应用饮食改进提高卒中后吞咽障碍患者吞咽安全性和有效性的研究  

The effect of dietary improvement on improving the safety and effectiveness of swallowing in patients with Dysphagia After Stroke

作　　者：吕孟菊 柳俊杰[1] 李雪琳[1] 任敏 阚玉稳 LYU Mengju;LIU Junjie;LI Xuelin;REN Min;KAN Yuwen(Department of Neurology,Chongqing Fuling Central Hospital,Chongqing,408000,China)

机构地区：[1]重庆市涪陵中心医院神经内科,重庆市408000 [2]重庆市涪陵中心医院健康体检中心,重庆市408000

出　　处：《中国护理管理》2022年第2期228-233,共6页Chinese Nursing Management

基　　金：重庆市科卫联合医学科研项目(2020MSXM065)。

摘　　要：目的:评价基于食品分级标准的饮食改进对卒中后吞咽障碍患者吞咽安全性和有效性的影响。方法:于2021年2月—7月便利选取重庆市某三级甲等医院神经内科收治的脑卒中后吞咽障碍患者为研究对象,以前3个月入院的39例患者为对照组,后3个月入院的39例患者为实验组,实验组予以施行基于食品分级标准的饮食改进,对照组予以常规饮食,比较两组患者连续3天每日三餐进食过程中吞咽安全性和有效性相关症状的发生率。结果:实验组的呛咳、音质改变、血氧饱和度下降≥3%的发生率均低于对照组(P<0.05),两组发绀发生率比较,差异无统计学意义(P>0.05),两组均无窒息发生;实验组口腔和咽部食物残留的发生率低于对照组(P<0.05),两组唇部闭合不全、分次吞咽的发生率比较,差异无统计学意义(P>0.05)。结论:基于食品分级标准的饮食改进可提高卒中后吞咽障碍患者的吞咽安全性和有效性。Objective:To explore the effect of dietary improvement based on food grade criteria on safety and efficacy of swallowing in patients with Dysphagia After Stroke(DAS).Methods:Convenience sampling was used to select the patients with DAS in the neurology department of a grade A hospital in Chongqing from February 2021 to July 2021.Patients hospitalized in the first 3 months were assigned into the control group(n=39),and those hospitalized in the latter 3 months were assigned into the experimental group(n=39).The participants in the experimental group were with dietary modifications based on food grade quantitative standard,and those in the control group were with regular diet.The incidence of symptoms related to swallowing safety and effectiveness were compared during feeding for three consecutive days.Results:The incidence of choking,sound quality change,and reduction in blood oxygen saturation≥3%in the experimental group was lower than that in the control group(P<0.05),there was no difference in the incidence of cyanosis(P>0.05),no asphyxia was observed in both groups.The incidence of oral and pharyngeal food residues in the experimental group was lower than that in the control group(P<0.05),and there was no difference in the incidence of incomplete lip closure and secondary swallowing between the two groups(P>0.05).Conclusion:Dietary improvement based on food grading criteria is benefit to improve the safety and efficacy of swallowing in patients with DAS.

关 键 词：食品分级 饮食改进 脑卒中 吞咽障碍 吞咽安全性 吞咽有效性 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]