急性脑卒中吞咽障碍患者早期康复护理的效果观察

Effect observation of early rehabilitation nursing on patients with dysphagia after acute stroke

目的观察早期康复护理在急性脑卒中吞咽障碍患者康复中的应用效果.方法选择2017年10月至2019年10月首都医科大学宣武医院收治的92例急性脑卒中吞咽障碍患者为研究对象,将患者按护理方法不同分为观察组和常规护理组,每组46例.常规护理组给予知识宣教、病情监测、心理护理和环境护理等常规护理;观察组针对不同吞咽障碍程度采取针对性基础训练和吞咽训练.比较两组患者临床疗效的差异,采用藤岛一郎吞咽疗效评价量表评定患者的吞咽功能;采用改良Barthel指数评定量表(MBI)评价患者的日常生活能力;采用Fugl-Meyer评定量表(FMA)评价患者的肢体功能;采用简明健康状况调查表(SF-36)评定患者的生活质量;采用自制调查问卷评价护理依从性、疾病知识知晓率和护理满意度;分析并比较两组患者吞咽障碍评分、日常生活能力评分、肢体功能评分、生活质量评分、护理依从性、疾病知识知晓率和护理满意度的差异.结果观察组总有效率显著高于常规护理组〔95.65%(44/46)比80.43%(37/46),P<0.05〕.干预后观察组吞咽障碍评分、日常生活能力评分、肢体功能评分、生活质量总评分、护理依从性、疾病知晓率、护理满意度均显著高于常规护理组〔吞咽障碍评分(分):8.72±1.93比6.27±1.73,日常生活能力评分(分):70.83±6.95比53.57±6.22,肢体功能评分(分):85.26±8.06比71.74±7.55,生活质量总评分(分):80.05±7.52比71.18±6.89,护理依从性:93.48%(43/46)比71.74%(33/46),疾病知识知晓率:95.65%(44/46)比78.26%(36/46),护理满意度:100.00%(46/46)比84.78%(39/46),均P<0.05〕.结论早期康复护理可有效提升急性脑卒中吞咽障碍患者的临床疗效.

Objective To explore the elinical effect of early rehabiliation nursing for patients with dysphagia after acute stroke.Methods The 92 patients with dysphagia after acute stroke admitted to Xuanwu Hospital of Capital Medical University from October 2017 to October 2019 were selected as research objects.According to difference in nursing methods,the patients were divided into an observation group and a routine nursing group,with 46 patients in each group.The routine nursing group was given routine nursing including knowledge education,disease condition monitoring.psychological nursing,environmental nursing,et.;the observation group was given targeted basic training and swallowing training according to difference in degrees of dysphagia.The difference of clinical efficacy between the two groups was compared.The swallowing function was evaluated by Fujishima Ichiro swallowing efficacy evaluation scale;the aetivity of daily living was evaluated by modified Barthel index rating scale(MBD);Fugl-Meyer Assessment(FMA)was used to evaluate limb function;the quality of life was assessed by the MOS item short from health survey(SF-36);self-made questionnaire was used to evaluate nursing compliance,awareness rate of disease know ledge and satisfaction toward nursing care.The swallow ing dysfunction score,daily life ability score,limb function score,quality of life score,nursing compliance,awareness rate of disease know ledge and satisfaction toward nursing care were analyzed and compared between the two groups.Results The total efficacy of the observation group was significantly higher than that in routine nursing group[95.65%(44/46)vs.80.43%(37/46),P<0.05].After.intervention,the swallowing dysfunction score,daily living ability score,limb function score,quality of life score,nursing compliance,disease awareness rate and the degree of satisfaction toward nursing care in the observation group were significantly higher than those in routine nursing group[swallowing dysfunction score(points);:8.72±1.93 vs.6.27±1.73.daily living ability score(points):70.83±6.95 vs.3.57±6.22,limb function score(points):85.26±1.93 vs.71.74±7.55,quality of life score(points):80.05±7.52 vs.71.18±6.89.nursing compliance:93.48%(43/46)vs.71.74%(33/46),awareness rate of disease know ledge:95.65%(44/46)vs.78.26%(36/46),satisfaction toward nursing:100.00%(46/46)vs.84.78%(39/46),all P<0.05].Conclusion Early rehabilitation nursing can effectively improve the clinical therapeutic effect of patients with swallowing dysfunction after acute stroke.