針對神經性損傷中非退化性疾病造成吞嚥障礙之治療成效研究

The Effectiveness of Treatment for Non-degenerative Disease in Neurologic Injury with Dysphagia

目的：本研究欲探討北部某醫學中心急性中風病人在吞嚥治療後移除鼻胃管的比例與移除天數，另外再以功能性由口進食量表(FOIS)及國際吞嚥障礙飲食標準量表(IDDSI-FDS)兩個量表來評估其功能性的進食狀態。方法：研究對象為47位腦中風入院的病人，年齡範圍為44到88歲，男性30位，女性17位，再依年齡分為老年組和非老年組。結果：在接受吞嚥治療後，北部某醫學中心中風病人鼻胃管移除率為57.44%，鼻胃管移除天數平均是10.26天。老年組鼻胃管移除率為55.56%，鼻胃管移除天數平均是9.4天，非老年組鼻胃管移除率為60%，鼻胃管移除天數平均是11.75天。評估功能性進食則以FOIS及IDDSI-FDS兩個量表進行治療前後比較，結果顯示所有病人在治療前後功能性由口進食量表及國際吞嚥障礙飲食標準量表的分數皆達顯著差異，但兩組間並無顯著差異。結論：研究中所有的病人在治療後皆有顯著進步，可知在急性期介入對吞嚥功能改善有正向助益，雖然在以國際吞嚥障礙飲食標準量表並無差異，建議未來可使用不同量表評估功能性進食狀況。

Objectives. This study intends to investigate the effectiveness of swallowing treatment for acute stroke patients on the number of days for nasogastric tube removal in Far Eastern Memorial Hospital. The functional oral intake scale (FOIS) and the International Dietary Standards Scale for Swallowing Disorders (IDDSI- FDS) were used to assess the patients’functional eating status before and after swallowing treatment.
Methods. The subjects of the study were 47 patients who stroked, ranging in age from 44 to 88 years old. Of the 47 patients, 30 were male and 17 were female. They were divided into an elderly group and a non-elderly group according to their ages.
Results. After receiving treatment, the nasogastric tube removal rate in the elderly group was 55.56% and the average number of days for nasogastric tube removal was 9.4 days. In the non-elderly group, the nasogastric tube removal rate was 60% and the average number of days for nasogastric tube removal was 11.75 days. In the evaluation of functional eating, results from the FOIS and the IDDSI-FSD showed that all patients before and after the treatment reached significant differences, but there was no significant difference between the two groups.
Conclusion. All patients in the study made significant progress after treatment. Intervention in the acute phase had a positive effect on the improvement of swallowing function. Although there was no difference in the IDDSI-FDS, future studies can use different scales to assess functional eating status.