容积-粘度吞咽测试联合个体化进食干预对听神经瘤术后患者吸入性肺炎发生的影响  

Effect of volume-viscosity swallowing test combined with individualised feeding intervention on aspiration pneumonia in postoperative patients with acoustic neuroma

作　　者：刘玉霞[1] 王胜文[1] 钟美浓 崔德珍[2] 吴珍[2] 黄师菊[1] 陈妙霞[1] 高玲玲[3] Liu Yuxia;Wang Shengwen;Zhong Meinong;Cui Dezhen;Wu Zhen;Huang Shiju;Chen Miaoxia;Gao Lingling(The Third Affiliated Hospital,Sun Yat-sen University,Guangzhou,510630;Lingnan Hospital,the Third Affiliated Hospital,Sun Yat-sen University,Guangzhou,510700;School of Nursing,Sun Yat-sen University,Guangzhou,510089,China)

机构地区：[1]中山大学附属第三医院,广东广州510630 [2]中山大学附属第三医院岭南医院,广东广州510700 [3]中山大学护理学院,广东广州510089

出　　处：《现代临床护理》2021年第9期41-46,共6页Modern Clinical Nursing

基　　金：中山大学护理青年人才培育基金项目,项目编号为N2018Y04。

摘　　要：目的评价容积-粘度吞咽测试联合个体化的进食计划对减少听神经瘤术后患者吸入性肺炎的效果。方法选取2018年7月至12月在本院神经外科住院行手术治疗的听神经瘤患者36例为对照组,术后7d内每日为患者行洼田饮水试验,结果异常者给予停留胃管鼻饲,正常与可疑者给予经口进食;2019年1月至6月在本院神经外科住院行手术治疗的听神经瘤患者36例为试验组,术后7d内每日为患者行容积-粘度吞咽测试,根据测试结果选择进食方式、经口进食食物的容积及稠度,同时制定个体化进食计划。比较两组患者吸入性肺炎发生情况以及胃管留置情况。结果干预后,试验组吸入性肺炎的发生率(2.8%)低于对照组(22.2%);试验组患者胃管留置率(16.7%)低于对照组(55.6%);试验组患者胃管留置时间(3.5±1.0)d短于对照组(4.8±0.9)d,两组比较,差异均有统计学意义(均P<0.05)。结论使用容积-粘度吞咽测试对听神经瘤术后患者进行吞咽功能评估,根据评估结果制定个体化的进食计划,可减少术后患者吸入性肺炎的发生,降低胃管留置率和缩短留置时间。Objective To evaluate the effect of volume-viscosity swallowing test combined with individualised feeding intervention on aspiration pneumonia in postoperative patients with acoustic neuroma.Methods Thirty-six patients who had acoustic neuroma and underwent surgical treatment at the neurosurgery department of our hospital between July and December 2018 were selected as the control group.The patients who failed daily Kubota Water Swallowing Test for 7 days after operation were given nasal feeding by gastric tube,and those who passed the Kubota Water Swallowing Test or in suspicious were given oral feeding.Between January and June 2019,another 36 patients who had acoustic neuroma and underwent the surgical treatment were assigned as trial group.To whom,daily volume-viscosity swallowing test was performed for 7 days after operation.The feeding methods together with the volume and viscosity of foods fed orally were decided according to the results of test and simultaneously offered with individualised feeding intervention.The two groups were compared with the incidence of dominant aspiration pneumonia,aspiration pneumonia and indwelling of gastric tube.Results The incidence of aspiration pneumonia in the trial group was lower than that in the control group(2.8%vs.22.2%,P<0.05)and the indwelling rate of gastric tube in the trial group was lower than that in the control group(16.7%vs.55.6%,P<0.05).The indwelling time of gastric tube in the trial group was significantly shorter than that of the control group(3.50±1.0d vs.4.8±0.9d,P<0.05).Conclusions The incidence of aspiration pneumonia,the gastric tube indwelling rate and the indwelling time would be reduced or lowered by application of the volume-viscosity swallowing test to evaluate the swallowing function of patients after acoustic neuroma surgery plus individualised feeding intervention.Better clinical outcomes would also achieved.

关 键 词：容积-粘度吞咽测试 饮食干预 听神经瘤 吸入性肺炎 

分 类 号：R473.6[医药卫生—护理学]