Changes in the Oral Moisture and the Amount of Microorganisms in Saliva and Tongue Coating after Oral Ingestion Resumption: A Pilot Study.
Changes in the Oral Moisture and the Amount of Microorganisms in Saliva and Tongue Coating after Oral Ingestion Resumption: A Pilot Study.
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DOI：
10.2174/1874210601610010079
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Ohuchi A
中科院分区：
文献类型：
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作者：
Kishimoto N;Stegaroiu R;Shibata S;Ito K;Inoue M;Ohuchi A
管饲与较高的吸入性肺炎发生率显著相关，吸入性肺炎主要与口腔微生物和唾液流量减少有关。因此，营养摄入方式的差异预计会影响口腔环境，但这一点尚未完全阐明。本研究的目的是调查，在管饲患者，口腔水分和微生物计数的变化，唾液和舌苔，发生在口服摄入恢复。研究参与者是新泻大学医学和牙科医院的7名管饲住院患者（72.7±8.5岁），他们在吞咽困难康复单位接受吞咽困难康复治疗，直到恢复口服摄入。观察并比较推荐口服前后患者的口腔健康状况、吞咽和营养状况、口腔黏膜水分、非刺激性唾液量、唾液和舌苔中的微生物（总微生物、链球菌、念珠菌）计数。恢复口服后，舌苔、呛咳、口腔粘膜水分和非刺激性唾液量明显改善。除舌苔链球菌外，其他研究参数无显著变化，舌苔链球菌在推荐口服后1周显著增加，但此后下降。恢复经口摄入后，口腔粘膜水分和非刺激性唾液量得到改善。然而，由于推荐口服摄入的链球菌计数暂时增加，因此根据口内微生物群的变化适当管理这些患者的口腔卫生非常重要。
Tube feeding has been significantly associated with a higher rate of aspiration pneumonia that is mainly related to oral microorganisms and a reduced salivary flow. Thus, the difference in the mode of nutritional intake is expected to affect the oral environment, but this has not yet been fully clarified. The purpose of this study was to investigate, in tube-fed patients, changes in the oral moisture and the counts of microorganisms in saliva and tongue coating, which occur after oral ingestion resumption. Study participants were 7 tube-fed inpatients of the Niigata University Medical and Dental Hospital (72.7±8.5 years old) who received dysphagia rehabilitation at the Unit of Dysphagia Rehabilitation until oral ingestion resumption. Their oral health, swallowing, and nutrition status, oral mucosal moisture, amount of unstimulated saliva and the counts of microorganisms (total microorganisms, streptococci, Candida) in saliva and tongue coating were investigated and compared before and after the recommencement of oral intake. Tongue coating, choking, oral mucosal moisture and amount of unstimulated saliva were improved significantly after resumption of oral ingestion. The other investigated parameters did not significantly change, except for the streptococci in tongue coating, which significantly increased 1 week after oral ingestion recommencement, but decreased thereafter. After oral intake resumption, oral mucosal moisture and amount of unstimulated saliva were improved. However, because of a transitory increase in the counts of streptococci with oral ingestion recommencement, it is important to appropriately manage oral hygiene in these patients, according to the changes in their intraoral microbiota.