早期护理干预老年脑卒中患者吞咽功能障碍预防吸入性肺炎的观察研究  

Observation and research on early nursing intervention of swallowing dysfunction in elderly stroke patients to prevent aspiration pneumonia

作　　者：吴惜燕[1] 韩巧琳[1] 林哲聪[1] WU Xiyan;HAN Qiaolin;LIN Zhecong(DepartmentⅡof Neurology,Jieyang People's Hospital,Guangdong,Jieyang 522000,China)

机构地区：[1]广东省揭阳市人民医院神经内二科,广东揭阳522000

出　　处：《中国医药科学》2021年第2期125-127,153,共4页China Medicine And Pharmacy

基　　金：广东省揭阳市科技计划项目(0018wsyl27)。

摘　　要：目的探讨早期护理干预老年脑卒中患者吞咽功能障碍预防吸入性肺炎的治疗效果。方法将2014年1月至2016年1月的110例于广东省揭阳市人民医院神经内科住院治疗的老年脑卒中患者随机分为对照组(55例)及干预组(55例)。两组患者均在入院时进行吞水功能测试(阳性、阴性)和NIHSS评分,并于治疗15 d后再次进行NIHSS评分评定。对照组予以神经内科常规护理及综合康复训练,干预组除上述治疗外,根据吞咽障碍程度,予以饮食指导及咽部冷刺激触发咽反射进行吞咽功能训练。结果入院后24 h内,对照组和干预组年龄、性别、卒中类型、NIHSS评分及吞咽功能评估比较,差异无统计学意义(P>0.05)。治疗15 d后,饮食指导及吞咽功能训练可显著降低干预组患者吸入性肺炎的发生率,有效降低NIHSS评分比较,差异有统计学意义(P<0.05)。结论早期针对老年脑卒中患者吞咽功能障碍进行护理干预,加强康复锻炼,可预防吸入性肺炎的发生,改善患者预后。Objective To investigate the therapeutic efficacy of early nursing inter vention of swallowing dysfunction in elderly stroke patients to prevent aspiration pneumonia.Methods A total of 110 elderly stroke patients admitted to the department of neurology of our hospital from January 2014 to January 2016 were randomly divided into the control group(n=55)and the intervention group(n=55).Patients in both groups were given water swallowing function test(positive and negative)and scored by NIHSS at admission and evaluated by NIHSS again after 15 days of treatment.The control group was given conventional nursing and comprehensive rehabilitation training in department of neurology.In addition to the above treatment,the intervention group was given dietary guidance and pharyngeal reflex triggered by cold stimulation of pharynx for swallowing function training according to the degree of dysphagia.Results within 24 hours after admission,there was no significant difference in age,gender,stroke type,NIHSS score and swallowing function evaluation between the control group and the intervention group(P>0.05).After 15 days of treatment,dietary guidance and swallowing function training could significantly reduce the incidence of aspiration pneumonia in the intervention group,and effectively reduce NIHSS score,with a statistically significant difference(P<0.05).Conclusion This research finds that early nursing intervention for swallowing dysfunction of elderly stroke patients and strengthening rehabilitation exercise can prevent the occurrence of aspiration pneumonia and improve the prognosis of patients.

关 键 词：护理 脑卒中 吞咽功能 吸入性肺炎 

分 类 号：R473.74[医药卫生—护理学]