急性缺血性卒中患者吞咽障碍管理循证方案的制定及实施

Application of an evidence-based dysphagia management protocol for patients with acute ischemic stroke

目的探讨基于循证的吞咽障碍管理方案在急性缺血性卒中患者的应用效果。方法将60例急性缺血性卒中患者随机分为对照组和干预组各30例,对照组给予常规入院评估与护理干预,干预组采用多伦多床旁吞咽筛查试验进行筛查,并实施基于循证的吞咽障碍管理方案。分别在干预前及干预第1、7天监测两组患者吞咽功能改善疗效、误吸风险发生率、卒中相关性肺炎发生率。结果观察组吞咽功能改善情况好于对照组,卒中相关性肺炎发生率显著低于对照组(P<0.05)。结论基于循证的吞咽障碍管理,可有效预防和改善缺血性卒中患者的吞咽障碍,促进吞咽功能恢复。

Objective To evaluate the efficacy of an evidence-based dysphagia management protocol for patients with acute ischemic stroke.Methods A total of 60 patients with acute ischemic stroke were randomly divided into a control group(n=30),who received routine admission assessment and nursing intervention,and an intervention group(n=30),who were screened with Toronto bedside swallowing screening test(TOR-BSST)and then subjected to the evidence-based dysphagia management protocol.The improvement of swallowing function,the incidence rates of aspiration and apoplexy associated pneumonia were monitored before,1 day and 7 days into the intervention.Results The total effective rate of swallowing function improvement in the intervention group was better than that in the control group;the incidence rates of apoplexy associated pneumonia was significantly lower in the former than in the latter(P<0.05).Conclusion The evidence-based dysphagia management protocol could prevent or better dysphagia in patients with acute ischemic stroke,and boost recovery of swallow function.