Clinical Observation On Dysphagia In Children With Cerebral Palsy By Intermittent Oro-esophageal Tube Feeding

Objective:To investigate the clinical effect of intermittent oro-esophageal tube feeding(IOE)on dysphagia in children with cerebral palsy,and to find a new treatment method for nutritional support,reducing complications and improving swallowing function of these children.Methods:Children with cerebral palsy who were admitted in rehabilitation medicine department of the first affiliated hospital of Zhengzhou university from february 2018 to october 2019 were enrolled in this study.The clinical effect of IOE and persistent naso-gastric tube feeding(PNG)on dysphagia in children with cerebral palsy was investigated.According to the inclusion criteria and exclusion criteria,80 children with cerebral palsy with dysphagia were included.The clinical evaluation of swallowing function was carried out by professional swallowing therapists in rehabilitation medicine department,and the basic information and clinical indexes were evaluated by rehabilitation medicine doctors.The participants were randomlydivided into case group and control group by random table method,40 cases per group.Among them 26 males and 14 females in the case group,with an average age of 6.25±2.10 months;30 males and 10 females in the control group,with an average age of 6.25±2.12 months.Sex,age,hemoglobin(HB),serum total protein(TP),serum albumin(ALB),prealbumin(PA),weight,upper arm circumference,dysphagia disorders survey(DDS),incidence of pneumonia were compared between the two groups.There was no significant statistical difference(P>0.05)between the two groups.The case group used IOE for nutritional support,and the control group used PNG for nutritional support.Both groups were given conventional comprehensive rehabilitation therapy and swallowing function training by professional rehabilitation therapists.Compared the swallowing function,growth and development status,nutritional status,and incidence of pneumonia in the two groups within 24 h of admission and 3 months after treatment.Results:1.There was no significant difference in HB,TP,ALB,PA,weight and upper arm circumference between the two groups on admission(all P>0.05).After 3 months of treatment,HB,TP,ALB,PA,weight and upper arm circumference of the control group and the case group were higher than those on admission,and HB,TP,ALB,PA,weight and upper arm circumference of the case group were higher than those of the control group,the difference was statistically significant(all P<0.05).2.After 3 months of treatment,the clinical efficacy of the children in the case group was significantly better(Z=-2.871,P=0.004)than that in the control group,and the total effective rate of clinical treatment in the case group was significantly higher(c2=18.660,P=0.000)than that in the control group,the difference was statistically significant(P<0.05).3.There was no significant difference in DDS scores(t=0.144,P=0.886)between the two groups on admission(P>0.05).After 3 months of treatment,DDS scores of the control group and the case group were lower than those on admission(the control group t=4.227,P=0.000;the case group t=15.115,P=0.000),and DDS scores of the case group were lower than those of the control group(t=-10.385,P=0.000),the difference was statistically significant(all P<0.05).4.There was no significant difference in the incidence of pneumonia(c2=0.052,P=0.820)between the two groups on admission(P>0.05).After 3 months of treatment,the incidence of pneumonia in the case group was lower than that in the control group(c 2=22.029,P=0.000),the difference was statistically significant(P<0.05).Conclusion:IOE can greatly improve the swallowing function and nutritional status of children with cerebral palsy and dysphagia,promote their growth and development,and can reduce the incidence of pneumonia.