团队式延续性护理联合神经肌肉电刺激在脑梗死后吞咽障碍患者中的应用

Application of team type continuous nursing combined with neuromuscular electrical stimulation in patients with dysphagia after cerebral infarction

目的探讨团队式延续性护理联合神经肌肉电刺激(NMES)在脑梗死后吞咽障碍患者中的应用效果。方法选择2019年5月至2020年9月神经康复中心接受NMES治疗的脑梗死后吞咽障碍患者80例作为研究对象,随机数字表法分为观察组和对照组,每组40例。观察组接受团队式延续性护理,对照组接受常规护理。连续干预8周评估并比较干预效果。干预8周,通过洼田饮水试验评估2组的吞咽功能,干预前、干预8周,比较2组舌骨喉复合体动度;干预前、干预4周、干预8周,比较2组生活质量[采用吞咽障碍患者生活质量量表(EDQoL)评估]。结果干预8周,观察组吞咽功能优于对照组(P<0.05);干预8周,2组甲状软骨前移、甲状软骨上移、舌骨前移、舌骨上移均增大,且观察组高于对照组(P<0.05);随着干预时间的延长,2组EDQoL评分较干预前逐渐降低,且观察组干预4周、干预8周的EDQoL评分均低于对照组(P<0.05)。结论在NMES治疗的基础上,为脑梗死后吞咽障碍患者实施团队式延续性护理,更利于改善患者的吞咽功能,提升舌骨喉复合体动度,从而提高患者的生活质量。

Objective To investigate the application effects of team type continuous nursing combined with neuromuscular electrical stimulation(NMES)in patients with dysphagia after cerebral infarction.Methods Eighty patients with dysphagia after cerebral infarction who were treated by NMES in our hospital from May 2019 to September 2020 were enrolled in the study,who were randomly divided into observation group and control group,with 40 cases in each group.The patients in control group were treated by routine nursing,however,the patients in observation group were treated by team type continuous nursing,with a intervention course of 8 weeks for both groups.The intervention effects were evaluated,and swallowing function was evaluated by water swallow test,and the hyoid laryngeal complex mobility was measured before and 8 weeks after intervention.Moreover the life quality of patients was evaluated by dysphagia(EDQoL)rating scales.Results After 8-week intervention,the swallowing function in observation group was superior to that in control group(P<0.05),and the thyroid cartilage,thyroid cartilage,hyoid bone and hyoid bone in both groups were increased,and the increase degree in observation group was more significant than that in control group(P<0.05).With the extension of the intervention time,the EDQoL scores in both groups were decreased gradually,moreover,which at 4 weeks and 8 weeks after intervention in observation group were significantly lower than those in control group(P<0.05).Conclusion On the basis of NMES treatment,the application of team type continuous nursing for patients with dysphagia after cerebral infarction is more conducive to improve the swallowing function of patients,enhance the mobility of hyoid bone laryngeal complex,so as to improve the life quality of patients.