多感官刺激联合间歇经口至食管管饲法在 老年脑卒中吞咽障碍的应用.

Objective To assess the effectiveness of multisensory stimulation combined with intermittent oroesophageal tube feeding in managing swallowing disorders among elderly stroke patients. Methods Stroke patients with swallowing disorders from February 2021 to October 2022 were randomly allocated into control group, observation group A, and observation group B. The control group received nasal gastric tube feeding on top of routine treatment; observation group A received intermittent oroesophageal tube feeding as an adjunct to routine treatment; observation group B, building upon observation group A, incorporated a multisensory stimulation protocol. The intervention duration for all three groups was 8 weeks. The study evaluated the Penetration- Aspiration Scale (PAS), Standard Swallowing Assessment (SSA), Swallowing Quality of Life Questionnaire (SWAL-QOL), body mass index (BMI), Nutritional Risk Screening 2002 (NRS2002), and laryngopharyngeal complex movement examination (hyoid bone elevation distance, thyroid cartilage elevation distance, hyoid bone anterior movement distance, thyroid cartilage anterior movement distance) before and after the intervention. Results After 8 weeks of intervention, except for the SWAL QOL score in the control group, the PAS score, SSA score, and SWAL-QOL score in the three groups showed improvement compared to preintervention levels (P<0.05). Observation group B demonstrated a significant difference in the PAS test and a lower SSA score compared to the other two groups (P<0.05), with a higher SWAL-QOL score than the control group (P<0.05), and no significant difference from observation group A (P>0.05). Regarding nutritional aspects, after 8 weeks of intervention, the BMI of all three groups increased compared to pre-intervention levels, and NRS2002 decreased (P<0.05). In the intergroup comparison, there was no significant difference in BMI among the three groups (P>0.05). Concerning NRS2002, observation group A and observation group B had lower scores than the control group (P<0.05), with no significant difference between observation group A and observation group B (P>0.05). In the laryngopharyngeal complex movement examination, after 8 weeks of intervention, except for the hyoid bone elevation distance in the control group, all other distances in the three groups increased compared to pre intervention levels (P<0.05). Observation group B had higher values than the other two groups in hyoid bone elevation distance and hyoid bone anterior movement distance (P<0.05), and only higher values than the control group in thyroid cartilage anterior movement distance and thyroid cartilage elevation distance, with no significant difference from observation group A (P>0.05). Conclusion The application of multisensory stimulation combined with intermittent oroesophageal tube feeding in stroke patients with swallowing disorders demonstrates improvements in swallowing function and enhances overall quality of life. Further research in this domain is warranted. [ABSTRACT FROM AUTHOR]