摘要
目的探讨精准护理干预在老年脑卒中后阻塞性睡眠呼吸暂停(OSA)并吞咽障碍患者中的应用效果。方法选取2016年2月—2017年11月常州市德安医院康复中心收治的老年脑卒中后OSA并吞咽障碍患者74例,采用随机数字表法分为对照组和观察组,每组37例。两组患者均实施康复科常规护理,观察组患者在常规护理基础上给予精准护理干预。比较两组患者护理前和护理8周后X线吞咽造影检查(VFSS)评分、多导睡眠图(PSG)监测结果、汉密尔顿焦虑量表(HAMA)评分,并观察两组患者护理期间不良事件发生情况。结果护理前两组患者VFSS评分、呼吸暂停低通气指数(AHI)、最长呼吸暂停时间及夜间最低动脉血氧饱和度(LSa O2)比较,差异无统计学意义(P>0.05);护理8周后观察组患者VFSS评分和夜间LSa O2高于对照组,AHI低于对照组,最长呼吸暂停时间短于对照组(P<0.05)。护理前两组患者HAMA评分比较,差异无统计学意义(P>0.05);护理8周后观察组患者HAMA评分低于对照组(P<0.05)。观察组患者护理期间误吸率低于对照组(P<0.05);两组患者护理期间呛咳发生率比较,差异无统计学意义(P>0.05)。结论精准护理干预在老年脑卒中后OSA并吞咽障碍患者中的应用效果确切,能有效改善OSA及吞咽障碍,减轻焦虑程度,减少误吸的发生。
Objective To investigate the application effect of precision nursing intervention in elderly post-stroke OSA patients complicated with dysphagia. Methods From February 2016 to November 2017,a total of 74 elderly post-stroke OSA patients complicated with dysphagia were selected in the Rehabilitation Center,Dean Hospital of Changzhou,and they were divided into control group and observation group according to random number table,each of 37 cases. Patients in the two groups received routine nursing care,while patients in observation group received precision nursing intervention based on routine nursing care. VFSS score,PSG monitoring results,HAMA score before nursing intervention and 8 weeks after nursing intervention were compared between the two groups,and incidence of adverse events during nursing intervention was observed. Results No statistically significant differences of VFSS score,AHI,the longest apnea time or nighttime LSaO2 was found between the two groups before nursing intervention（P〈0.05）;8 weeks after nursing intervention,VFSS score and nighttime LSaO2 in observation group were statistically significantly higher than those in control group,AHI in observation group was statistically significantly lower than that in control group,meanwhile the longest apnea time in observation group was statistically significantly shorter than that in control group（P〈0.05）. No statistically significant differences of HAMA score was found between the two groups before nursing intervention（P〈0.05）,while HAMA score in observation group was statistically significantly lower than that in control group 8 weeks after nursing intervention（P〈0.05）. Incidence of accidentally inhalation in observation group was statistically significantly lower than that in control group during nursing intervention（P〈0.05）,while no statistically significant differences of incidence of irritating cough was found between the two groups（P〈0.05）. Conclusion Application effect of precision nursing intervention has cert
作者
宦红美
陈其珍
何俊
焦素芹
张丽霞
胡翠琴
HUAN Hong-mei;CHEN Qi-zhen;HE Jun;JIAO Su-qin;ZHANG Li-xia;HU Cui-qin(Dean Hospital of Changzhou,Changzhou 213000,China;Rehabilitation Medical Center,the People＇ s Hospital of Jiangsu Province,Nanjing 210000,China)
出处
《实用心脑肺血管病杂志》
2018年第5期63-66,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
2017年江苏省科技发展计划项目(BE2017752)
常州市2017年科技支撑计划项目(CE20175033)
关键词
卒中
睡眠呼吸暂停
阻塞性
吞咽障碍
老年人
精准护理干预
治疗结果
Stroke
Sleep apnea
obstructive
Swallowing disorder
Aged
Precision nursing intervention
Treatment outcome
