摘要
目的探讨急性脑卒中并发吞咽障碍患者早期康复护理干预在不同时间介入与远期进食功能改善的关系。方法收集神经科监护室、普通病房急性脑卒中并发吞咽障碍103例患者,按从发病到开始康复护理干预介入时间分成4组:A组:0<t<48 h,B组:2<t<7 d,C组:7<t<14 d,D组:14<t<28 d;各组病例均给予4周的综合康复护理干预,包括摄食体位的指导、咽肌电刺激训练、半糊状结构食物摄食训练指导、舌咽肌的协调综合吞咽动作训练、指导常规食物喂送等;干预护理前、后均采用日本洼田氏饮水试验、日本藤岛一郎氏和才藤荣一氏吞咽障碍程度分级量表对患者吞咽功能进行评定,比较各组护理干预前、后吞咽功能的改善程度。结果通过康复护理干预,4组病例吞咽进食功能较干预前均有不同程度的改善,A、B、C组干预前、后吞咽障碍改善程度的差异均有统计学意义(P<0.01,P<0.05),D组干预前、后吞咽障碍改善程度的差异无统计学意义(P>0.05)。干预后,A组吞咽功能好于B组,但差异无统计学意义(P>0.05);A组吞咽功能好于C组和D组,差异均有统计学意义(P<0.05,P<0.01)。结论不同介入时间康复护理干预均能积极有效地提高脑卒中吞咽障碍患者远期功能改善率,缩短发病与护理干预措施的间隔时间,更有利于促进吞咽功能的康复,提高患者自主进食能力。
Objective To explore the relationship between different beginning time and improved outcomes of nursing rehabilitation interventions for acute cerebral stroke patients with dysphasia and its effect. Methods 103 of acute cerebral stroke patients with dysphagia from NICU and common wards were divided into four groups by the different beginning time of nursing interventions, time（t） was counted from the onset of the stroke to the beginning of nursing intervention. Group A was 0- hrs, group B was 48- hrs, group C was 7 days-, group D was 14-28days. All patients were received 4 weeks comprehensive rehabilitation interventions, which included the instruction of correct feeding position, electric stimulation with triangle curve to fauces, mixture food swallow training, flexibility and coordination training of faucial muscles, the guidance of routine foods feeding and swallow food independently finally. Three kinds of Japanese dysphagia score scales were used to evaluate swallow function of four groups at beginning and at end of 4 weeks intervention and to compare the changes of pre-intervention and post-intervention of each group. Finally post-intervention outcomes were compared between group A and other three groups. Results Four groups＇ patients got improvement of wallow function at different levels after the nursing interventions. The improvement after intervention was statistical significant than that before intervention in group A, group B and group C （P〈0.01 ,P〈0.05）, but no significant in group D （P〉0.05）. Compared with post-intervention results among groups, there was no significant difference between group A and group B（P〉0.05 ）, but significant different between group A and group C or group D （P〈0.05）. Conclusion Nursing rehabilitation interventions with different beginning time can improve swallow function of cerebral stroke patients. It is more conductive to promoting the rehabilitation of swallowing function and the improvement of patients serf-eating by shortening the interv
出处
《中国慢性病预防与控制》
CAS
2012年第2期158-160,共3页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
脑卒中
吞咽障碍
护理
干预
Cerebral stroke
Dysphagia
Nursing
Interventions
