脑卒中后中度吞咽障碍患者康复训练及饮食护理干预的应用效果

Effect of rehabilitation training and diet nursing intervention in patients with moderate dysphagia after stroke

目的探讨脑卒中后中度吞咽障碍患者康复训练及饮食护理干预的应用效果。方法选取2018年5月~2020年5月大连港医院收治的脑卒中后中度吞咽障碍的94例患者作为研究对象,按照随机抽签法分为参照组(47例)和实验组(47例)。参照组患者采用脑卒中对症康复治疗和常规护理,包括肠内营养以及饮食用药的简单宣教。实验组患者则在脑卒中对症康复治疗和常规护理的基础上采用康复训练及饮食护理干预,两组均干预8周。比较两组患者的吞咽障碍好转情况,并测定两组白蛋白、血红蛋白等营养指标,统计两组吸入性肺炎、腹胀腹泻及胃食管反流等并发症情况。结果两组干预前的吞咽功能障碍评分比较,差异无统计学意义(P>0.05);两组患者干预后的吞咽功能障碍评分均低于干预前,差异有统计学意义(P<0.05),且实验组干预后的吞咽功能障碍评分低于参照组,差异有统计学意义(P<0.05)。两组患者干预前的白蛋白、血红蛋白等营养指标比较,差异无统计学意义(P>0.05);两组患者干预后的白蛋白、血红蛋白等营养指标均高于干预前,差异有统计学意义(P<0.05),且实验组干预后的白蛋白、血红蛋白等营养指标高于参照组,差异有统计学意义(P<0.05)。实验组患者的并发症总发生率低于参照组,差异有统计学意义(P<0.05)。结论康复训练及饮食护理干预的应用,对于脑卒中后中度吞咽障碍患者有良好的干预效果,有助于改善吞咽障碍,提升患者的营养状况。

Objective To investigate the effect of rehabilitation training and diet nursing intervention in patients with moderate dysphagia after stroke.Methods A total of 94 patients with moderate dysphagia after stroke admitted to Dalian Port Hospital from May 2018 to May 2020 were selected as the research objects.According to the random lottery method,they were divided into the reference group(47 cases)and the experimental group(47 cases).The patients in the reference group were treated with stroke rehabilitation and routine nursing,including enteral nutrition and simple education of dietary medication.The patients in the experimental group were treated with rehabilitation training and diet nursing intervention on the basis of symptomatic rehabilitation treatment and routine nursing of stroke,both groups were treated for 8 weeks.The improvement of dysphagia in the two groups were compared,and the nutritional indexes such as albumin and hemoglobin in the two groups were measured.The complications such as aspiration pneumonia,abdominal distension,diarrhea and gastroesophageal reflux in the two groups were analyzed.Results There was no significant difference in dysphagia score between the two groups before intervention(P>0.05).The dysphagia scores in the two groups after intervention decreased,and the differences were statistically significant(P<0.05).The score of dysphagia in the experimental group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Albumin,hemoglobin and other nutritional indicators before intervention were compared between the two groups,there were no significant differences(P>0.05).The nutritional indicators such as albumin and hemoglobin after intervention were higher than those before intervention in the two groups,and the differences were statistically significanttions in the experimental group were lower than those in the reference group,and the differences were statistically significant(P<0.05).Conclusion The application of rehabilitation training and diet nursing intervention has a good effect on patients with moderate dysphagia after stroke,which is helpful to improve dysphagia and improve the nutritional status of patients.