医护合作对脑卒中吞咽障碍患者吸入性肺炎发生率的影响  

The Effects of Doctor - nurse Cooperation's Health Education on the Prevention of Aspiration Pneumonia in Patients with Stroke

作　　者：张秀果[1] 田悦平[1] 曹奎粉[1] 

机构地区：[1]河北医科大学第三医院神经内科,河北省石家庄市050051

出　　处：《中国全科医学》2010年第33期3792-3793,共2页Chinese General Practice

基　　金：河北省卫生厅指导性课题(07263)

摘　　要：目的研究医护合作的健康教育方法对伴有吞咽障碍的脑卒中患者吸入性肺炎发生率、吞咽障碍改善程度及医护满意度的影响。方法以180例伴有吞咽障碍的脑卒中患者作为研究对象,随机分为干预组和对照组,干预组96例,依据吞咽障碍的程度对其进行医护合作的健康教育,包括入院宣教、基础吞咽功能训练、体位、喂食注意事项、食物选择及咽部滞留物的去除方法等。对照组84例,对其实施常规的健康教育,对两组患者的吸入性肺炎发生率、吞咽障碍恢复程度、健康教育知晓程度及满意度进行统计学分析。结果干预组96例患者中痊愈45例,显效34例,有效13例,无效4例;对照组84例患者中痊愈33例,显效23例,有效10例,无效18例,两组患者吞咽功能恢复程度间差异有统计学意义(u=2.086,P<0.05);干预组发生吸入性肺炎27例(28.1%),对照组发生吸入性肺炎38例(45.2%),吸入性肺炎的发生率间差异有统计学意义(χ2=5.687,P<0.05);两组患者健康教育相关知识的知晓度及满意度比较,差异亦均有统计学意义(P<0.05)。结论医护合作的健康教育方法可明显改善脑卒中患者的吞咽功能、提高健康教育相关知识的知晓率及患者对医护的满意度,同时减低了吸入性肺炎的发生。Objective To investigate the effect of doctor-nurse cooperation＇s health education on the prevalence of aspiration pneumonia and the improvement rate of dysphagia in patients with stroke,as well as on the degree of satisfaction.Methods A total of 180 stroke patients with dysphagia were evaluated.All the subjects were divided randomly into treatment group and control group.The treatment group was provided with doctornurse cooperation health education,including hospitalization education,primary swallowing function training,posture and feeding precautions,choice of food and removal of pharyngeal retention food,meanwhile,the control group was provided with conventional education by nurses.The prevalence of aspira-tion pneumonia,the improvement rate of dysphagia,the awareness rate of health education and the satisfaction to the hospital＇s service were analyzed statistically.Results Among the 96 cases in treatment group,45 of them were recovered fully,34 having excellent efficacy,13 having effectiveness,4 cases not having efficacy.As to the 84 cases in control group,33 of them were re-covered fully,23 having excellent efficacy,10 having effectiveness,18 cases not having efficacy.The difference between the two groups in the improvement rate of dysphagia was significant（u = 2.086,P 0.05）.27（28.1%） cases in treatment group developed aspiration pneumonia,and 38（45.2%） cases in control group developed the same disease,the difference between the two groups was significant（χ2 = 5.687,P 0.05）.The difference of awareness rate of health education and satisfaction to the hospital＇s service was also significant（P 0.05）.Conclusion In stroke patients with dysphagia,doctor-nurse cooperation＇s health education is associated with the increase of the recovery of dysphagia,the awareness of health education and the satisfaction to the hospital＇s service,as well as the decrease of the prevalence of aspiration pneumonia.

关 键 词：医护合作 脑卒中 吞咽困难 吸入性肺炎 健康教育 

分 类 号：R743.3[医药卫生—神经病学与精神病学]