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Impacto na saúde oral da nutrição entérica prolongada por gastrostomia endoscópica : estudo restrospetivo
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Abstract(s)
Introdução: A disfagia possui elevada incidência na população geriátrica, surgindo em consequência de patologias subjacentes, intervenções cirúrgicas ou de causa desconhecida. Provoca carências nutricionais que requerem uma intervenção cirúrgica para devolver suporte nutricional, neste caso, Gastrostomia Endoscópica Percutânea (GEP), esta encontrase frequentemente associada a uma fraca saúde oral.
Objetivo: Verificar alterações orais em pacientes com GEP, da Consulta de Nutrição Artificial do Grupo de Estudo de Nutrição Entérica do Hospital Garcia de Horta.
Materiais e Métodos: Estudo retrospetivo, observacional e não interventivo, avalia uma amostra de conveniência de 39 doentes com idade de 65,33±17,41, utilizando dados clínicos recolhidos em estudos prévios e referentes a dois períodos distintos: T0 (pré gastrostomia) T1 (3 meses após GEP). Os hábitos de higiene oral foram recolhidos mediante um questionário. A presença de placa bacteriana e o estado inflamatório gengival, foram determinados pelo Índice de Placa (IP) e o Índice Gengival (IG),
respetivamente. Sobre a condição periodontal aplicou-se o Índice Periodontal Comunitário (IPC) e a Perda de Inserção Periodontal (PIP). E para a avaliação intraoral da cárie dentária foi utilizado o Índice de dentes Cariados, Perdidos e Obturados (CPO).
Resultados: Entre T0 e T1, houve ligeira redução no valor médio de IP e um leve aumento de IG, no entanto, não se verificou significância estatística. Para os restantes parâmetros, manteve-se a frequência de bolsas periodontais bem como a de perda de inserção. O índice CPO revelou ter sido o único com diferença estatística significativa.
Conclusões: Mesmo não se revelando diferenças estatísticas significativas na maioria dos índices orais avaliados, no início do estudo esta população demonstrou uma condição periodontal debilitada face à média nacional. É vital fornecer estratégias de prevenção que promovam melhores resultados na saúde oral e qualidade de vida de pacientes gastrotomizados.
Introduction: Dysphagia has high incidence in the geriatric population, arising in result of underlying pathologies, surgical interventions or of unknown causes. It causes nutritional deficiencies that intervention a surgical intervention to return nutritional support, in this case, Percutaneous Endoscopic Gastrostomy (PEG), which is associated with poor oral health. Aim: Verify alterations in the oral cavity of patients with PEG, from the Artificial Nutrition Consultation of the Study Group of Enteric Nutrition of the Hospital Garcia de Horta. Materials and Methods: Retrospective, observational and noninterventional study evaluates a convenience sample of 39 patients aged 65.33±17.41, using clinical data collected in previous studies and referring to two distinct periods: T0 (pregastrostomy) T1 (3 months after PEG). Oral hygiene habits were collected through a questionnaire. The presence of bacterial plaque and the inflammatory gingival status were determined by the Plaque Index (IP) and the Gingival Index (IG), respectively. Concerning the periodontal status, the Community Periodontal Index (CPI) and the Attachment Loss (AL) were applied. And for the intraoral evaluation of dental caries, the Decayed, Lost and Filled Teeth Index (DMFT) was used. Results: Between T0 and T1, there was a slight reduction in the mean value of PI and a slight increase in GI, however, there was no statistical significance. For the remaining parameters, the frequency of periodontal pockets and insertion loss were maintained. The DMFT index revealed to be the only one with a statistically significant difference. Conclusions: Even not revealing statistically significant differences in most of the oral indices evaluated, at the beginning of the study this population showed a periodontal condition weakened compared to the national average. It is vital to provide prevention strategies that promote better oral health outcomes and quality of life for patients undergoing gastrostomy.
Introduction: Dysphagia has high incidence in the geriatric population, arising in result of underlying pathologies, surgical interventions or of unknown causes. It causes nutritional deficiencies that intervention a surgical intervention to return nutritional support, in this case, Percutaneous Endoscopic Gastrostomy (PEG), which is associated with poor oral health. Aim: Verify alterations in the oral cavity of patients with PEG, from the Artificial Nutrition Consultation of the Study Group of Enteric Nutrition of the Hospital Garcia de Horta. Materials and Methods: Retrospective, observational and noninterventional study evaluates a convenience sample of 39 patients aged 65.33±17.41, using clinical data collected in previous studies and referring to two distinct periods: T0 (pregastrostomy) T1 (3 months after PEG). Oral hygiene habits were collected through a questionnaire. The presence of bacterial plaque and the inflammatory gingival status were determined by the Plaque Index (IP) and the Gingival Index (IG), respectively. Concerning the periodontal status, the Community Periodontal Index (CPI) and the Attachment Loss (AL) were applied. And for the intraoral evaluation of dental caries, the Decayed, Lost and Filled Teeth Index (DMFT) was used. Results: Between T0 and T1, there was a slight reduction in the mean value of PI and a slight increase in GI, however, there was no statistical significance. For the remaining parameters, the frequency of periodontal pockets and insertion loss were maintained. The DMFT index revealed to be the only one with a statistically significant difference. Conclusions: Even not revealing statistically significant differences in most of the oral indices evaluated, at the beginning of the study this population showed a periodontal condition weakened compared to the national average. It is vital to provide prevention strategies that promote better oral health outcomes and quality of life for patients undergoing gastrostomy.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Nutrição entérica Saúde oral Gastrostomia endoscópica percutânea Disfagia