연하장애를 가진 뇌졸중 환자에서 비위관 삽입이 연하 기능에 미치는 영향
The Influence of Nasogastric Tubes on Swallowing Function in Stroke Patient with Dysphagia
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Objective: To determine whether the use of a nasogastric (NG) tube influenced swallowing function in stroke patients with dysphagia. Method: Thirty stroke patients with dysphagia (20 men and 10 women, average age=61.4±15.8 years) were included. All patients used NG tubes for nutrition supply and did not show massive aspiration on videofluoroscopic swallowing study (VFSS). VFSS was done using barium (5 ml each) as a contrast medium to evaluate swallowing function. The swallowing trigger time, pharyngeal transit time, duration of pharyngeal response were measured with and without the NG tube. Presence of residual material, aspiration, and movement pattern of the hyoid (degree of anterior and superior displacement) were also recorded using VFSS with and without the NG tube. Result: Swallowing trigger time decreased slightly after removal of the NG tube, but the reduction was not statistically significant (P=0.28). Pharyngeal transit time and duration of pharyngeal response showed no significant change after removal of the NG tube. The presence of aspiration did not change either. Anterior and superior excursion of the hyoid bone did not differ statistically with or without the NG tube. More residual material was found after swallowing with the NG tube in place (P=0.04). Conclusion: NG tube placement did not influence laryngeal elevation, swallowing reflex, and aspiration severity in stroke patients with dysphagia. Therefore, direct swallowing therapy with NG tube placement may be a safe training method.
Abstract
Objective: To determine whether the use of a nasogastric (NG) tube influenced swallowing function in stroke patients with dysphagia. Method: Thirty stroke patients with dysphagia (20 men and 10 women, average age=61.4±15.8 years) were included. All patients used NG tubes for nutrition supply and did not show massive aspiration on videofluoroscopic swallowing study (VFSS). VFSS was done using barium (5 ml each) as a contrast medium to evaluate swallowing function. The swallowing trigger time, pharyngeal transit time, duration of pharyngeal response were measured with and without the NG tube. Presence of residual material, aspiration, and movement pattern of the hyoid (degree of anterior and superior displacement) were also recorded using VFSS with and without the NG tube. Result: Swallowing trigger time decreased slightly after removal of the NG tube, but the reduction was not statistically significant (P=0.28). Pharyngeal transit time and duration of pharyngeal response showed no significant change after removal of the NG tube. The presence of aspiration did not change either. Anterior and superior excursion of the hyoid bone did not differ statistically with or without the NG tube. More residual material was found after swallowing with the NG tube in place (P=0.04). Conclusion: NG tube placement did not influence laryngeal elevation, swallowing reflex, and aspiration severity in stroke patients with dysphagia. Therefore, direct swallowing therapy with NG tube placement may be a safe training method.
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