removal (odds ratio, 4.55; < 0.05) than patients who had total dependence (<20). Every one-point increase in FOIS score indicated a 3.07 times greater chance of NGT removal (odds ratio, 3.07; < 0.05). The BI and FOIS evaluations may indicate the probability of NGT removal in patients.

摘要

脑卒中患者的功能损伤程度不同,康复治疗对于实现功能恢复至关重要。许多脑卒中后患者需要通过鼻饲管(NGT)进行康复治疗,从急性治疗过渡到急性后期治疗(PAC)。然而,长期留置 NGT 会导致多种并发症,早期拔除 NGT 可有效降低死亡率。本研究旨在使用 PAC-脑血管病(CVD)计划和身体功能评估量表工具,证明与脑卒中患者出院前 NGT 拔除相关的因素。

在这项回顾性队列研究中,数据收集于 2017 年 1 月至 2022 年 8 月。我们将入院时带有 NGT 的患者分为出院时带有和不带有 NGT 的两组,比较他们的基线特征和身体功能状况。使用逻辑回归分析检测 NGT 拔除的预测因素。

共有 63 名患者:22 名无 NGT 拔除,41 名有 NGT 拔除。NGT 拔除率为 65%。年龄和 Barthel 指数(BI)、功能性口腔摄入量表(FOIS)、简易精神状态检查和简明中国失语症测验的日常生活活动能力评分在 NGT 拔除状态方面存在显著差异,但只有 BI 和 FOIS 与 NGT 拔除显著相关。BI 评分表示严重至中度依赖(21-90)的患者 NGT 拔除的可能性是完全依赖患者(<20)的 4.55 倍(优势比,4.55;<0.05)。FOIS 评分每增加 1 分,NGT 拔除的可能性增加 3.07 倍(优势比,3.07;<0.05)。

BI 和 FOIS 评估可能表明患者 NGT 拔除的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2a6/9960104/705b58618fae/medicina-59-00368-g001.jpg

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