脑卒中后吞咽障碍康复管理流程构建与应用

Construction and application of a rehabilitation management process for post-stroke dysphagia

目的构建脑卒中后吞咽障碍康复管理流程,评价应用效果。方法通过循证证据检索和专家咨询构建脑卒中后吞咽障碍康复管理流程。按照住院时间将411例初发脑卒中患者分为对照组198例和干预组213例;对照组给予常规康复护理流程;干预组实施脑卒中后吞咽障碍康复管理流程,包括吞咽障碍筛查、吞咽障碍程度判定、摄食风险评估、康复介入及动态评估。结果干预组患者康复介入时间显著短于对照组(P<0.01);入院时及脑卒中后1个月,两组吞咽障碍发生率差异无统计学意义(均P>0.05),脑卒中后1个月干预组吞咽障碍严重程度及生活质量评分显著优于对照组(均P<0.01)。结论应用脑卒中后吞咽障碍康复管理流程能有效缩短脑卒中患者康复介入时间,降低患者吞咽障碍严重程度,提高其生活质量。

Objective To construct a rehabilitation management process for Post-stroke Dysphagia(PSD),and to explore its application effects.Methods A rehabilitation management process for PSD was constructed via evidences searching and expert consultation.Then totally 411 first stroke patients were divided into a control group(n=198)and an intervention group(n=213)chronologically,the control group was cared using the routine rehabilitation nursing process,while the intervention group was treated using the rehabilitation management process,including PSD screening,PSD severity determination,food intaking risk assessment,rehabilitation intervention and dynamic assessment.Results The rehabilitation intervention time in the intervention group was statistically shorter than that of the control group(P<0.01);at admission and one month after stroke attack,there was no significant difference in the incidence of PSD between the two groups(P>0.05),at one month after stroke attack,the PSD severity and quality of life in the intervention group were significantly better than those in the control group(P<0.01 for both).Conclusion Application of the rehabilitation management process for PSD could effectively shorten the rehabilitation intervention time for stroke patients,alleviate their severity of dysphagia,and improve their quality of life.