Objective To investigate the influence of nasogastric on in-ward frequency, fatality rate, hospitalization cost and caregiver stress to severe dementia patients who combined with swallowing dysfunction. Method Sixty-eight dementia patient's who combined with swallowing dysfunction were recruited in the study in our department from Jan 2013 to Jan 2016. Thirty-eight cases were given nasogastric feeding, thirty cases were not given nasogastric feeding. The time of feeding in-ward frequency, hospitalization cost, death toll of all the patient's for one year were recorded. Zarit caregiver burden interview(ZBI) was used to caregiver when first visit (0 month) and three months later. The time of feeding, in-ward frequency, the average single hospitalization cost, death toll and the score of ZBI were Compared between two groups.Results ①There was a fidgeting after the nasal feeding ,the first week tube drawing number is (4.20±2.47) t;②Compared with non-nasal feeding group, the feeding time of nasal feeding group were significantly shortened [(32.45±4.76)minVS(65.37±12.57) min,P=0.000,t=11.326],the in-ward frequency[(1.92±0.97)t VS(10.25±3.55)t,P=0.000,t=12.885], fatality rate(10.52% VS 40.00%, P=0.004,t=0.894) and the average single hospitalization cost of nasal feeding group in one year[(8152.15±1972.82) y VS (33632.50±33273.07)y,P=0.000,t=4.326]were decreased significantly;③Compared with non-nasal feeding group, the ZBI grade [(66.45±9.95)VS( 80.75±6.15),P=0.000,t=7.348]of nasal feeding group were decreased significantly.Conclusion Nasogastric feeding can decrease the in-ward frequency, fatality rate and hospitalization cost of dementia patients who combined with swallowing dysfunction in one year, and also can decreased Caregiver stress.%目的 探讨鼻饲进食对重度痴呆合并吞咽功能障碍患者的住院次数、病死率、住院费及照料者压力的影响.方法 选择本科2013年1月-2016年1月住院的重度痴呆患者68例,其中38例给予鼻饲进食,30例未予鼻饲进食.记录所有患者留置胃管时及留置胃管后表现,喂食时间,1年内住院次数、每次住院费、死亡人数,对所有患者与分别于初诊时(0个月)及3个月后行照料者负担量表测试(ZBI).对比两组患者进食时间,1年内住院次数、病死率、平均单次住院费,对比两组患者第0个月及第3个月ZBI评分.结果 ①鼻饲组患者,鼻饲后出现烦躁,第1周拔管次数(4.20±2.47)·w-1;②与非鼻饲组相比,鼻饲组喂食时间明显缩短[(32.45±4.76)min VS(65.37±12.57)min,P=0.000,t=11.326],1年内住院次数[(1.92±0.97)次VS(10.25±3.55)次,P=0.000,t=12.885],病死率(10.52%VS 40.00%,P=0.004,t=0.894)、平均单次住院费[(8152.15±4972.82)元VS(33632.50±33273.07)元,P=0.000,t=4.326]均显著降低;③与非鼻饲组相比,第3个月鼻饲组ZBI评分显著下降[(66.45±9.95)VS(80.75±6.15),P=0.000,t=7.348].结论 ①鼻饲进食可减少重度痴呆合并吞咽功能障碍患者1年内住院次数、病死率、住院费,可短期改善照料者负担;②鼻饲进食可增加患者不适感.
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