Effectiveness of Water Jelly Ingestion for Both Rehabilitation and Prevention of Aspiration Pneumonia in Elderly Patients With Moderate to Severe Dysphagia.
Effectiveness of Water Jelly Ingestion for Both Rehabilitation and Prevention of Aspiration Pneumonia in Elderly Patients With Moderate to Severe Dysphagia.
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DOI：
10.1097/mcg.0000000000001493
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发表时间：
2022-02-01
影响因子：
2.9
通讯作者：
Takada H
中科院分区：
文献类型：
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作者：
Morita A;Horiuchi A;Horiuchi I;Takada H
我们对中重度吞咽困难的老年患者进行了回顾性分析，评价了水果冻摄入对康复和预防吸入性肺炎的有效性。研究1：纳入连续36例在内窥镜吞咽评估中有临界摄入的患者(男18例，女18例，平均年龄82±9 y)，分为水果冻(50~100 m L)摄取训练组和未训练对照组。然后使用食物摄入量水平量表比较他们的食物摄入量水平。研究二：连续入选因吸入性肺炎住院的患者(，男35例，女29例，平均年龄81±9 y)，随机分为两组，每餐后即刻循环摄入水凝胶组和对照组。比较两组患者住院期间新发生的吸入性肺炎的发生率。在研究1中，纳入了Hyodo-Komagane评分为8分的36名患者。12例接受水冻摄取训练的患者中有3例(25%)能够吃纯饮食(5级，2例；6级，1例)，而没有接受这项训练的24名患者(0%)都不能吃任何形式的饮食(5级和6级，没有患者)(P=0.011)。研究2：入选患者。循环服药组34例(0%)未发生新的吸入性肺炎，而餐后未服药组住院期间新发吸入性肺炎的发生率为17%(5/30)(P=0.031)。在中重度吞咽困难的老年患者中，服用水凝胶对康复和预防吸入性肺炎都是有效的。
We evaluated the effectiveness of water jelly ingestion for both rehabilitation and the prevention of aspiration pneumonia in a retrospective analysis of elderly patients with moderate to severe dysphagia. Study 1: consecutive patients with borderline ingestion in an endoscopic swallowing evaluation were enrolled (n=36, 18 men and 18 women: mean age 82±9 y) and categorized into a group with water jelly (50 to 100 mL) ingestion training 3×/day or an untrained control group. Their food intake levels were then compared using a Food Intake Level Scale. Study 2: consecutive patients who were hospitalized because of aspiration pneumonia were enrolled (n=64, 35 men and 29 women: mean age 81±9 y) and categorized into a group with cyclic ingestion of water jelly immediately after each meal or a control group. The incidence of aspiration pneumonia that was newly developed during hospitalization was compared between the groups. In study 1, 36 patients with a Hyodo-Komagane score of 8 were enrolled. Three of the 12 (25%) patients who underwent water jelly ingestion training were able to eat a pureed diet (level 5, 2 patients; level 6, 1 patient) while none of the 24 patients (0%) who did not undergo this training were able to eat any form of diet (levels 5 and 6, no patients) (P=0.011). In study 2, 64 patients were enrolled. No newly developed aspiration pneumonia was observed in the 34 patients (0%) who received cyclic water jelly ingestion, whereas 17% (5/30) of patients not receiving water jelly after meals newly developed aspiration pneumonia during hospitalization (P=0.031). Water jelly ingestion was effective for both rehabilitation and the prevention of aspiration pneumonia in elderly patients with moderate to severe dysphagia.