集束化护理干预在脑卒中吞咽功能障碍患者中的应用

Application of Cluster Nursing Intervention in Patients with Swallowing Dysfunction

目的:探讨集束化护理干预对脑卒中吞咽功能障碍患者的临床疗效及吞咽功能的改善作用,并评估护理质量。方法:选择2017年6月-2018年4月在笔者所在医院进行治疗的脑卒中合并吞咽功能障碍患者100例,随机分为对照组和研究组,每组50例,对照组进行常规护理,研究组患者应用集束化护理干预。应用藤岛分级法和洼田氏饮水试验评估吞咽功能,观察临床疗效和误吸发生率,评估护理满意度。结果:研究组总有效率和护理满意度分别为68.00%(34/50)、(96.82±7.39)分,均高于对照组的52.00%(26/50)、(91.54±8.15)分,差异均有统计学意义(P<0.05);研究组误吸发生率为14.00(7/50),低于对照组的32.00(16/50),差异有统计学意义(P<0.05);研究组藤岛分级评分为(8.23±0.47)分,高于对照组的(6.15±0.52)分,差异有统计学意义(P<0.05);研究组洼田氏饮水试验评分为(1.40±0.41)分,低于对照组的(2.57±0.43)分,差异有统计学意义(P<0.05)。结论:应用集束化护理对脑卒中吞咽功能障碍患者进行干预,临床疗效显著,能够显著改善患者吞咽困难状况,降低患者误吸发生率,护理质量得到显著提高。

Objective:To explore the clinical efficacy and improvement of swallowing function in patients with swallowing dysfunction caused by clustering nursing intervention,and to evaluate the quality of nursing.Method:A total of 100 stroke patients with swallowing dysfunction treated in our hospital from June in 2017 to April in 2018 were selected and randomly divided into the control group and the study group,50 patients in each group.The control group received routine nursing,and the study group applied bundled care interventions.The effect of swallowing function,the clinical curative effect and the incidence of misabsorption were observed and the nursing satisfaction was evaluated.Result:The total effective rate and nursing satisfaction of the study group were 68.00%(34/50)and(96.82±7.39)points respectively,higher than 52.00%(26/50)and(91.54±8.15)points of the control group,the differences were statistically significant(P<0.05).The incidence of aspiration of the study group was 14.00%(7/50),lower than 32.00%(16/50)of the control group,the difference was statistically significant(P<0.05).The score of Fujima grading method in the study group was(8.23±0.47)points,which was significantly higher than(6.15±0.52)points in the control group,the difference was statistically significant(P<0.05),and the score of Watian drinking water test in the study group was(1.40±0.41)points,which was significantly lower than(2.57±0.43)points in the control group,the difference was statistically significant(P<0.05).Conclusion:The application of clustering nursing for stroke patients with swallowing dysfunction has significant clinical efficacy,which can significantly improve the dysphagia of patients,reduce the incidence of aspiration,and improve the quality of care.