232例脑卒中后吞咽障碍的临床护理体会

Clinical Nursing Experience of Dysphagia after Cerebral Apoplexy(with 232 Cases)

目的探析综合性康复护理干预对脑卒中后并发吞咽障碍患者预后和生存质量的影响。方法选择我院神经内科2017年2月至2018年2月收治的脑卒中后并发吞咽障碍患者232例为研究对象,采用随机数字法将研究对象分为两组—观察组(120例)和对照组(112例),观察组应用综合性康复护理干预方案,对照组给予常规护理方案,对比分析两组护理方案对患者吞咽功能改善作用和生存质量评分状况及并发症发生率。结果观察组吞咽功能改善总有效率为95.8%;与对照组76.8%对比,差异具统计学意义(P<0.05)。观察组护理干预后,生存质量GQOLI-74量表各维度即社会功能、物质生活、心理功能、身体功能评分均高于对照组,差异有统计学意义(P<0.05)。观察组营养不良2例,腹痛腹泻2例,肺炎3例,并发症率为5.8%;对照组营养不良6例,腹痛腹泻7例,肺炎9例,并发症率为19.6%,对比差异有统计学意义(P<0.05)。结论针对临床收治的脑卒中后吞咽障碍的患者,重视全面、整体护理干预的实施,可显著改善吞咽功能,提高患者生存质量,防范并发症发生。

Objective To explore the effect of comprehensive rehabilitation nursing intervention on prognosis and quality of life in patients with dysphagia after cerebral apoplexy.Methods 232 patients with dysphagia after cerebral apoplexy treated in department of Neurology of Jinzhou traditional Chinese medicine hospital from February 2017 to February 2018 were selected as the research subjects.According to random number method,the subjects were divided into two groups,the observation group(120 cases)and the control group(112 cases).To compared the improvement of swallowing function and the score of quality of life and the incidence of complications between the two groups.Results The total effective rate of improvement in swallowing function in the observation group was 95.8%,and the difference was statistically signifi cant in comparison with that in the control group(76.8%)(P<0.05).After the nursing intervention in observation group,the score of dimensions of the quality of life GQOLI-74 scale(such as social function,material life,psychological function and physical function)of the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,there were 2 cases of malnutrition 2 cases of abdominal pain and diarrhea,3 cases of pneumonia,the complication rate was 5.8%.In the control group,there were 6 cases of malnutrition,7 cases of abdominal pain and diarrhea,9 cases of pneumonia,and the complication rate of 19.6%,the difference was statistically signifi cant(P<0.05).Conclusions For patients with dysphagia after cerebral apoplexy,attention should be paid to the implementation of comprehensive and holistic nursing intervention,which can signifi cantly improve the swallowing function,the quality of life and prevent complications.