NNN-链接护理模式联合IDDSI分级膳食管理在脑卒中后吞咽障碍患者中的应用  

Effects of NNN-link nursing model combined with IDDSI graded diet management in patients with post-stroke dysphagia

作　　者：胡丹元[1] 朱薇[1] 商萍[1] 李婵 Hu Danyuan;Zhu Wei;Shang Ping;Li Chan(Rehabilitation Department,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第二医院康复科,温州325000

出　　处：《中华现代护理杂志》2024年第16期2201-2206,共6页Chinese Journal of Modern Nursing

基　　金：浙江省教育厅一般科研项目(Y201738702)。

摘　　要：目的探讨NNN-链接护理模式联合国际吞咽障碍食物标准行动委员会(IDDSI)分级膳食管理在脑卒中后吞咽障碍(DAS)患者中的应用效果。方法采用便利抽样法,选择2021年5月—2023年5月温州医科大学附属第二医院收治的160例DAS患者,采用电脑随机数字表法将研究对象分组,对照组与观察组各80例。对照组接受神经内科常规护理,观察组在此基础上开展NNN-链接护理模式联合IDDSI分级膳食管理。比较两组患者干预1、7、14 d的标准吞咽功能量表(SSA)、功能性经口摄食量表(FOIS)评分;比较两组干预前后微型营养评价(MNA)、吞咽状态护理结局评估、吞咽障碍特异性生活质量量表(SWAL-QOL)评分,临床疗效和卒中相关性肺炎(SAP)发生率。结果最终观察组79例,对照组78例完成研究。干预7、14 d,观察组的SSA评分低于对照组,FOIS评分高于对照组,护理依从性高于对照组,MNA、护理结局及SWAL-QOL评分高于对照组,总有效率高于对照组,SAP发生率低于对照组,以上差异均有统计学意义(P<0.05)。结论NNN-链接护理模式联合IDDSI分级膳食管理能够改善DAS患者的吞咽功能,提高临床疗效及生活质量,降低SAP发生率。Objective To explore the effect of the NNN-link nursing model combined with International Dysphagia Diet Standardisation Initiative(IDDSI)graded diet management in patients with post-stroke dysphagia.Methods From May 2021 to May 2023,convenience sampling was used to select 160 post-stroke dysphagia patients admitted to the Second Affiliated Hospital of Wenzhou Medical University.Study subjects were divided into a control group and an observation group using the computer random number table method,with 80 cases in each group.The control group received routine nursing in Department of Neurology,while the observation group was treated with NNN-link nursing model combined with IDDSI graded diet management on this basis.This study compared the Standardized Swallowing Assessment(SSA)and Functional Oral Intake Scale(FOIS)scores of two groups of patients who underwent intervention for 1 day,7 days and 14 days,and compared the Mini-Nutritional Assessment(MNA),Swallowing Nursing Outcome Assessment,Swallowing-Quality of Life(SWAL-QOL)score,clinical efficacy,and incidence of stroke associated pneumonia(SAP)between two groups before and after intervention.Results In the end,79 cases in the observation group and 78 cases in the control group completed the study.After 7 days and 14 days of intervention,the SSA score of the observation group was less than that of the control group,the FOIS score was more than that of the control group,and the nursing compliance was higher than that of the control group,the MNA,nursing outcomes,and SWAL-QOL scores were more than those of the control group,and the total effective rate was higher than that of the control group,the incidence of SAP was lower than that of the control group,and the above differences were statistically significant(P<0.05).Conclusions The combination of NNN-link nursing model and IDDSI graded diet management can improve the swallowing function of post-stroke dysphagia patients,increase clinical efficacy and quality of life,and reduce the incidence of SAP.

关 键 词：脑卒中后吞咽障碍 NNN-链接护理模式 国际吞咽障碍食物标准行动委员会 膳食管理 

分 类 号：R473.74[医药卫生—护理学]