营养管理结合专职康复护理在脑卒中吞咽困难及偏瘫患者中的应用

Application of nutrition management combined with full-time rehabilitation nursing in stroke patients with dysphagia and hemiplegia

目的探讨营养管理结合专职康复护理在脑卒中吞咽困难及偏瘫患者中的临床应用价值。方法选取2018年1月~2019年9月本院收治的急性缺血性脑卒中合并吞咽困难及偏瘫患者80例为研究对象,采用随机数字表法分为两组,各40例。对照组实施常规营养支持与康复干预,观察组实施早期膳食管理营养支持及专职康复护理,比较两组饮水和经口进食恢复时间;比较干预后1个月两组营养状况;比较干预后1个月两组热量代谢情况;比较干预后1个月两组ESS和Barthel指数评分。结果观察组饮水和经口进食恢复时间均显著短于对照组(P<0.05),干预后1个月,观察组转铁蛋白水平、前白蛋白水平、白蛋白水平高于对照组(P<0.05),观察组热量摄入量和尿素氮均显著高于对照组(P<0.05),干预后1个月,观察组ESS与Barthel指数评分均明显高于同期对照组(P<0.05)。结论针对缺血性脑卒中合并吞咽困难患者,进行早期营养膳食管理及专职康复护理,对提高患者营养状况,促进神经功能恢复,提高生活质量有重要价值。

Objective To explore the clinical application value of nutrition management combined with full-time rehabilitation nursing in stroke patients with dysphagia and hemiplegia.Methods 80 patients with acute ischemic stroke and dysphagia and hemiplegia admitted to our hospital from January 2018 to September 2019 were selected as the study subjects.They were divided into two groups by using the random number table method,with 40 cases in each group.The control group implemented conventional nutritional support and rehabilitation intervention,and the observation group implemented early dietary management nutritional support and full-time rehabilitation nursing.The drinking and oral feeding recovery time,nutritional status,caloric metabolism,Epworth sleepiness score(ESS)and Barthel index scores one month after the intervention were compared between the two groups.Results The recovery time of drinking and oral feeding in the observation group was significantly shorter than that in the control group(P<0.05);one month after the intervention,the transferrin,prealbumin,and albumin levels in the observation group were higher than those in the control group(P<0.05),the caloric intake and urea nitrogen of the observation group were significantly higher than those of the control group(P<0.05);One month after intervention,the ESS and Barthel index scores of the observation group were significantly higher than those of the control group at the same period(P<0.05).Conclusion For the patients with ischemic stroke and dysphagia,early nutritional dietary management and full-time rehabilitation nursing are of great value to improve the nutritional status of patients,promote the recovery of nerve function and improve the quality of life.