行动管理联合卧位康复训练在预防脑卒中后吞咽障碍患者吸入性肺炎的应用

Application of action management combined with recumbent rehabilitation training in the prevention of aspiration pneumonia in patients with dysphagia after stroke

目的:探讨行动管理联合卧位康复训练在预防脑卒中后吞咽障碍患者吸入性肺炎的应用效果。方法:选取60例脑卒中后吞咽障碍患者为研究对象,根据护理干预方式不同分为观察组和对照组,每组各30例。对照组患者采用常规护理干预;观察组患者在对照组基础上给予行动管理联合卧位康复训练干预,干预时间均为1个月。比较两组患者吞咽功能[洼田饮水试验及功能性经口摄食评表(FIOS)评分]、进食情况[自主进食时间、实际进食比例、进食评估调查表(EAT-10)评分]、吸入性肺炎发生情况(吸入性肺炎风险评分、吸入性肺炎发生率)、血氧饱和度、生活质量[Barthel指数评估表(BI)及日常生活能力表(ADL)评分]。结果:干预1个月后,两组患者洼田饮水试验结果比较,差异有统计学意义(P<0.05);吸入性肺炎发生率比较,差异无统计学意义(P>0.05)。观察组患者FIOS、实际进食比例、EAT-10评分、BI评分及ADL评分高于对照组(P<0.05);自主进食时间、吸入性肺炎风险评分、血氧饱和度下降2%的占比低于对照组(P<0.05)。结论:行动管理联合卧位康复训练可有效提高脑卒中后吞咽障碍患者吞咽功能、日常生活能力及生活质量,降低吸入性肺炎发生风险,促进患者康复。

Objective:To explore the application effects of action management combined with recumbent rehabilitation training on the prevention of aspiration pneumonia in patients with dysphagia after stroke.Methods:60 patients with dysphagia after stroke were selected as the observation subjects,and they were divided into observation group and control group according to different nursing intervention methods,with 30 cases in each group.The control group was given routine nursing intervention,while the observation group was given action management combined with recumbent rehabilitation training on this basis,and both groups were continuously intervened for 1 month.The swallowing function[water swallow test,Functional Oral Intake Scale(FIOS)],eating status[autonomous eating time,actual eating proportion,Eating Assessment Tool Questionnaire(EAT-10)],occurrence of aspiration pneumonia(aspiration pneumonia risk score,incidence rate of aspiration pneumonia)and changes in blood oxygen saturation and quality of life[Barthel Index(BI),Activity of Daily Living(ADL)]before intervention and after 1 month of intervention were compared between the two groups.Results:After 1 month of intervention,there was statistical difference in the result of water swallow test between the two groups(P<0.05),but there was no significant difference in the incidence rate of aspiration pneumonia(P>0.05).The FIOS,actual eating proportion,EAT-10,BI and ADL in observation group were higher than those in control group(P<0.05),while the autonomous eating time,aspiration pneumonia risk score and the number of cases with oxygen saturation decreased by 2%were lower than those in control group(P<0.05).Conclusion:Action management combined with recumbent rehabilitation training can effectively enhance the swallowing function,daily living ability and quality of life of patients with dysphagia after stroke,reduce the risk of aspiration pneumonia,and promote the rehabilitation of patients.