人性化干预管理联合进食体位指导预防脑卒中后吞咽障碍患者肺部感染的应用研究  

Application of humanized intervention management combined with feeding posture guidance in the prevention of pulmonary infections in patients with swallowing disorder after stroke

作　　者：蒋愈娇[1] 文国强[1] 黄莉[1] JIANG Yu-jiao;WEN Guo-qiang;HUANG Li(Hainan General Hospital,Haikou,Hainan 570311,China)

机构地区：[1]海南省人民医院神经内科,海南海口570311

出　　处：《中华医院感染学杂志》2018年第19期3019-3022,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(814301)

摘　　要：目的分析人性化干预管理联合进食体位指导预防脑卒中后吞咽障碍患者并发肺部感染的应用效果。方法选择2014年1月-2017年5月医院收治的脑卒中吞咽障碍患者146例为研究对象,随机分为对照组和试验组,各73例。对照组患者接受人性化干预管理,试验组接受人性化干预管理的基础上联合进食体位指导。于管理前及管理2个月后评估患者吞咽功能及生活质量,并观察管理期间两组不良反应情况。结果管理前,两组吞咽功能障碍分级差异无统计学意义(P=0.706);管理实施后,两组吞咽功能障碍分级差异有统计学意义(P=0.031)。管理期间,试验组不良反应发生率为4.11%(3/73)低于对照组的20.55%(15/73)(P=0.001);两组患者接受管理后的SWAL-QOL评分均高于接受管理前(P<0.001),且管理后试验组SWAL-QOL评分为(157.28±15.83)分高于对照组(P<0.001)。结论吞咽障碍患者脑卒中后应用人性化干预管理联合进食体位指导效果较好,可提高患者吞咽能力,对吞咽障碍引起的肺炎进行有效预防,减轻疾病后遗症对患者的影响,改善患者病后生活质量。OBJECTIVE To study the effect of human intervention management combined with feeding posture guidance in the prevention of postoperative stroke in patients with dysphagia complicated with pulmonary infection.METHODS 146 cases of patients with post-stroke dysphagia were enrolled in our hospital from Jan.2014 to May2017,and were divided into control group and observation group according to the random number table method,with 73 cases in each group.The patients in the control group received humanized intervention management,and the patients in the observation group were treated with human intervention management combined with feeding posture guidance.The patient＇s swallowing function and quality of life were assessed before and 2 months after management,and the adverse effects were compared between the two groups.RESULTS There was no significant difference between the two groups in the classification of swallowing dysfunction（P=0.706）.After management,the scores of swallowing dysfunction in the observation group were significantly better than those in the control group（P=0.031）.The incidence of adverse reactions during the management in the observation group was 4.11%（3/73）,significantly lower than that in the control group（20.55%,15/73）（P =0.001）.The SWAL-QOL scores of both groups were improved after management as compared to those before management（P〈0.001）,and the SWAL-QOL score of the observation group（157.28±15.83）was significantly higher than that of the control group（P〈0.001）.CONCLUSIONThe effect of human intervention management combined with feeding posture guidance on post-stroke dysphagia patients is significant,which can improve the patient＇s ability to swallow,effectively preventing the occurren of pneumonia caused by swallowing disorders,thereby reducing the impact of disease sequelae,and improving the quality of life of the patient after the disease.

关 键 词：脑卒中后吞咽障碍 人性化干预管理 进食体位指导 肺部感染 生活质量 

分 类 号：R563.1[医药卫生—呼吸系统]