摘要
[目的]观察间歇性鼻饲联合吞咽训练对脑卒中吞咽障碍病人的影响。[方法]纳入南昌大学第二附属医院2017年8月-2018年9月接受康复护理干预的60例脑卒中吞咽障碍病人,按随机数字表法分为两组,每组30例。对照组采取鼻饲留置+常规吞咽功能训练,观察组采取间歇性鼻饲法+吞咽功能康复护理训练。干预前及干预后4周,采用洼田饮水试验评估吞咽障碍程度并进行疗效评定,采取视频透视吞咽检查(VFSS)观察吞咽不同阶段的情况,行血常规检查评估营养状态及统计吸入性肺炎发生率。[结果]干预后两组洼田饮水试验分级、VFSS评分、体质指数、血清白蛋白、血红蛋白、氮均较干预前明显改善,且观察组显著优于对照组(P<0.05);观察组显效率显著高于对照组(P<0.05);观察组吸入性肺炎发生率明显低于对照组(P<0.05)。[结论]间歇性鼻饲联合吞咽训练可有效改善脑卒中吞咽障碍病人的营养状态,且利于吞咽功能恢复,降低吸入性肺炎发生率。
Objective:To observe the effect of intermittent nasal feeding combined with swallowing training on stroke patients with dysphagia. Methods:Sixty stroke patients with dysphagia who received rehabilitation nursing intervention from the Second Affiliated Hospital of Nanchang University from August 2017 to September 2018 were enrolled in this study and divided into two groups according to the random number table,30 cases in each group. The control group received nasal feeding and regular swallowing function training, and the observation group received intermittent nasal feeding combined with swallowing function rehabilitation nursing training. Before the intervention and 4 weeks after the intervention,the Water Swallowing Test(WST)was used to evaluate the degree of dysphagia and the efficacy was evaluated. Video fluoroscopy swallowing study(VFSS)was used to observe the different stages of swallowing. Blood routine examination was used to assess the nutritional status and statistics the incidence of aspiration pneumonia. Results:After the intervention,the WST grading,VFSS score,body mass index(BMI),serum albumin,hemoglobin,and nitrogen of the two groups were significantly improved compared with the status before the intervention,and the observation group was significantly better than the control group(P<0. 05). The efficiency was significantly higher than that of the control group(P<0. 05). The incidence of aspiration pneumonia in the observation group was significantly lower than that of the control group(P<0. 05). Conclusions:Intermittent nasal feeding combined with swallowing training could effectively improve the nutritional status of stroke patients with dysphagia,which was conducive to recovery of swallowing function and could reduce the incidence of aspiration pneumonia.
作者
周玉妹
张超
方小群
符芳
汪秋艳
彭慧
ZHOU Yumei;ZHANG Chao;FANG Xiaoqun;FU Fang;WANG Qiuyan;PENG Hui(Second Affiliated Hospital of Nanchang University,Jiangxi 330006 China)
出处
《护理研究》
北大核心
2019年第17期2935-2939,共5页
Chinese Nursing Research
基金
江西省教育厅科学技术研究项目，编号：170104
关键词
间歇性鼻饲法
吞咽训练
脑卒中
吞咽障碍
吸入性肺炎
营养评估
护理
intermittent nasal feeding
swallowing training
stroke
dysphagia
aspiration pneumonia
nutritional assessment
nursing
