个案管理模式在老年脑卒中吞咽障碍患者治疗中的效果观察  

Observation on the effect of case management model in the treatment of elderly stroke patients with dysphagia

作　　者：沈卫红 刘丹丹 李丽 徐寒冬 徐建华 Shen Weihong;Liu Dandan;Li Li;Xu Handong;Xu Jianhua(Department of Nursing,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China;Department of Neurology,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China;Department of Cardiology,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China)

机构地区：[1]复旦大学附属金山医院护理部,上海201508 [2]复旦大学附属金山医院神经内科,上海201508 [3]复旦大学附属金山医院心内科,上海201508

出　　处：《老年医学与保健》2023年第4期700-704,共5页Geriatrics & Health Care

基　　金：上海市中西医结合学会社区医学与健康管理研究项目(2021-61);复旦复星护理科研基金(FNF202207)。

摘　　要：目的 观察医院个案管理模式在老年脑卒中吞咽障碍患者治疗中的效果,旨在为防治老年脑卒中患者的并发症提供方法。方法 选择2022年1月—2022年12月于复旦大学附属金山医院神经内科收治的老年脑卒中患者120例,根据数字表法随机分为观察组和对照组,每组60例。2组在采取相同治疗措施的同时,观察组采取个案管理模式,对照组采取常规护理模式,为期1个月。观察并比较2组治疗前后营养水平、饮食意外事件、生活自理能力及SSA量表评分变化。结果 治疗1个月后,观察组SSA量表评分低于对照组(P<0.05);观察组BMI指数、白蛋白和血红蛋白指标值均高于对照组(P<0.05);观察组总饮食意外事件发生率低于对照组(P<0.05);观察组生活自理能力评分高于对照组(P<0.05)。结论 个案管理模式可改善老年脑卒中患者吞咽功能,保障营养水平,减少饮食意外事件发生,提高患者的生活自理能力。Objective To observe the effect of hospital case management model in the treatment of elderly stroke patients with dysphagia,and provide methods for prevention and treatment of complications in elderly stroke patients.Meth⁃ods A total of 120 elderly stroke patients admitted to Department of Neurology,Jinshan Hospital Affiliated to Fudan Univer⁃sity from January 2022 to December 2022 were selected and randomly divided into observation group and control group ac⁃cording to numerical table method,with 60 cases in each group.When the two groups received the same treatment measures,the observation group adopted a case management model,while the control group adopted a routine nursing model for a peri⁃od of one month.The changes in the nutritional level,dietary accident,self⁃care ability and SSA scale score before and after treatment were observed and compared between the two groups.Results After 1 month of intervention,the SSA scale score of the observation group was lower than that of the control group(P<0.05);BMI and levels of albumin and hemoglobin of the observation group were higher than those of the control group(P<0.05);the self⁃care ability score of the observation group was higher than that of the control group(P<0.05).The total incidence of dietary accident in the observation group was lower than that in the control group(P<0.05).Conclusion The case management model can improve the swallowing function,guarantee the nutrition level,reduce the occurrence of dietary accidents and improve the self⁃care ability of elderly stroke patients.

关 键 词：老年 脑卒中 个案管理模式 SSA量表评分 营养水平 饮食意外事件 生活自理能力 

分 类 号：R473.74[医药卫生—护理学]