穴位按摩联合吞咽功能评估在降低脑卒中患者误吸发生率中的应用

Application of acupoint massage combined with swallowing function assessment in reducing the incidence of aspiration in stroke patients

目的探讨穴位按摩联合吞咽功能评估在降低脑卒中患者误吸发生率中的应用价值。方法选取2018年8月至2019年7月中山市陈星海医院收治的脑卒中患者104例,采用随机数字表法分为观察组和对照组,各52例。对照组采用常规护理措施预防误吸;观察组患者入院24 h内采用标准吞咽功能评估量表(SSA)进行初步筛查,并针对不同风险人群除采用常规护理措施外增加穴位按摩干预。比较两组患者干预后误吸发生率、吸入性肺炎发生率及吞咽功能评分的改善情况。结果干预后,观察组吞咽困难改善率为(86.53%)高于对照组(65.38%),差异有统计学意义(P<0.05)。观察组患者误吸、吸入性肺炎的发生率(3.85%)、(1.92%)均低于对照组(13.46%)、(7.69%),但组间比较差异无统计学意义(P>0.05)。结论穴位按摩联合吞咽功能评估简便易行,可有效改善吞咽功能,减少误吸、吸入性肺炎的发生率,患者对护理的满意度也得到了提高。

Objective To explore the application value of acupoint massage combined with swallowing function assessment in reducing the incidence of aspiration in stroke patients.Methods A total of 104 patients with stroke admitted to this hospital from August 2018 to July 2019 were selected and divided into observation group and control group by random number table method,with 52 cases in each group.The control group was treated with routine nursing measures to prevent aspiration.Observation group was initially screened by standardized swallowing assessment(SSA)within 24 hours after admission,and acupoint massage intervention was added in addition to conventional nursing measures for different risk groups.The incidence of aspiration,aspiration pneumonia and the improvement of swallowing function scores were compared between the two groups after intervention.Results After intervention,the improvement rate of dysphagia in the observation group(86.53%)was higher than that in the control group(65.38%),and the difference was statistically significant(P<0.05).The incidence of aspiration and aspiration pneumonia in observation group(3.85%),(1.92%)were lower than those in the control group(13.46%),(7.69%),and the difference was not statistically significant(P>0.05).Conclusions Acupoint massage combined with swallowing function assessment is simple and easy to perform,can effectively improve swallowing function,reduce the incidence of aspiration and aspiration pneumonia,patients'satisfaction with nursing has also been improved,which is worthy of clinical promotion and application.