早期吞咽功能训练对老年脑梗死合并吞咽障碍患者的影响及预后观察

Influence of early swallowing function training on elderly patients with cerebral infarction complicated with dysphagia and observation on the prognosis

目的对老年脑梗死合并吞咽障碍患者进行早期吞咽功能训练,评估对患者吞咽功能的改善作用及预后。方法选择2018年1月—2019年3月本院收治的急性脑梗死合并吞咽功能障碍老年患者120例作为研究对象,随机数表法分为对照组和干预组两组,每组各60例。对照组患者进行常规护理,研究组患者在常规护理基础上同时应用早期吞咽功能训练。评估患者吞咽功能、误吸、吸入性肺炎及死亡发生率,评估护理满意度。结果干预组干预后患者藤岛分级法评分、洼田氏饮水试验评分均优于对照组,差异有统计学意义(t=11.037,10.033,P=0.000)。干预组患者洼田氏饮水试验干预后(Ⅰ级+Ⅱ级+Ⅲ级)发生率为68.33%,高于对照组的56.67%,差异有统计学意义(χ^(2)=9.381,P=0.002)。干预组患者误吸发生率为28.33%,低于对照组的46.67%,差异有统计学意义(χ^(2)=9.941,P=0.002);干预组护理满意度为(95.79±5.04)分,高于对照组的(90.84±5.26)分,差异有统计学意义(t=10.725,P=0.000)。结论对老年脑梗死合并吞咽障碍患者进行早期吞咽功能训练,患者吞咽功能改善显著,误吸发生率下降,护理质量满意度得到显著提高。

Objective Early swallowing function training was carried out for elderly patients with cerebral infarction complicated with dysphagia,to evaluate the improvement of swallowing function and prognosis of patients.Methods 120 elderly patients with acute cerebral infarction complicated with swallowing dysfunction those admitted to our hospital from January 2018 to March 2019 were enrolled in the study,and they were randomly divided into the control group(60 cases)and the intervention group(60 cases)according to random number table method.Control group received routine care,while early swallowing training was applied in intervention group on basis of control group.Assessed the incidence of swallowing function,aspiration,aspiration pneumonia and death,and satisfaction nursing was assessed.Results Fujishima classification score and Watian drinking water test score of intervention group were better than those of the control group after intervention,the differences were statistically significant(t=11.037,10.033,P=0.000).The incidence of Watian drinking test(gradeⅠ+Ⅱ+Ⅲ)in intervention group was 68.33%,which was higher than 56.67%of control group,the difference was statistically significant(χ^(2)=9.381,P=0.002).The incidence of aspiration in intervention group was 28.33%,which was lower than 46.67%of the control group,and the difference was statistically significant(χ^(2)=9.941,P=0.002).The nursing satisfaction of intervention group was(95.79±5.04)points,it was higher than(90.84±5.26)points of the control group,the difference was statistically significant(t=10.725,P=0.000).Conclusions Early swallowing function training for elderly patients with cerebral infarction combined with dysphagia significantly improves swallowing function of patients,reduces the incidence of aspiration,and significantly improves satisfaction on nursing quality.