改良式口腔护理在脑卒中吞咽功能障碍患者中的应用研究

Application of Modified Oral Nursing in Stroke Patients with Dysphagia

目的探讨改良式口腔护理在脑卒中吞咽功能障碍患者中的应用效果。方法选取本院于2017年11月-2018年11月收治的60例脑卒中伴吞咽功能障碍患者,按者随机数字表法分为2组,每组30例,对照组行传统口腔护理,试验组给予改良式口腔护理干预,分别于治疗前、后,统计并比较两组口腔清洁度、误吸率、肺部感染率,另评估吞咽功能。结果试验组口腔清洁度(4.34±0.56)分,高于对照组(3.19±1.05)分,两组比较差异显著(t=4.50,P<0.05);试验组未发生口腔溃疡病例,对照组为1例,两组比较无显著差异(x^2=0.62,P<0.05)。试验组误吸发生率(6.67%)低于对照组(36.67%),两组比较差异明显(x^2=10.34,P<0.05)。试验组肺部感染发生率相比对照组,无显著差异(x^2=1.04,P>0.05)。试验组吞咽功能总有效率(93.33%)较对照组(76.67%),明显高于后者(x^2=10.89,P<0.05)。结论针对脑卒中吞咽功能障碍患者,采用电动牙刷震动按摩器+冷热刺激疗法的改良式口腔护理措施,能促进咀嚼肌与舌的运动,预防误吸,改善吞咽障碍症状。

Objective To explore the effect of modified oral nursing in stroke patients with dysphagia.Methods 60 patients with cerebral apoplexy accompanied by dysphagia admitted to our hospital from November 2017 to November 2018 were randomly divided into two groups with 30 in each group.The control group received traditional oral nursing while the test group received improved oral nursing intervention.Before and after treatment,the oral cleanness and pulmonary infections of the two groups were compared.And their swallowing function was evaluated.Results The oral cleanliness of the test group [(4.34±0.56)] was higher than that of the control group [(3.19±1.05)],and the difference between the two groups was significant ( P <0.05).There were no cases of oral ulcer in the test group and one case in the control group,and there was no significant difference between the two groups ( x^2 =0.62,P <0.05).The incidence of misprision in the test group (6.67%) was lower than that in the control group (36.67%),and the difference between the two groups was significant ( x^2 =1.04,P <0.05).The incidence of pulmonary infections in the test group was not significantly different from that in the control group ( x^2 =10.34,P >0.05).The total effective rate of swallowing function in the test group (93.33%) was significantly higher than that in the control group (76.67%)( P <0.05).Conclusion For the patients with dysphagia after stroke,the improved oral nursing measures of electric toothbrush vibration massager plus cold and heat stimulation therapy can promote the movement of masticatory muscles and tongue,prevent mistaken inhalations and improve the symptoms of dysphagia.