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Abstract(s)
Introdução: A disfagia apresenta uma alta incidência na população geriátrica, tanto em
casos de patologia neurológica como oncológica dos dermátomos da cabeça e pescoço.
A nutrição entérica é essencial para o suporte nutricional destes doentes.
Objetivo: Esta investigação teve como objetivo avaliar o impacto da alimentação entérica
na cavidade oral, investigando diferenças significativas após 3 e 6 meses de supressão de alimentação oral.
Métodos: Foram recrutados doentes da consulta de Nutrição Artificial do Hospital Garcia
de Orta (HGO), e observados em três tempos: T0 (dia da colocação), T1 (3 meses depois) e T2 (6 meses depois). Foram avaliados através da aplicação de um questionário relativo aos hábitos de higiene oral, de uma análise microbiológica da cavidade oral e de parâmetros relativos à saúde oral como: Índice de Placa (IP), Índice Gengival (IG), Índice Periodontal Comunitário (PIP), Índice de perda de Inserção Periodontal (IPC) e Índice de Dentes Cariados Perdidos e Obturados (CPO).
Resultados: A amostra em estudo inclui 22 doentes com idade de 61,9 ± 18,5 anos que
foram submetidos a PEG por patologia neurológica (63,6%) ou não neurológica (36,4%).
Após 3 meses da intervenção verificou-se um aumento nos valores de IP e IG com
significado estatístico, enquanto que os restantes parâmetros não revelaram diferenças.
No estudo microbiológico verificou-se um aumento de 40,9% para 63,6% doentes que se
encontravam colonizados com Candida spp. e de 36,3% para 27,3% doentes colonizados com bactérias gram-negativo não fermentadoras de lactose. Após 6 meses verificou-se um aumento dos valores de IP, IG e CPO com significado estatístico, bem como uma manutenção das espécies de Candida spp. e bactérias gram-negativo encontradas.
Conclusão: A população em estudo apresenta uma fraca saúde oral, sendo necessárias
medidas de prevenção e educação dos cuidadores, de forma a obter uma melhoria na
saúde oral de doentes disfágicos com alimentação entérica.
Introduction: Dysphagia presents a high prevalence amongst the elder population, both in neurological as oncologic cases of the head and neck. Enteral nutrition is essential as the main strategy to feed these patients. Objective: With this investigation, we evaluated the impact of enteral nutrition in the oral cavity and the possible changes after 3 and 6 months of per oris feeding suppression. Methods: A convenience sample group was recruited at the Artificial Feeding Outpatient Clinic of the Hospital Garcia de Orta. Informed consent of all patients was obtained. Patients were evaluated through a questionnaire regarding oral health habits, through a microbiological analysis (MacConkey and BrillanceCandidaTM agar media) and parameters relative to oral health such as: Plaque Index (PI), Gingival Index (GI), Community Periodontal Index (CPI), Periodontal insertion loss (PIP) and Decayed, Missed and Filled teeth (DMFT). Results: The studied group included 22 patients, age 61,9 ± 18,5 years, that underwent PEG due to neurological disorders (63,6%) or non-neurological disorders (36,4%). After 3 moths of enteric nutrition PI and GI showed an increase with statistical meaning. All the remaining parameters did not show any statistical meaning. In the microbiological study we found a change from 40,9% to 63,6% patients colonized with Candida spp and 36,3% to 27,3% colonized with lactose non-fermenting gram negative bacteria. After 6 moths of enteric nutrition PI, GI and DMFT showed an increase with statistical meaning. The species of Candida spp and lactose non fermenting gram negative bacteria found remained the same at this point. Conclusion: The population within the study was found to have a poor oral hygiene and we defend that caregivers should be instructed in how to maintain and improve the oral health of dysphagic patients.
Introduction: Dysphagia presents a high prevalence amongst the elder population, both in neurological as oncologic cases of the head and neck. Enteral nutrition is essential as the main strategy to feed these patients. Objective: With this investigation, we evaluated the impact of enteral nutrition in the oral cavity and the possible changes after 3 and 6 months of per oris feeding suppression. Methods: A convenience sample group was recruited at the Artificial Feeding Outpatient Clinic of the Hospital Garcia de Orta. Informed consent of all patients was obtained. Patients were evaluated through a questionnaire regarding oral health habits, through a microbiological analysis (MacConkey and BrillanceCandidaTM agar media) and parameters relative to oral health such as: Plaque Index (PI), Gingival Index (GI), Community Periodontal Index (CPI), Periodontal insertion loss (PIP) and Decayed, Missed and Filled teeth (DMFT). Results: The studied group included 22 patients, age 61,9 ± 18,5 years, that underwent PEG due to neurological disorders (63,6%) or non-neurological disorders (36,4%). After 3 moths of enteric nutrition PI and GI showed an increase with statistical meaning. All the remaining parameters did not show any statistical meaning. In the microbiological study we found a change from 40,9% to 63,6% patients colonized with Candida spp and 36,3% to 27,3% colonized with lactose non-fermenting gram negative bacteria. After 6 moths of enteric nutrition PI, GI and DMFT showed an increase with statistical meaning. The species of Candida spp and lactose non fermenting gram negative bacteria found remained the same at this point. Conclusion: The population within the study was found to have a poor oral hygiene and we defend that caregivers should be instructed in how to maintain and improve the oral health of dysphagic patients.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Alimentação entérica Saúde oral Gastrotomia endoscópica percutânea Disfagia