吞水测试在急性脑卒中患者康复评估中的应用

目的调查急性缺血性脑卒中患者吞咽困难的发生情况,及早采取针对性措施,改善脑卒中患者吞咽功能,减少并发症发生。方法对100名急性缺血性脑卒中患者,在入院24 h内未进食、水之前由受过专门训练的康复护士进行吞水测试,有针对性地进行吞咽功能康复训练。结果23例未通过吞水测试,经过康复训练,调整饮食结构,其中19例(82.6%)出院前可以正常吞咽,有4例(17.4%)需留置经鼻胃管,鼻饲饮食。吞咽困难患者营养不良发生率较非吞咽困难者高,且早期预后差,住院天数延长。结论吞水测试能够及时测试缺血性脑卒中患者是否存在吞咽困难及其程度,及早采取针对性措施,可以减少吸入性肺炎等并发症,降低营养不良发生率,对脑卒中患者整体康复过程起着积极作用。

Objective To investigate the incidence of dysphagia and confirm the application of water swallowing test in estimating recovery in the patients with acute ischemic stroke. Methods The water swallowing test was performed by professional healing nurses in 100 cases of acute ischemic stroke patients who had not had food and water within 24 hours after admission. Healing exercises of swallow function were performed pertinently. Results 23% of 100 cases of acute ischemic stroke patients didn＇t pass the initial water swallowing test. 85. 6% of dysphagia patients could swallow normally before leaving hospital, and 17.4% need indwell nasal-gastric tube. The state of illness in patients with dysphagia was more serious than those without dysphagia, and the difference was statistically significant （ P〈0.01 ）. The rate of malnutrition in the dysphagia group was higher than patients in the group without dysphagia （ 11.7% ）, and the difference was statistically significant, too （P〈0.05 ）. Conclusion The water swallowing test can test whether the patients with acute ischemic stroke have dysphagia and its degree. Pertinent measure can be adopted as soon as possible. The complications such as pneumonia can be lessened. The rate of malnutrition can be lowered. It plays a positive effect on healing of patients with stroke.