摘要
目的:总结在社区对10例经皮穿刺内窥镜下胃造瘘术后患者进行吞咽功能康复护理的经验。方法:采用前瞻性研究方法,共纳入10例接受经皮穿刺内窥镜下胃造瘘术(percutaneous endosc opicgastrostomy,PEG)的中、重度中枢性吞咽功能障碍者,给予规范的康复护理和吞咽康复训练;同时,对康复护理人员普及PEG置管后规范的康复护理知识和出现其他异常问题时的护理技能等。结果:患者入选和2、4、8、12周后的《洼田饮水试验》评分分别为5.0和4.7、3.9、3.1、2.4分,体重指数分别为20.32和20.29、20.45、20.74和21.04。患者入选2、4、8和12周后的《洼田饮水试验》评分改善值分别为0.3、1.1、1.9和2.6分;入选12周后的体重和体重指数均数分别改善2.1kg和0.72。10例患者中仅有1例在吞咽功能改善后成功拔除PEG置管,但发生5人次肺部感染、1例PEG造瘘管管口轻度感染、1例PEG术后胃出血、2人次因PEG造瘘管内置蘑菇头脱落至十二指肠球部而堵塞肠管、1次造瘘管外部橡皮管断裂。结论:规范的康复护理有利于患者的吞咽功能训练、提高生存质量。
ABSTRACT Objective： To summarize the experience of the swallowing rehabilitation nursing of ten cases after percutaneous endoscopic gastrostomy in the community. Methods： A prospective study was conducted which accepted ten patients with moderate and severe central swallowing disorder who had percutaneous endoscopic gastrostomy （PEG） and were given standardized rehabilitation nursing and swallowing rehabilitation training. At the same time, the rehabilitation nursing staff should be trained on the standardized rehabilitation nursing knowledge which the PEG catheter is placed postoperatively and the nursing skills which deal with the appearance of other abnormalities. Results： The scores of the enrolled patients in 2, 4, 8 and 12 weeks evaluated with Kubota＇s drinking water test were： 5.0, 4.7, 3.9, 3.1 and 2.4, respectively, and their body mass index 20.32, 20.29, 20.45, 20.74 and 21.04, respectively. Their scores of improvement value in 2, 4, 8, and 12 weeks evaluated with Kubota＇s drinking water test were 0.3, 1.1, 1.9 and 2.6, respectively. After 12 weeks their body weight and body mass index were improved 2.1 kg and 0.72. Among of ten patients, only one successfully removed the PEG catheter, five person times occurred pulmonary infections, one had mild PEG fistula catheter orifice infection, one suffered from gastrorrhagia PEG postoperative, two had PEG fistula built-in mushroom head offin the duodenal intestine that blocked intestine, and one got fistula external rubber tube rupture. Conclusion： The standardized rehabilitation nursing is benefit for the patients＇ swallowing rehabilitation training and improves their quality of life. KEY WORDS percutaneous endoscopic gastrostomy; rehabilitative nursing; rehabilitation training of swallowing function; moderate and severe swallowing dysfunction
出处
《上海医药》
CAS
2013年第5期18-22,共5页
Shanghai Medical & Pharmaceutical Journal
基金
2010年上海市残疾人联合会立项课题(编号:2010-010)
关键词
经皮穿刺内窥镜下胃造瘘术
康复护理
吞咽功能康复训练
中
重度吞咽功能障碍
percutaneous endoscopic gastrostomy
rehabilitative nursing
rehabilitation training of swallowing function
moderate and severe swallowing dysfunction
