目标化个体营养健康教育在卒中后吞咽障碍患者中的应用效果

Application effect of targeted individual nutrition health education in patients with dysphagia after stroke

目的探讨目标化个体营养健康教育在卒中后吞咽障碍患者中的应用效果。方法选择2017年1月1日至12月31日在该院康复科住院的161例老年卒中后吞咽障碍患者为研究对象,将其分为干预组(n=81)和对照组(n=80),对照组患者采用常规的营养健康教育方法,干预组采用目标化个体营养健康教育方法,比较两组患者入院时、出院后3个月的上臂围、肱三头肌皮褶厚度、清蛋白、总胆固醇等水平,以及营养不良发生率和遵医依从性情况。结果两组患者入院时的上臂围、肱三头肌皮褶厚度、清蛋白、总胆固醇等营养指标比较,差异无统计学意义(P>0.05)。出院后3个月发生营养不良干预组和对照组分别为4例(5.00%)和12例(15.58%),两组比较差异有统计学意义(P<0.05);出院后3个月干预组和对照组患者的上臂围分别为(25.42±2.44)、(22.61±1.96)cm,肱三头肌皮褶厚度分别为(16.73±0.99)、(14.52±1.07)mm,清蛋白分别为(40.49±6.27)、(36.68±4.14)g/L,总胆固醇分别为(5.27±1.01)、(4.21±0.43)mmol/L,干预组均明显高于对照组(P<0.01);干预组患者的遵医依从性总得分及依从性等级分布均明显优于对照组(P<0.01)。结论目标化个体营养健康教育模式在卒中后吞咽障碍患者中的应用可以降低患者出院后的营养不良发病率,并增强患者的遵医依从性。

Objective To explore the application effect of targeted individual nutrition health education in the patients with dysphagia after stroke.Methods A total of 161 elderly patients with dysphagia after stroke in the rehabilitation department of this hospital from January 1,to December 31,2017 were selected as the study subjects and divided into the intervention group(n=81)and control group(n=80).The control group adopted the conventional nutrition health education method,while the intervention group used the targeted individual nutrition health education method.The upper arm circumference,triceps skinfold thickness,albumin,total cholesterol levels,incidence rate of malnutrition and medical compliance at the time of admission and in 3 months after discharge were compared between the two groups.Results There were no statistically significant differences in the nutritional parameters of upper arm circumference,triceps skinfold thickness,albumin and total cholesterol between the two groups(P>0.05).The malnutrition occurrence in 3 months after discharge had 4 cases(5.00%)in the intervention group and 12 cases(15.58%)in the control group.and the difference between the two groups was statistically significant(P<0.05).The upper arm circumference in 3 months after discharge in the intervention group was(25.42±2.44)cm,the triceps skin fold thickness was(16.73±0.99)mm,albumin(40.49±6.27)g/L,and total cholesterol was(5.27±1.01)mmol/L,which were significantly higher than(22.61±1.96)cm,(14.52±1.07)mm,(36.68±4.14)g/L and(4.21±0.43)mmol/L in the control group,the intervention group was significantly higher than the control group,and the difference between the two groups was statistically significant(P<0.01).The total scores of medical compliance and compliance grades distribution in the intervention group were significantly better than those in the control group(P<0.01).Conclusion The application of targeted individual nutrition health education model in stroke patients with dysphagia can reduce the incidence rate of malnutrition after discharge,and enhance the patient′s medical compliance.