뇌졸중 환자에서 24시간 식도 산도 검사를 이용한 구강식도관과 비위관의 위식도 역류 비교
Gastroesophageal Reflux during Nasogastric Tube Feeding versus Oroesophageal Tube Feeding in Stroke Patients: A 24-Hour Esophageal pH-monitoring
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초록
Objective: Patients who are diagnosed to dysphagia after stroke may receive tube feeding such as percutaneous endoscopic gastrostomy (PEG), nasogastric tube or oroesophageal (OE) tube. Although the most common complication for stroke patients is known to be aspiration pneumonia, the physiology of gastroesophageal reflux (GER) associated with tube feeding has not been fully assessed. OE tube feeding and nasogastric tube feeding are non-invasive tube feeding methods both, but the tube can be inserted intermittently using OE tube to avoid continuous esophageal reflux. Method: The goal of this study was to examine, by 24-hour esophageal pH monitoring, whether GER is related to feeding method, nasogastric tube versus OE tube. 7 stroke patients were examined 24-hour esophageal pH monitoring during nasogastric tube feeding and OE tube feeding, sequentially. The parameters were collected of total acid exposure time, the mean esophageal pH, total reflux episode and deMeester composite score. Result: Total reflux episode improved only in OE tube feeding, statistically (P＜0.05). There were no significant differences between the two groups for total acid exposure time, the mean esophageal pH and deMeester composite score. Conclusion: OE tube can be a possible substitute for nasogastric tube in patients with dysphagia suffering from gastroesophageal reflux disease. And OE tube feeding may be used to facilitate recovery of swallowing function without aggravated reflux disease associated with tube feeding.
Abstract
Objective: Patients who are diagnosed to dysphagia after stroke may receive tube feeding such as percutaneous endoscopic gastrostomy (PEG), nasogastric tube or oroesophageal (OE) tube. Although the most common complication for stroke patients is known to be aspiration pneumonia, the physiology of gastroesophageal reflux (GER) associated with tube feeding has not been fully assessed. OE tube feeding and nasogastric tube feeding are non-invasive tube feeding methods both, but the tube can be inserted intermittently using OE tube to avoid continuous esophageal reflux. Method: The goal of this study was to examine, by 24-hour esophageal pH monitoring, whether GER is related to feeding method, nasogastric tube versus OE tube. 7 stroke patients were examined 24-hour esophageal pH monitoring during nasogastric tube feeding and OE tube feeding, sequentially. The parameters were collected of total acid exposure time, the mean esophageal pH, total reflux episode and deMeester composite score. Result: Total reflux episode improved only in OE tube feeding, statistically (P＜0.05). There were no significant differences between the two groups for total acid exposure time, the mean esophageal pH and deMeester composite score. Conclusion: OE tube can be a possible substitute for nasogastric tube in patients with dysphagia suffering from gastroesophageal reflux disease. And OE tube feeding may be used to facilitate recovery of swallowing function without aggravated reflux disease associated with tube feeding.
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