多学科协作模式在预防ICU获得性吞咽功能障碍中的应用研究

Application of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU

目的探讨多学科协作模式在预防ICU获得性吞咽功能障碍的临床应用效果。方法成立多学科团队,收集2019年7月至2020年3月在新疆医科大学第一附属医院神经外科ICU的118例住院患者为研究对象。采用类实验研究方法,根据入院先后顺序将患者分为试验组和对照组各59例,对照组实施ICU常规护理措施,试验组实施多学科协作护理模式,比较2组患者的重症监护室获得性吞咽障碍(ICU-ASD)的发生率、并发症的发生率。结果2组患者气管拔管后24 h吞咽功能障碍的发生率比较差异无统计学意义(P>0.05);对照组患者气管拔管后48、72 h吞咽功能障碍的发生率分别为11.86%(7/59)、16.95%(10/59),试验组分别为1.69%(1/59)、3.39%(2/59),差异有统计学意义(χ^(2)值为4.827~7.230,P<0.05或0.01);对照组患者发生误吸、吸入性肺炎、营养不良的发生率分别为11.86%(7/59)、10.17%(6/59)、8.47%(5/59),试验组分别为1.69%(1/59)、0、0,差异有统计学意义(χ^(2)值为4.827,P<0.05)。结论多学科协作模式可有效预防ICU-ASD的发生率,最终减少患者并发症的发生。

Objective To explore the clinical effect of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU.Methods A multidisciplinary team was set up to collect 118 patients in Neurosurgery ICU of our hospital as the research object.The patients were divided into the experimental group and the control group,59 cases in each group.The control group implemented the routine nursing measures of ICU,and the experimental group implemented the multidisciplinary cooperative nursing mode.The incidence of ICU acquired swallowing disorders(ICU-ASD)and complications of the two groups were compared.Results There was no significant difference between the two groups in the incidence of swallowing dysfunction 24 hours after tracheal extubation(P>0.05).The incidence of swallowing dysfunction 48 hours and 72 hours after tracheal extubation in the control group was 11.86%(7/59)and 16.95%(10/59)respectively,while the test group was 1.69%(1/59)and 3.39%(2/59)respectively.The difference was statistically significant(χ^(2)values were 4.827 to 7.230,P<0.05 or 0.01);the incidence of aspiration,aspiration pneumonia and malnutrition in the control group were 11.86%(7/59),10.17%(6/59)and 8.47%(5/59),respectively,while the test group were 1.69%(1/59),0 and 0,respectively,with statistically significant difference(χ^(2)value was 4.827,P<0.05).Conclusion Multidisciplinary cooperation model can effectively prevent the incidence of ICU-ASD,and ultimately reduce the incidence of complications.