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吞咽困难患者口服补液溶液凝胶用于水和电解质摄入的安全性

The Safety of Oral Rehydration Solution Jelly for Water and Electrolyte Intake in Patients with Dysphagia.

作者信息

Nakagawa Kazuharu, Yoshimi Kanako, Yoshizawa Akira, Aritaki Kota, Yamaguchi Kohei, Nakane Ayako, Tohara Haruka

机构信息

Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Ther Clin Risk Manag. 2023 Mar 9;19:219-227. doi: 10.2147/TCRM.S398281. eCollection 2023.

Abstract

PURPOSE

Oral rehydration solutions (ORSs) are effective in replacing fluids and electrolytes and are widely used. OS-1 Jelly (Otsuka Pharmaceutical Factory, Tokushima, Japan) is a jelly drink corresponding to code 2-1 of the 2021 Japanese Dysphagia Diet. Although jelly drinks are less likely to be aspirated than liquids, their physical properties vary depending on the product. Therefore, the severity of dysphagia may affect intake status. This study aimed to investigate the association between the intake status of ORS jelly and swallowing function.

PATIENTS AND METHODS

Thirty-six patients with dysphagia who required videoendoscopic swallowing evaluation at our university hospital were enrolled. Videoendoscopic swallowing evaluation was performed, and each participant swallowed 5 mL of OS-1 Jelly or thickened water modified to International Dysphagia Diet Standardization Initiative (IDDSI) level 2 three times. Statistical analysis was performed to determine the difference in the number of swallows, time until the swallowing reflex, position for inducing the swallowing reflex, presence of pharyngeal residue, penetration, or aspiration between ORS jelly and thickened water.

RESULTS

The time until the swallowing reflex was induced and the position of the swallowing reflex triggered were significantly earlier for ORS jelly (=0.012, =0.001). The incidence of pharyngeal residue was significantly lower with ORS jelly (=0.002). The Penetration-Aspiration Scale score was similar for both samples (=0.062), and no aspiration was observed in either sample.

CONCLUSION

Patients with dysphagia who can swallow thickened water modified to IDDSI level 2 can consume ORS jelly. ORS jelly, which requires no thickening and can be easily and safely consumed, is effective for water and electrolyte intake in patients with dysphagia.

摘要

目的

口服补液溶液(ORS)在补充液体和电解质方面有效且应用广泛。OS-1果冻(日本德岛大冢制药厂生产)是一种符合2021年日本吞咽困难饮食代码2-1的果冻饮料。尽管果冻饮料比液体更不易被误吸,但其物理性质因产品而异。因此,吞咽困难的严重程度可能会影响摄入情况。本研究旨在调查ORS果冻的摄入情况与吞咽功能之间的关联。

患者与方法

招募了36名在我校医院需要进行视频内镜吞咽评估的吞咽困难患者。进行了视频内镜吞咽评估,每位参与者分三次吞咽5毫升OS-1果冻或按照国际吞咽困难饮食标准化倡议(IDDSI)2级标准调制的增稠水。进行统计分析以确定ORS果冻和增稠水在吞咽次数、吞咽反射出现时间、诱发吞咽反射的位置、咽部残留、渗透或误吸情况方面的差异。

结果

ORS果冻诱发吞咽反射的时间和触发吞咽反射的位置明显更早(=0.012,=0.001)。ORS果冻的咽部残留发生率显著更低(=0.002)。两个样本的渗透-误吸量表评分相似(=0.062),且两个样本均未观察到误吸。

结论

能吞咽按照IDDSI 2级标准调制的增稠水的吞咽困难患者可以食用ORS果冻。ORS果冻无需增稠,可轻松安全食用,对吞咽困难患者的水和电解质摄入有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ff2/10010143/c1a6749e1a37/TCRM-19-219-g0001.jpg

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