临床护理路径在急性脑梗死吞咽障碍中的应用研究  

Application research of clinical nursing pathway in swallowing disorder patients with acute cerebral infarction

作　　者：顾志娥[1] 俞龙[1] 刘必琴 秦长江[1] 

机构地区：[1]江苏省苏北人民医院神经内科,江苏扬州225001

出　　处：《实用临床医药杂志》2015年第14期7-10,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨临床护理路径在急性脑梗死吞咽障碍患者中的应用效果。方法选取急性脑梗死后吞咽障碍患者60例按入院时间段分为对照组和观察组各30例,对照组在药物治疗基础上采取常规护理方法,观察组在药物治疗基础上采取临床护理路径实施护理,内容包括吞咽功能评估、健康宣教、心理护理、摄食训练、基础训练、康复训练、试食、出院指导、电话跟踪随访服务1周。住院第15天采用自行设计的有关吞咽障碍的知识问卷、洼田饮水试验评估患者掌握吞咽障碍知识的程度和吞咽障碍程度改善的情况,并记录上述时间内患者并发症(吸入性肺炎和营养不良)发生情况。结果观察组患者吞咽障碍知识知晓率显著高于对照组,差异有统计学意义(P<0.05);观察组吞咽障碍改善总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组吸入性肺炎和营养不良的发生率显著低于对照组,差异有统计学意义(P<0.05)。结论应用临床护理路径可以有效提高患者及其家属有关吞咽障碍的知识水平、有效改善患者吞咽障碍程度、显著降低吞咽障碍并发症的发生率,值得临床推广应用。Objective To study the application effect of clinical nursing pathway in swal- lowing disorder patients with acute cerebral infarction. Methods A total of 60 swallowing disorder patients with acute cerebral infarction hospitalized in our department the patients were divided into control group with 30 eases and the observation group with 30 eases according to admission time. The control group was given the routine nursing while the observation group was given clinical nurs- ing pathway on the basis of control group, including swallowing function assessment, health educa- tion, psychological nursing, feeding training, basic training and rehabilitation training, diet test, discharge guidance, and one- week telephone follow- up service. On the lith day after admission, questionnaire and kubota drinking water test was used to evaluate the extent of the mastery of swal- lowing disorder knowledge and improvement of swallowing disorder, and the complications occur- rence （aspiration pneumonia and malnutrition） was recorded. Results The awareness of swallow- ing disorder knowledge in the observation group was higher than that in the control group, the dif- ference was statistically significant（P〈0.05）. The improvement of total efficacy rate in the obser- vation group was higher than that in the control group, the difference was statistically significant（P 〈0.05）. The occurrence rate of aspiration pneumonia and malnutrition in the observation group was lower than that in the control group, the difference was statistically significant （ P 〈 0.05）. Conclusion Clinical nursing pathway can effectively increase the level of swallowing disorder knowledge in patients and their families , improve the degree of swallowing disorder , reduce theincidence of complications of swallowing disorder, so it is worthy of widely promotion in clinic.

关 键 词：临床护理路径 急性脑梗死 吞咽障碍 效果 

分 类 号：R473.5[医药卫生—护理学]