预见性护理干预及吞咽训练对老年卒中后吸入性肺炎患者吞咽困难及预后的影响研究  

Effect of predictive nursing intervention and swallowing training on dysphagia and prognosis in elderly patients with post-stroke aspiration pneumonia

作　　者：杨丽红[1] 寇雪莲[1] 何松彬[1] YANG Lihong;KOU Xuelian;HE Songbin(Department of Neurology, Zhoushan Hospital in Zhejiang Province, Zhoushan 316000, China)

机构地区：[1]浙江省舟山医院神经内科

出　　处：《中国现代医生》2019年第17期156-160,共5页China Modern Doctor

基　　金：浙江省科技计划项目(2017C33188)

摘　　要：目的探讨预见性护理干预联合吞咽训练对老年卒中后吸入性肺炎患者吞咽困难及预后的影响。方法选取2014年2月~2017年2月我科收治的卒中后吸入性肺炎患者190例。采取单纯随机法将其分为观察组和对照组,各95例。对照组给予常规护理干预,观察组给予预见性护理干预联合吞咽训练。干预2周后,比较两组患者误吸发生率、吞咽功能训练效果、神经功能缺损程度及生活质量。结果干预2周后,观察组误吸发生率为10.5%,显著低于对照组的28.4%,两组具有统计学意义(P<0.05)。在吞咽功能训练效果方面,观察组有效率为94.7%,显著高于对照组(80.0%),两组具有统计学意义(P<0.05)。在神经功能缺损评分方面,观察组患者干预后评分为(11.9±2.2)分,显著低于对照组(16.4±2.7)分,两组具有统计学意义(P<0.05)。在生活质量评分方面,无论是躯体功能、社会功能、情绪功能还是总体健康状况评分,观察组评分均显著优于对照组(P<0.05)。结论预见性护理干预联合吞咽训练可有效降低误吸发生率,促进患者吞咽功能恢复,改善神经功能,提高生活质量,值得进一步推广和应用。Objective To investigate the effect of predictive nursing intervention combined with swallowing training on dysphagia and prognosis in elderly patients with post-stroke aspiration pneumonia. Methods A total of 190 patients with post-stroke aspiration pneumonia admitted to our department from February 2014 to February 2017 were enrolled. They were divided into observation group(95 cases) and control group(95 cases) by simple random method. The control group received routine nursing intervention, and the observation group received predictive nursing intervention combined with swallowing training. After 2 weeks of intervention, the incidence of aspiration, the effect of swallowing function training, the degree of neurological deficit and the quality of life were compared between the two groups. Results After 2 weeks of intervention, the incidence of aspiration in the observation group was 10.5%, which was significantly lower than that in the control group(28.4%). The difference between the two groups was statistically significant(P<0.05). In the training effect of swallowing function, the effective rate of the observation group was 94.7%, which was significantly higher than that of the control group(80.0%), and the difference between the two groups were statistically significant(P<0.05). In the neurological deficit score, the score of the observation group was(11.9±2.2) after intervention, which was significantly lower than that of the control group(16.4±2.7)(P<0.05). In terms of quality of life scores, the scores of physical function, social function, emotional function or overall health status score in the observation group were significantly better than those of the control group(P<0.05). Conclusion Predictive nursing intervention combined with swallowing training can effectively reduce the incidence of aspiration, promote the recovery of swallowing function, improve neurological function and improve the quality of life. It is worth further promotion and application.

关 键 词：预见性护理 脑卒中 吸入性肺炎 吞咽训练 吞咽困难 

分 类 号：R473[医药卫生—护理学]