预见性护理联合标准吞咽功能评估在老年脑卒中吞咽障碍患者中的临床应用

Clinical application of predictive nursing care combined with standard swallowing function evaluation in elderly patients with stroke swallowing dysfunction

目的 探讨预见性护理联合标准吞咽功能评估在老年脑卒中吞咽障碍患者中的临床应用效果.方法 选取2014年10月~2016年1月于该院就诊的151例老年脑卒中吞咽障碍患者为研究对象,A组77例患者采用预见性护理联合标准吞咽功能评估的治疗方案,B组74例患者仅给予神经内科常规的治疗护理和基本的康复训练.对比两组患者的肺部感染、吸入性肺炎、住院时间和费用,治疗效果,以及治疗前后的各项营养指标.结果 A组中有2例（2.60%）患者发生了肺部感染,明显少于B组8例（10.81%）（χ 2=4.116 5,P=0.0425）;A组中有8例（10.39%）患者发生了吸入性肺炎,明显少于B组的25例（33.78%）（χ 2=12.092 6,P=0.000 5）;A组患者的平均住院时间为（12.89±2.27）d,明显少于B组（19.32±3.58）d（t=13.234 4,P=0.000 0）;A组患者的平均住院费用为（1.92±0.35）万元,明显低于B组（2.89±0.61）万元（t=12.043 4,P=0.000 0）;A组患者的总有效率为92.21%,明显高于B组70.27%（χ 2=12.023 0,P=0.000 5）;治疗后A组患者的各项营养指标均明显优于B组（均P〈0.05）.结论 对于老年脑卒中吞咽障碍患者,采用预见性护理联合标准吞咽功能评估的治疗方案疗效好,治愈率高、肺部感染少、吸入性肺炎发生率低、恢复快.

Objective To investigate the clinical application of predictive nursing care combined with standard swallowing function evaluation in elderly patients with dysphagia after stroke.Methods From October 2014 to January 2016,151 cases of senile cerebral stroke dysphagia patients were treated in our hospital.77 cases in group A were treated with preview nursing combined with standardized swallowing function evaluation,74 cases in group B were only given principles rehabilitation nursing department of neurology and basic conventional treatment.The pulmonary infection,aspiration pneumonia,hospitalization time and cost,treatment effect,as well as the nutritional index before and after treatment of the two groups were tested and compared.Results Patients in group A occurred 2 cases （2.60%） pulmonary infection,it were significantly lesser than 8 cases （10.81%） of group B （χ 2=4.1165,P=0.0425）.Patients in group A had 8 cases （10.39%） aspiration pneumonia patients,which was significantly lesser than 25 cases （33.78%） in group B （χ 2=12.0926,P=0.0005）.The average hospitalization time for the patients in group A （12.89±2.27） was significantly shorter than （19.32±3.58） days in group B （t=13.2344,P=0.0000）.The average hospitalization expenses in group A with （1.92±0.35） million lower than （2.89±0.61） million in group B （t=12.0434,P=0.0000）.Patients in group A with the total effective rate was 92.21%,which was significantly higher than 70.27% in group B （χ 2=12.0230,P=0.0005）.After treatment,the nutritional indexes in group A were signifi cantly better than in group B （P〈0.05）.Conclusions For patients that have the aged stroke dysphagia, foreseeable nursing with the combination of the treatment schemes of standard swallowing function has the advantages of good curative effect,high recovery rate,low pulmonary infection,low occurrence rate of aspiration pneumonia and quick recovery.