食品结构调整对后组颅神经损伤并发吞咽障碍患者的护理干预

Nursing intervention of food structure adjustment in patients with posterior cranial nerve injury complicated with dysphagia

目的探讨食品结构调整护理干预方案对后组颅神经损伤并发吞咽障碍患者的作用.方法选择2017年7月至2019年6月湖州市第一人民医院收治的后组颅神经损伤并发吞咽障碍患者56例,按照随机数字表法将患者分为饮食干预护理组和常规护理对照组,每组各28例.常规护理对照组采用神经外科常规治疗护理措施进行护理,包括药物治疗、饮食指导、口腔护理和康复训练等;饮食干预护理组在常规治疗护理的基础上,根据患者吞咽障碍等级采取个体化的食品结构调整进行干预,包括依据膳食结构标准分级,制定个性化饮食方案,建立多学科团队指导模式,制定"吞咽障碍患者摄食状况记录表"等.两组干预周期均为3周.干预结束后,采用洼田饮水试验对两组患者进行评估,观察两组患者吞咽功能改善率以及首次恢复进流食的时间.结果饮食干预护理组的吞咽功能改善率明显优于常规护理对照组〔92.86%(26/28)比89.28%(25/28)〕,首次恢复进流食的时间明显短于常规护理对照组(d:5.26±0.73比7.19±1.12),差异均有统计表意义(均P<0.05).结论结合食品结构调整的护理方案可以帮助后组颅神经损伤并发吞咽障碍患者在早期恢复吞咽功能.

Objective To investigate the nursing in tervention of food structure adjustment in patients with posterior cranial nerve injury complicated with dysphagia.Methods From July 2017 Io June 2019.56 patients with cranial nerve injury complicated with dysphagia in the First People's Hospital of Huzhou were selected and divided into diet intervention nursing group and routine nursing control group according to the method of random number table,with 28 cases in each group.The routine nursing control group adopted the neurosurgical routine treatment nursing measures,including drug treatment,diet guidance,oral care,rehabilitation training,etc.;the diet intervention nursing group adopted the individualized food structure adjustment according to the patients'swallowing disorder level on the basis of the routine treatment nursing for intervention,including making personalized diet plan according to the standard grading of dietary structure,establishing multi—disciplinarv team guidance mode,and making"record table of eating status of patients with dysphagia".The intervention period was 3 weeks.At the end of the intervention,Wada drinking water test was used to evaluate the two groups of patients,and the improvement rate of swallowing function and the time of first return to liquid food were observed.Results The improvement of swallowing function in the diet intervention nursing group was significantly better than that in the routine nursing control group[92.86%(26/28)vs.89.28%(25/28)],and the time of first return to liquid food was significantly shorter than that in the control group(d:5.26+0.73 vs.7.19±1.12),the difference was statistically significant between the two groups(P<0.05).Conclusion The nursing plan combined with food structure adjustment can help the patients with posterior cranial nerve injury complicated with dysphagia to restore swallowing function in the early stage.