右腦中風半側忽略和吞嚥功能的關聯性

The Relationship between Nasogastric Tube Feeding and Hemineglect in Patients after Right Hemisphere Stroke

杜國賢(Kwo-Shieng Tuo) ； 孫淑芬(Shu-Fen Sun) ； 許耕豪(Ken-Hao Hsu) ； 王志龍(Jue-Long Wang)

《台灣復健醫學雜誌》 34卷1期 (2006/03) Pp. 55-59

https://doi.org/10.6315/2006.34(1)08

摘要

本研究的目的在探討單純右腦中風後半側忽略病人，是否常合併有吞嚥功能障礙，須用鼻胃管進食，可否獨立進食，與住院期間是否較易有肺炎的併發症。42位經電腦斷層或核磁共振檢查確定為單純右腦中風，且符合研究條件的病人，病人以線段中分測驗(Schenkenberg test)是否向右側偏移10%，區分為半側忽略（實驗組）與沒有半側忽略（對照組），實驗組又以是否向右側偏移50%，區分為顯著半側忽略與輕微半側忽略組。
研究結果顯示單純右腦中風病人如果合併顯著半側忽略時，有超過一半的病人須用鼻胃管進食，而即使不用鼻胃管進食，大多仍無法獨立進食，臨床上須更加強吞嚥功能障礙評估及治療，並預防併發症的產生。另外比較輕微半側忽略組與對照組，統計上並無顯著差異，兩組大多可獨立進食，且住院期間均無肺炎的併發症，研究結果顯示單純右腦中風病人如果半側忽略不顯著時（線段中分測驗偏移不超過50%），不會明顯增加使用鼻胃管進食的機率。

關鍵字

右腦中風 ； 半側忽略 ； 鼻胃管進食 ； 進食功能

並列摘要

The purpose of this study was to evaluate impairment of swallowing, nasogastric tube feeding, feeding function, and complications of pneumonia in 42 patients hospitalized following a right hemispheic stroke with or without hemineglect. Twenty-three patients with diagnoses of right hemispheric stroke and left hemineglect, as demonstrated by computed tomographic scan or magnetic resonance imaging, comprised the experimental group. The diagnosis of hemineglect is based on the Schenkenberg test (i.e., line bisection test) of greater than 10% right deviation. Nineteen age-, lesion-, and Brunnstrom stage-matched right hemispheic stroke patients without hemineglect were designated as the control group. The 23 patients with neglect were then divided into two groups, 15 with severe neglect and 8 with mild neglect, corresponding to more than 50% right deviation or 10-50% right deviation, respectively.
The results of this study revealed that more than one-half of patients status post a right hemispheric stroke with severe hemineglect require nasogastric tube feeding. Most of the patients with severe hemineglect who didn't require nasogastric tube feeding, however, could not feed themselves independently. Therefore, we should pay more attention to these patients regarding their thorough evaluation, treatment, and prevention of complications. No significant differences were noted between the patients with mild hemineglect and the patients without hemineglect. Indeed, most such patients could feed themselves independently. No cases of pneumonia were noted in these patients during hospitalization.
The results of this study have demonstrated that nasogastric tube feeding rates did not increase inpatients after a right hemispheric stroke without severe hemineglect (i.e., line bisection test deviation ≤ 50%) as compared with patients in which there was no hemineglect.

並列關鍵字

right hemisphere stroke ； hemineglect ； nasogastric tube feeding ； feeding function