吞咽枕姿势代偿法对卒中吞咽障碍患者心理状态的影响  

Effect of swallowing pillow posture compensation method on the psychological state of stroke patients with dysphagia

作　　者：李雪梅 华锋凯[2] 李雪莲 Li Xuemei;Hua Fengkai;Li Xuelian(Department of Rehabilitation Medicine,The First Affiliated Hospital of Guangxi University ofScience and Technology,Liuzhou Guangxi,545006,China;Department of Nursing,The First Affiliated Hospital of Guangxi University ofScience and Technology,Liuzhou Guangxi,545006,China;Department of Critical Care Medicine,The Third People's Hospital of Yulin,Yulin Guangxi,537000,China)

机构地区：[1]广西科技大学第一附属医院康复医学科,广西柳州545006 [2]广西科技大学第一附属医院护理部,广西柳州545006 [3]玉林市第三人民医院重症医学科,广西玉林537000

出　　处：《中外女性健康研究》2023年第4期1-3,15,共4页Women＇s Health Research

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题课题名称:联合吞咽枕姿势代偿法在改善脑卒中吞咽障碍中的应用研究课题编号:Z20190764。

摘　　要：目的:探讨对于脑卒中吞咽障碍患者实施吞咽枕姿势代偿法进行干预,对患者抑郁-焦虑-压力量表简体中文版(DASS-21)评分结果的影响。方法:本研究选取2021年1月至2021年12月本院收治的脑卒中吞咽障碍患者92例作为观察对象,利用随机数字表格法分组,对照组46例予以常规护理,研究组46例予以常规护理同时开展吞咽枕姿势代偿法干预,干预3月后对比两组患者DASS-21评价患者心理应激,使用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价负性情绪,吞咽功能、生活质量、残疾程度与社会功能用Rankin修订量表(mRS)评价。结果:干预前两组患者心理应激DASS-21量表各维度评分对比,无统计学意义(P>0.05);干预后研究组患者DASS-21量表压力、焦虑、抑郁等维度评分均低于对照组,差异有统计学意义(P<0.05);干预后两组DASS-21量表评分均下降,与干预前对比,差异有统计学意义(P<0.05)。护理干预前两组患者SAS、SDS评分对比,无统计学意义(P>0.05);护理干预后研究组患者SDS与SAS评分均低于对照组,差异有统计学意义(P<0.05);护理后两组患者SAS与SDS评分均下降,差异有统计学意义(P<0.05)。干预前两组患者吞咽功能对比,无统计学意义(P>0.05);干预后两组吞咽功能评分均升高,差异有统计学意义(P<0.05);干预后研究组患者吞咽功能评分均高于对照组,差异有统计学意义(P<0.05)。干预前两组患者mRS评分、ADL评分对比,无统计学意义(P>0.05);干预后研究组与对照组患者mRS评分、ADL评分均下降,与干预前对比,差异有统计学意义(P<0.05);干预后研究组患者mRS评分、ADL评分低于对照组,差异有统计学意义(P<0.05)。结论:脑卒中吞咽障碍患者开展吞咽枕姿势代偿疗法干预,可有效提高患者吞咽功能水平,降低患者心理应激反应,缓解患者焦虑与抑郁情绪,降低患者残疾程度,提高患者生活能力。Objective:Objective:To explore the effect of swallowing posture compensation on the scores of Depression Anxiety Stress Scale(DASS-21)in stroke patients with dysphagia.Methods:92 stroke patients with dysphagia admitted to our hospital from January 2021 to December 2021 were selected as the subjects of this study.They were divided into two groups by double-blind method.46 patients in the control group were given routine nursing care,and 46 patients in the study group were given routine nursing care.At the same time,the swallowing occipital posture compensation intervention was carried out.Three months after the intervention,DASS-21 was compared between the two groups to evaluate the patients'psychological stress,and SAS and SDS were used to evaluate the negative emotions,Swallowing function,quality of life,disability and social function were assessed with Rankin revised scale(MRS).Results:Before the intervention,there was no significant difference in the scores of psychological stress DASS-21 between the two groups(P>0.05);After the intervention,the scores of stress,anxiety and depression of DASS-21 scale in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05);After the intervention,the scores of DASS-21 in the two groups decreased,and the difference was statistically significant compared with that before the intervention(P<0.05).Before nursing intervention,there was no significant difference in SAS and SDS scores between the two groups(P>0.05);After nursing intervention,the scores of SDS and SAS in the study group were lower than those in the control group(P<0.05);After nursing,the scores of SAS and SDS in the two groups decreased,and the difference was statistically significant(P<0.05).There was no significant differencein swallowing function between the two groups before intervention(P>0.05);After the intervention,the swallowing function scores of the two groups increased,and the difference was statistically significant(P<0.05);After the interventio

关 键 词：脑卒中吞咽障碍 心理应激 焦虑 抑郁 生活质量 吞咽障碍 

分 类 号：R255.2[医药卫生—中医内科学]