Neurogenic dysphagia refers to swallowing disorders caused by the damage of swallowing central or peripheral nerves and muscles. According to statistics, about 50% of patients with neurological diseases will be complicated with neurogenic dysphagia. Common diseases include stroke, dementia, Parkinson's disease and neuromuscular diseases. Dysphagia has a great impact on the quality of life of patients, and is related to malnutrition, aspiration pneumonia and even death. In severe cases, tracheotomy is required to maintain airway patency and discharge secretions. The common nutritional support methods for patients with neurogenic dysphagia after tracheotomy are nasogastric or nasointestinal tube placement and percutaneous gastrostomy. intermittent oro-esophageal tube feeding (IOE) is a new nutrition method proposed by scholars in recent years. Studies have shown that it can improve the swallowing function of patients with dysphagia while meeting the nutritional needs of patients, so as to effectively improve the quality of life of patients. However, there are few studies on patients with dysphagia after tracheotomy. This study aims to compare the intervention effects of two kinds of tube feeding methods in patients with neurogenic dysphagia after tracheotomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
140
A disposable gastric tube was used to perform enteral nutrition support therapy, and contraindications were evaluated again. Inform the patient and family members of the precautions for intermittent feeding through oral tube, and play the video of the operation process to make them actively cooperate with the operation.
For patients at risk of repeated aspiration and regurgitation, and for patients with gastric nutritional intolerance that cannot be improved by gastrointestinal motivity drugs, indwelling intestinal tube and retropyloric feeding are given.
Beijing Rehabilitation Hospital, Capital Medical University
Beijing, China
Decannulation time of the tracheostomy tube
Decannulation time of the tracheostomy tube, corresponding to the number of days between entering the decannulation protocol to removal.
Time frame: From date of randomization until extubation, assessed up to 30 days
Decannulation rate
The rate of successful decannulation among enrolled patients
Time frame: From date of randomization until extubation, assessed up to 30 days
Penetration-Aspiration Scale (PAS) score
The Penetration-Aspiration Scale (PAS) is a standardized tool for evaluating swallowing safety. It primarily assesses the risk of food or liquid entering the airway (aspiration) or remaining in the larynx (penetration). The scale consists of 8 levels (1-8), with higher scores indicating greater risk and severity of aspiration. It should be used in conjunction with clinical observations (FEES).
Time frame: up to 30 days
Nutritional status-albumin(ALB, g/L), prealbumin (PA, mg/L) and body mass index (BMI)
Nutritional status assessed includes albumin (ALB, g/L), prealbumin (PA, mg/L) and body mass index (BMI) at baseline,, 2 weeks after treatment and 1month after treatment.
Time frame: up to 30 days
ChSwallowing Quality of Life questionnaire (ChSWAL-QoL)
ChSWAL-QoL was assessed using the Chinese version of the Swallowing Quality of Life scale\[20\] at baseline,, 2 weeks after treatment and 1month after treatment.
Time frame: up to 30 days
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