链式康复护理措施在脑卒中吞咽障碍患者中的应用  

Application of chain rehabilitation nursing measures in stroke patients with dysphagia

作　　者：程双玉 李依婷 胡新亚 庄田新 王丽娟 王静 CHENG Shuang-yu;LI Yi-ting;HU Xin-ya;ZHUANG Tian-xin;WANG Li-juan;WANG Jing(Department of Rehabilitation Medicine,Department of Nursing,Kaifeng 475002,Henan,CHINA;Department of Rehabilitation Medicine2,Kaifeng Central Hospital,Kaifeng 475002,Henan,CHINA)

机构地区：[1]开封市中心医院康复医学科,河南开封475002 [2]开封市中心医院护理部,河南开封475002

出　　处：《海南医学》2025年第8期1200-1204,共5页Hainan Medical Journal

基　　金：河南省科技攻关计划项目(编号:LHGJ20200843)。

摘　　要：目的探讨链式康复护理措施在脑卒中吞咽障碍患者中的应用效果。方法选择2023年1月至2024年3月开封市中心医院收治的80例脑卒中吞咽障碍患者作为研究对象,按随机数表法分为观察组和对照组各40例。对照组患者采用常规康复护理措施,观察组患者采用链式康复护理措施,所有患者均护理至出院,出院后随访3个月回院复查。比较两组患者随访3个月后的临床疗效,以及护理前、随访3个月后的功能性经口摄食量表(FOIS)、Rosenbek渗漏-误吸分级量表(PAS)评分、血清血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PA)水平及吞咽障碍特异性生活质量量表(SWAL-QOL)评分的变化。结果随访3个月后,观察组患者临床疗效总有效率为90.00%,明显高于对照组的70.00%,差异有统计学意义(P<0.05);护理前,两组患者FOIS、PAS评分比较差异均无统计学意义(P>0.05);随访3个月后,观察组患者的FOIS评分(5.11±0.62)分,明显高于对照组的(4.57±0.58)分,PAS评分为(2.44±0.59)分,明显低于对照组的(3.51±0.63)分,差异均有统计学意义(P<0.05);护理前,两组患者血清Hb、ALB、PA水平比较差异均无统计学意义(P>0.05);随访3个月后,观察组患者的Hb、ALB、PA水平分别为(139.05±9.41)g/L、(40.57±3.42)g/L、(275.23±21.70)mg/L,明显高于对照组的(131.31±7.45)g/L、(36.24±3.71)g/L、(257.82±18.61)mg/L,差异均有统计学意义(P<0.05);护理前,两组患者SWAL-QOL评分比较差异均无统计学意义(P>0.05);随访3个月后,观察组患者的SWAL-QOL评分为(154.72±18.36)分,明显高于对照组的(136.81±16.50)分,差异有统计学意义(P<0.05)。结论链式康复护理措施有助于改善脑卒中吞咽障碍患者的吞咽功能、营养状态及生活质量,具有临床应用价值。Objective To explore the application effect of chain rehabilitation nursing measures in stroke pa-tients with dysphagia.Methods From January 2023 to March 2024,80 stroke patients with dysphagia treated in Kai-feng Central Hospital were selected as the research subjects.They were divided into an observation group and a control group according to the random number table method,with 40 cases in each group.Patients in the control group were treated with routine rehabilitation nursing,and patients in the observation group received chain rehabilitation nursing.All patients were cared for until discharge and followed up 3 months after discharge for re-examination.Comparisons were made between the two groups regarding clinical effectiveness after 3 months of follow-up,as well as changes in the Functional Oral Feeding Scale(FOIS),the Rosenbek Penetration-Aspiration Scale(PAS),serum hemoglobin(Hb),albumin(ALB),prealbumin(PA)levels,and the Swallowing Quality of Life Questionnaire(SWAL-QOL)scores before care and 3 months after follow-up.Results After 3 months of follow-up,the total effective rate of clinical efficacy in the observation group was 90.00%,significantly higher than the control group's 70.00%,with a statistically significant difference(P<0.05).Before nursing,there were no statistically significant differences between the two groups in FOIS and PAS scores(P>0.05).After 3 months of follow-up,the FOIS score of the observation group was(5.11±0.62)points,significantly higher than the control group's(4.57±0.58)points,and the PAS score was(2.44±0.59)points,significantly lower than the control group's(3.51±0.63)points,with statistically significant differences(P<0.05).Before nursing,there were no statistically significant differences in serum Hb,ALB,and PA levels between the two groups(P>0.05).After 3 months of follow-up,the levels of Hb,ALB,and PA in the observation group were(139.05±9.41)g/L,(40.57±3.42)g/L,and(275.23±21.70)mg/L,respectively,significantly higher than corresponding(131.31±7.45)g/L,(36.24±3.71)g

关 键 词：脑卒中 吞咽障碍 链式康复护理 营养指标 生活质量 

分 类 号：R473.74[医药卫生—护理学]